局部解剖學(xué) 7head學(xué)習(xí)資料

Head

BoundariesofheadandneckLinebetween:inferiorborderofmandible,angleofmandible,apexofmastoidprocess,superiornuchalline,externaloccipitalprotuberanceDivisionofhead

Headisdividedintocraniumandfacebylinethrough：superiorborderoforbit,superiorborderofzygomaticarch,superiorborderofexternalacousticpore,

mastoidprocessFaceDivision：eyenosemouthlateralfacialregion:

Boundary:面?zhèn)葏^(qū)是指由顴弓、鼻唇溝、下頜骨下緣和胸鎖乳突肌上份前緣圍成的區(qū)域Regions:buccalregionparotideomassetericregiondeeplateralfacialregionLateralfacialregionBoundary面?zhèn)葏^(qū)是指由顴弓、鼻唇溝、下頜骨下緣和胸鎖乳突肌上份前緣圍成的區(qū)域Regionsbuccalregion頰區(qū)parotideomassetericregion腮腺咬肌區(qū)deeplateralfacialregion面?zhèn)壬顓^(qū)

SkinincisionsSuperficialstructureoffaceSkin：isverythin.薄而柔軟，富于彈性，含有較多的皮脂腺、汗腺和毛囊，是癤腫的好發(fā)部位。瞼部皮膚最薄，淺筋膜組織疏松，易出現(xiàn)水腫。皮紋走向不同。superficialfascia：containFacialm.，a.,v.andn.Facialm.：connectskinandfacialbones

insuperficialfascia.Nodeepfascia.Faciala.Facialv.Facialn.Terminalbranchesoftrigeminaln.LymphdrainageFacialm.—Epicranius顱頂肌

(occipitofrontalis枕額肌)FrontalbellyOccipitalbellyGaleaaponeurotica帽狀腱膜—Orbicularisoculi—Buccinator—Orbicularisoris—Nasalis—Platysmaa.offaceBranchesofexternalcarotida.toheadFaciala.maxillarya.Superficialtemporala.Transversefaciala.Occipitala.post.Auriculara.

origin,coursingBranchoffexternalcarotida.Runsforwardoverdigastricandsubmandibulargland,Loopsaroundinf.borderofmandible(whereitispalpable)atant.borderofmassetertoentertheface,takesthecourse1cmlateraltotheangleofmouth,lateraltoalaofnose,tomedialangleofeye,Liesdeeptomostfacialmuscles

Branchesoffaciala.：Inf.labiala.Sup.labiala.

Angulara.內(nèi)眥動脈Faciala.Isoneterminalbranchofexternalcarotida.，Ascendsinfrontofear(whereitispalpable)tosupplytemporalandant.portionofscalpSuperficialtemporala.Abranchofsuperficialtemporala.runsbetweenzygomaticarchandparotidducttosupplythecheekregionTransversefaciala.Isoneterminalbranchofexternalcarotida.EntrancetoinfratemporalfossamedialtoneckofmandibleBranches：Inf.alveolara.

Pos.sup.alveolara.Middlemeningeala.

：enterstheskullthroughforemenspinosum，suppliescraniumandduramaterMaxillarya.Retromandibularv.

andFacialv.Facialv.Beginsatmedialangleofeye(angularvein)Runsdownwardandbackwardposteriortothefaciala.about0.5

cm，Belowangleofmandible,joinsant.branchofretromandibularv.toformcommonfacialv.,whichdrainsintointernaljugularv.Formedbyunionofsuperficialtemporalandmaxillaryveins,Dividesintotwobranches：

—Ant.branchuniteswithfacialv.,—Pos.branchjoinspos.auricularv.tobecomeexternaljugularv.Retromandibularv.FacialveincommunicateswithcavernoussinusFacialveincommunicateswithcavernoussinus海綿竇

throughophthalmicveins眼靜脈viathedeepfacialveins面深靜脈andpteygoidveousplexus翼靜脈叢cavernoussinusdeepfacialv.

ophthalmicv.pteygoidplexusfacialv.

throughophthalmicv.

throughpteygoidveousplexusviadeepfacialv.Facialv.communicatewithcavernoussinus“Dangerarea”危險三角：liesbetweenrootofnoseandtwoanglesofmouth，thefacialv.hasnovalvesinthisareaFacialn.(Ⅶ)facialn.leavesskullandenterparotidgland,3parts:—1stpart：betweenstylomastoidforamenandparotidgland—2ndpart：dividesinto2trunksfirst,then5branchesinparotidgland—3irdpart：5branchesoutofparotidgland:

TemporalbranchesZygomaticbranches

BuccalbranchesMarginalmandibularbranchCervicalbranchOphthalmicn.(Ⅴ1)→supraorbitaln.:piercessupraorbitalforamen→skinof↘Supratrochlearn.Maxillaryn.(Ⅴ2)→infraorbitaln.:piercesinfraorbitalforamen→skinofMandibularn.(Ⅴ3)→mentaln.:piercesmentalforamen→skinofThreebranchesofTrigeminaln.totheskinofheadMandibularn.Mandibularnerve

下頜神經(jīng)

自卵圓孔出顱進入顳下窩主要分支：Auriculotemporaln.耳顳神經(jīng)頰神經(jīng)舌神經(jīng)下牙槽神經(jīng)

TerminalbranchesoftrigeminalnerveParotideomassetericregionBoundary上界：顴弓與外耳道下界：下頜骨下緣平面前界：咬肌前緣后界：乳突和胸鎖乳突肌上份前緣ContentsMasticatorym.a.v.ParotidglandMasticatorym.—Temporalis：

—Origin：temporalfossa—Insertion：coronoidprocessofmandible—Action：elevatesandretractsmandible—Masseter：

—Origin：inferiorborderandmedialsurfaceofzygomaticarch—Insertion：lateralsurfaceoframusofmandibleandangleofmandible—Action：elevatesmandible—lateralpterygoid—Medialpterygoid

ParotidglandLocation:

situatedbelowtheexternalauditorymeatusandliesinadeephollowbehindtheramusofmandibleandinfrontofthesternocleidomastoidSuperficialpart:triangularinshape,liesbelowandinfrontoftheexternalacousticmeatus,andpartiallycoversthemasseter.

Deeppart:liesdeeptomedialpterygoid.Arisesfrontant.borderofgland，

Lies1-1.5cmbelowandparalleltozygomaticarch，

Runsforwardovermasseter,passesthebuccinatorandoralmucosatoopenopposite2nduppermolartoothParotidductTheparotidglandisenclosedwithinawell-definedcapsule

orsheathwhichisextensionoftheinvestingfasciaoftheneck.Thesuperficiallayerofthecapsuleisthickandunyielding,andtightlyaffixedtotheunderlyingglandulartissuebynumerousfibroussepta.Thedeeplayerisquitethinandeasilydisrupted.

ThecapsuleiscontinuousasmassetericfasciacoveringthemasseterParotideomassetericfasciaRelationshipsofparotidglandSuperiorly－externalacosticmeatus,pos.marginoftemporomandibularjointAnteromedialy－masseter,ramusofmandible,pos.partofmedialpterygoidPosteromedial－mastoidprocess,sternocleidomastoid,pos.bellyofdigastric,

styloidprocessandm.around,internalcarotida.,internaljugularv.,Ⅸ～Ⅻcranialnerves“Parotidbed”－

styloidprocessandm.aroundinternalcarotida.,internaljugularv.,Ⅸ～ⅫcranialnervesTransversalMaxillarya.,v.Tranversefaciala.,v.Branchesoffacialn.

StructurespassingthroughtheparotidglandVerticalExternalcarotida.Retromandibularv.Superficialtemporala.，v.Auriculotemporaln.Structurespassingthroughtheparotidgland穿經(jīng)腮腺的血管神經(jīng)的位置關(guān)系（由淺入深）：面神經(jīng)及其分支下頜后靜脈頸外動脈和耳顳神經(jīng)DeeppartoflateralfacialregionBoundary頂：蝶骨大翼的顳下面底：平下頜骨下緣前壁：為上頜骨體的后面后壁：腮腺深部外側(cè)壁：下頜支內(nèi)側(cè)壁：翼突外側(cè)板和咽側(cè)壁Contentslateralpterygoid、MedialpterygoidPteygoidvenousplexusMaxillaryA.,V.MandibularN.Maxillaryartery上頜動脈

平下頜頸處自頸外動脈發(fā)出，經(jīng)下頜頸的深面進入顳下窩，以翼外肌為標志可分為三段第一段（下頜段）：自起點至翼外肌下緣，主要分支有下牙槽動脈和腦膜中動脈第二段（翼肌段）：位于翼外肌的淺面，主要分支有頰動脈,顳深前、中、后動脈第三段（翼腭窩）：主要分支有上牙槽后動脈和眶下動脈Pteygoidvenousplexus翼靜脈叢LocatedbetweenandaroundMasticatorym.Receivesbloodfromallregionssuppliedbymaxillarya.CommunicateswithFacev.bydeepfacialv.,Cavernoussinusbyv.drainingbaseofskullProvidespossiblepathwayforspreadofinfectiontocranialcavityMandibularnerve

下頜神經(jīng)

自卵圓孔出顱進入顳下窩分支耳顳神經(jīng)頰神經(jīng)舌神經(jīng)下牙槽神經(jīng)

Spacesoflateralfacialregion面?zhèn)葏^(qū)的間隙Masseterspace

咬肌間隙Liesbetweenthemasseter,andramusofmandible內(nèi)容：咬肌的血管和神經(jīng)臨床：此間隙的前方緊鄰下頜第三磨牙，許多牙源性感染如第三磨牙冠周炎、牙槽膿腫和下頜骨骨髓炎等均有可能擴散至咬肌間隙而引起繼發(fā)感染Pterygomandibualspace

翼下頜間隙Liesbetweenramusofmandibleandmedialpterygoid隔下頜支與咬肌間隙相鄰，兩間隙經(jīng)下頜切跡相交通。內(nèi)容：舌神經(jīng)、下牙槽神經(jīng)和同名動、靜脈臨床：行下牙槽神經(jīng)阻滯麻醉術(shù)時，即注射麻醉藥于此間隙內(nèi)。牙源性感染亦常累及此間隙Sublingualspace

舌下間隙位置：下頜骨體的內(nèi)側(cè)境界上界：口底粘膜下界：下頜舌骨肌及舌骨舌肌前外側(cè)：下頜舌骨線以下的下頜骨體內(nèi)側(cè)面后界：舌根Sublingualspace舌下間隙Liesbetweenmucousmembraneoffloorofmouthandmylohyoidandhyoglossus內(nèi)容：舌下腺下頜下腺深部及腺管下頜下神經(jīng)節(jié)舌神經(jīng)舌下神經(jīng)及血管lymphdrainage

ofhead

Lymphnodesofhead:Islocatedatjunctionofheadandneck,Consistofoccipitalln.,

mastoidln.,parotidln.submandibularln.,submentallymphnodes.DrainintodeepcervicallymphnodesSubmandibularlymphnodeliesnearthesubmandibulargland,receivelymphaticvesselsfromtheface,noseandmouth

Lymphdrainage

面部淺層的淋巴管豐富，吻合成網(wǎng)，通常注入下頜下淋巴結(jié)和頦下淋巴結(jié)→頸外側(cè)深淋巴結(jié)Cranium顱部Calvaria顱頂Frontoparietooccipitalregion額頂枕區(qū)Temporalregion顳區(qū)Baseofskull顱底Cranialcavity顱腔FrontoparietooccipitalregionBoundaries

境界前：眶上緣后：枕外隆凸和上項線兩側(cè)：上顳線Layersoffrontoparietooccipitalregion5Layersfromsuperficialtothedeep：SkinSuperficialfascia：richinfatandfibroustract，a.,v.,n.epicranial(Galea)aponeurosisandoccipitofrontalis帽狀腱膜及枕額肌Subaponeuroticspace(looseconnectivetissue)腱膜下隙Pericranium顱骨外膜

Scalp頭皮:Theanterior3layersabovearecloselyjointtogether，A.,V.,N.insuperficialfasciaofCalvariaAnt.group

Supratrochleara.v.n.Supraorbitala.v.n.Lateralgroup

AnteriorauriculargroupSuperficialtemporala.,v.Auriculotemporaln.PosteriorauriculargroupPosteriorauriculara.，v.Lesseroccipitaln.（Cn2-3）Pos.groupOccipitala.v.Greateroccipitaln.（Cn2

)3irdoccipitaln.3groups:Temporalregion

Boundaries

Superior－superiortemporallineInferior－superiorborderofzygomaticarchAnterior－thejunctionoffrontalandzygomaticbonesPosterior－posteriorportionofsuperiortemporallineLayersoftemporalregionConsistsof5layers:SkinSuperficialfascia:containLateralgroupofa.,v.,andn.Temporalfascia:2layersTemporalisPeriosteumCranialcavityHypophysis垂體ShapeandLocationPea-sizedorganattachedbyinfundibulumtohypothalamus,liesinhypophysialfossaConsistsoftwoparts:AdenohypophysisNeurohypophysisRelationshipAnterior－tuberculumsellaePosterior－dorsumsellaeAnterolateraly－opticcanalAbove－diaphragmsellae,opticchiasmaandopticnerveLaterally－cavernoussinusBelow－sphenoidsinusCavernoussinus海綿竇location:liesoneachsideofsellaturcicaStructurespassingthroughthecavernoussinusinternalcarotida.abducentn.Structurespassalonglateralwallofthecavernoussinusoculomotorn.trochlearn.ophthalmicn.maxillaryn.Tentoriumcerebelli小腦幕Emissaryv.導(dǎo)靜脈Parietalemissaryv.頂導(dǎo)靜脈穿過頂孔，連接顳淺靜脈與上矢狀竇Mastoidemissaryv.乳突導(dǎo)靜脈穿過乳突孔，連接枕靜脈與乙狀竇condylaremissaryv.髁導(dǎo)靜脈穿過髁管，連接枕下靜脈叢與乙狀竇Frontalemissaryv.額導(dǎo)靜脈穿過盲孔，連接額竇及鼻腔的靜脈與上矢狀竇Diploicv.板障靜脈Frontaldiploicv.額板障靜脈連接眼上靜脈與上矢狀竇Anteriortemporaldiploicv.顳前板障靜脈連接顳深前靜脈與蝶竇Posteriortemporaldiploicv.顳后板障靜脈連接顱外淺靜脈與乙狀竇Occipitaldiploicv.枕板障靜脈連接枕靜脈與橫竇Communicationsbetweenextracranial

andintracranialveinsCavernoussinus海綿竇Superiorophthalmicv.

眼上靜脈Inferiorophthalmicv.

眼下靜脈pteygoidveousplexus

翼靜脈叢veousplexusofforamenovale卵圓孔靜脈叢emissaryv.破裂孔導(dǎo)血管Angularvein內(nèi)眥靜脈Facialvein

面靜脈Internaljugularv.頸內(nèi)靜脈Deepfacialvein

面深靜脈Youmustidentifyfollowstructures！Faciala.&v.Transversefaciala.Branchesoftrigeminaln.Supratrochleara.v.n.Supraorbitala.v.n.Mentaln.Auriculotemporaln.ParotidglandParotidductBranchesoffaci