解剖_颅骨.l

Skull颅,The skull is composed of 23 bonesCerebral cranium 脑颅Facial cranium 面颅,Frontal bone,Zygomatic bone,Nasal bone,Maxilla,Mandible,Sphenoid bone,parietal bone,Temporal bone,Occipital bone,Skull颅,Cerebral cranium 脑颅 (8) larger, upper and posterior part, contains and protects the brainSingle bones: frontal bone 额骨 ethmoid bone 筛骨sphenoid bone 蝶骨occipital bone 枕骨Paired bones: temporal bone 颞骨parietal bone 顶骨,frontal bone 额骨,parietal bone 顶骨,temporal bone 颞骨,occipital bone 枕骨,sphenoid bone 蝶骨,ethmoid bone 筛骨,ethmoid bone 筛骨,筛骨迷路 ethmoidal labyrinth,筛骨垂直板 perpendicular plate of ethmoid,鸡冠 crista galli,筛板cribriform plate,sphenoid bone 蝶骨,翼突 pterygoid process,greater wing of sphenoid bone蝶骨大翼,lesser wing of sphenoid bone蝶骨小翼,蝶骨体 Corpus sphenoidale,temporal bone 颞骨,颞骨鳞部 squamous part of temporal bone,颞骨岩部 petrous part of tempordl bone,鼓部Tympanic part,Lateral view,Medial view,Skull颅,Facial cranium 面颅 (15) smaller, lower, and anterior part, contains bones that surrounded the eye, nose and mouthSingle bones:mandible下颌骨 vomer 犁骨hyoid bone 舌骨,Skull颅,Facial cranium 面颅Paired bones: maxilla 上颌骨nasal bone 鼻骨 lacrimal bone 泪骨 palatine bone 腭骨zygomatic bone 颧骨 inferior nasal concha 下鼻甲,Bones of facial cranium 面颅骨,面颅上颌为中心，上鼻泪，下下颌，外颧内甲后犁腭，舌骨颈前单落脚。,Mandible下颌骨,Body of mandible 下颌体 Alveolar arch 牙槽弓 Base of mandible 下颌底Mental protuberance 颏隆凸Mental foramen 颏孔Mental spine 颏棘Digastric fossa 二腹肌窝,Mandible下颌骨,Ramus of mandible 下颌支Coronoid process 冠突Condylar process 髁突head of mandible下颌头 neck of mandible下颌颈Mandibular notch下颌切迹Mandibular foramen 下颌孔Mandibular lingula下颌小舌Angle of mandible下颌角Masseteric tuberosity 咬肌粗隆pterygoid tuberosity翼肌粗隆,The skull as a whole 颅的整体观,Superior surface of skull,Bones: frontal bone 额骨paired parietal bone 顶骨occipital bone 枕骨Sutures缝: Coronal suture 冠状缝Sagittal suture 矢状缝 Lambdoid suture 人字缝parietal tuber 顶结节 parietal foramen 顶孔,Posterior surface of skull,External occipital protuberance 枕外隆凸Superior nuchal line 上项线Inferior nuchal line 下项线,Internal surface of calvaria,Sulcus for superior sagittal sinus上矢状窦沟Granular foveola 颗粒小凹 Sulcus for middle meningeal artery 脑膜中动脉沟,Internal surface of base of skull,Base of skull forms three fossae Anterior cranial fossa 颅前窝Middle cranial fossa 颅中窝Posterior cranial fossa 颅后窝,各孔出入的血管、神经,圆孔：上颌神经（三叉神经第二支)卵圆孔:下颌神经（三叉神经第三支)破裂孔：颈内动脉、破裂孔导血管颈静脉孔：舌咽神经、迷走神经、副神经、颈内静脉,颅底解剖,颅底内面可明显地区分出颅前、中、后三窝。此区结构上的特点是窝内硬脑膜与颅底骨紧密相连，有许多血管和神经穿过颅底，颅底骨质本身厚薄不一，承受的压力和张力也不一致。因此，颅底薄弱处最易骨折，多伴有硬脑膜撕裂，损伤血管及神经。 ,Anterior cranial fossa 颅前窝,Formed by orbital part of frontal bone, cribriform plate of ethmoid, and lesser wings of sphenoidfrontal crest 额嵴 foramen cecum 盲孔 crista galli 鸡冠 cribriform plate 筛板 cribriform foramina 筛孔(有嗅丝通过）,颅前窝,颅前窝容纳大脑额叶、嗅球和嗅束，外侧以较薄的眶板与眶腔相邻，内侧以更薄且多孔的筛板与鼻腔相邻，有嗅神经(II)穿筛孔入颅。由于骨质最薄，骨折易发生于颅前窝。伤及眶板时，易造成眶内或结膜下血肿；伤及筛板时，易造成鼻腔内出血和脑脊液鼻漏，同时可能丧失嗅觉。,Middle cranial fossa 颅中窝,Formed by the body and greater wings of sphenoid, petrous part of temporalBody of sphenoid bone 蝶骨体 Hypophysial fossa 垂体窝 Optic canal 视神经管 Anterior clinoid process 前床突 Tuberculum sellae 鞍结节 Dorsum sellae 鞍背 Posterior clinoid process 后床突 Sella turcica 蝶鞍 Carotid sulcus 颈动脉沟,Meddle cranial fossa 颅中窝,Superior orbital fissure 眶上裂Foramen rotundum 圆孔 Foramen ovale 卵圆孔 Foramen spinosum 棘孔Sulcus for middle meningeal artery 脑膜中动脉沟Foramen lacerum 破裂孔 Internal opening of carotid canal 颈动脉管内口Trigeminal impression 三叉神经压迹Arcuate eminence 弓状隆起Tegmen tympani 鼓室盖,颅中窝-1,颅中窝两侧容纳大脑颞叶，中部容纳垂体。两侧窝内，从前向后呈弧形排列着一系列孔和裂：即眶上裂：其中通过动眼神经()、滑车神经()、眼神经(v，)、展神经()和眼静脉；视神经管：其中通过视神经()和眼动脉；圆孔：其中通过上颌神经(v：)；卵圆孔：其中通过下颌神经(V。)和导静脉；棘孔：其中通过脑膜中动脉。在垂体窝两侧还有破裂孔，其中有颈内动脉通过。,颅中窝-2,颅中窝中部的垂体窝底，即蝶窦的上壁，因蝶窦与鼻腔相通，故垂体肿瘤，可经鼻腔蝶窦入路切除。通常可从颅的侧位x一线片上测量蝶鞍的大小，判断垂体是否有肿瘤。一般蝶鞍的前后径为1112mm，深径为9 10mm。 颅中窝的骨质也厚薄不一，有许多孔裂，垂体窝和鼓室盖处的骨质较薄，其下方分别为蝶窦和鼓室，从结构力学分析，这些部位容易发生骨折。如损伤上述孔裂内的神经，易产生相应的体征。,颅中窝-3,如伤及眶上裂内四条神经，则会出现眶上裂综合征表现为患侧眼球固定于正中位不能转动，上睑下垂，瞳孔扩大，角膜反射消失，额部皮肤感觉消失等体征。 鼓室盖的骨折，血液和脑脊液可流入鼓室，并可经咽鼓管流入咽腔。如鼓膜破裂，还可从外耳道流出。中耳的炎症可向上蔓延，引起耳源性脑膜炎。骨折损及垂体窝时，血液与脑脊液可经蝶窦流入鼻腔。,Posterior cranial fossa 颅后窝,Formed by occipital and the petrous part of temporal boneforamen magnum 枕骨大孔 clivus 斜坡 internal opening of hypoglossal canal 舌下神经管内口 internal occipital protuberance 枕内隆凸internal occipital crest 枕内嵴 sulcus for transverse sinus 横窦沟 sulcus for sigmoid sinus 乙状窦沟 jugular foramen 颈静脉孔 internal acoustic pore 内耳门internal acoustic meatus 内耳道,颅后窝-1,颅后窝的骨质较厚，由颞骨和枕骨组成，两侧容纳小脑半球。枕骨大孔前面的斜坡承托脑桥和延髓。枕骨大孔除脊髓外，还有椎动脉和副神经脊髓根通过。舌下神经管，其中有舌下神经()通过。再向外侧的颞骨岩部中央有内耳门和内耳道，其中有面神经()和前庭蜗神经()通过。内耳门后下方有颈静脉孔，其中有颈内静脉、舌咽神经()、迷走神经(x)和副神经()通过。颈静脉孔向后外侧延续为乙状窦沟，然后转向内后续为横窦沟，沟中分别有乙状窦和横窦经过。颈内静脉起始与乙状窦中部常有导静脉（分别为髁导静脉与乳突导静脉）与颅外枕静脉相连，这是颅内外肿瘤或炎症相互转移或蔓延的一个途径。,颅后窝-2,颅后窝一旦骨折，多后果严重。因为血肿可压迫延髓出现呼吸抑制而死亡。如伤及颈静脉孔的神经时，可出现颈静脉孔综合征，表现为舌音语言障碍，腭弓麻痹伴有鼻音，声音嘶哑，逐渐发生吞咽困难，导致吸入性肺炎。这种综合征也出现于颈静脉孔处转移肿瘤的压迫。,Internal surface of base of skull,颏孔位于下颌第二前磨牙或第二前磨牙与第一磨牙之间的下颌体中部，其中有颏神经、颏动脉和颏静脉通过。此处是下颌部局部的注射部位。,External surface of base of skull,alveolar arch 牙槽弓bony palate 骨腭median palatine suture 腭中缝incisive foramina 切牙孔incisive canal 切牙管greater palatine foramen 腭大孔posterior nasal apertures 鼻后孔lateral pterygoid plate翼突外侧板 medial pterygoid plate翼突内侧板 Pterygoid fossa翼突窝 mandibular fossa 下颌窝articular tubercle 关节结节styloid process 茎突stylomastoid foramen 茎乳孔occipital condyle 枕髁jugular foramen 颈静脉孔external opening of carotid canal 颈动脉管外口external opening of hypoglossal canal 舌下神经管外口,Lateral surface of skull,External acoustic pore 外耳门 Mastoid process 乳突 Zygomatic arch 颧弓 Temporal fossa 颞窝 Superior temporal line 上颞线Pterion 翼点 a point near the sphenoid fontanel of the skull, at the junction of the greater wing of the sphenoid, temporal, frontal, and parietal bones. It is situated a little above the level of the zygomatic process. It is known as the weakest part of the skull, and also intersects the course of the anterior division of the middle meningeal artery,Lateral surface of skull,Infratemporal fossa 颞下窝Pterygomaxillary fissure 翼上颌裂 Pterygopalatine fossa 翼腭窝 Sphenopalatine foramen 蝶腭孔,Anterior surface of skull,Frontal region: Frontal squama 额鳞 Frontal tuber 额结节 Superciliary arch 眉弓 Glabella 眉间,Orbit 眶,pyramid-shaped paired cavitiesBase: supraorbital notch/foramen 眶上切迹/眶上孔 infraorbital foramen 眶下孔Apex: optic canal 视神经管Walls Superior: fossa for lacrimal gland 泪腺窝Superior orbital fissuer 眶上裂Medial:fossa for lacrimal sac 泪囊窝Inferior:Inferior orbital fissure 眶下裂 infraorbital groove 眶下沟 infraorbital canal 眶下管,left,眶上孔或眶上切迹supraorbital notch/ foramen,眶下孔infraorbital foramen,视神经管optic canal,泪腺窝 fossa for lacrimal gland,泪囊窝fossa for lacrimal sac,眶下裂inferior orbital fissure,眶上裂Superior orbital fissure,眶下沟infraorbital groove,眶上切迹（孔） 位于眶上缘内、中i/3交界处，其中有眶上神经、眶上动脉和眶上静脉通过。此处是额部局部麻醉的注射部位。 眶下孔位于眶下缘中点下方0.51cm处，其中有眶下神经、眶下动脉和眶下静脉通过。此处是眼和口之间局部麻醉的注射部位。,Bony nasal cavity 骨性鼻腔,Roofcribriform plate of ethmoid boneFloorbony palateMedial wall bony septum of nose Lateral wall Nasal conchae鼻甲Anterior piriform aperture 梨状孔Posterior posterior nasal aperture 鼻后孔,Lateral wall Superior, middle and inferior nasal conchae 上、中、下鼻甲Superior, middle and inferior nasal meatus 上、中、下鼻道(underlying each concha)Sphenoethmoidal recess 蝶筛隐窝Sphenopalatine foramen 蝶腭孔,Paranasal sinuses 鼻旁窦,Air contained space in bones around the nasal cavity.Frontal sinus 额窦Maxillary sinus 上颌窦Sphenoidal sinus 蝶窦Ethmoidal sinus/cellules 筛窦/筛小房,Paranasal sinuses 鼻旁窦, Sphenoidal sinus 蝶窦Lies in body of sphenoid boneDrain into sphenoethmoidal recess,Paranasal sinuses 鼻旁窦,Frontal sinus 额窦Lies in frontal bone, deep to superciliary archDrain to anterior part of middle nasal meatus,Paranasal sinuses 鼻旁窦,Maxillary sinus 上颌窦Largest paired sinus, lie in the body of maxilla;Opening into middle nasal meatus,Paranasal sinuses 鼻旁窦, Ethmoidal sinus/cellules 筛窦/筛小房Lie in ethmoidal bone, contains large number of air cells, divided into anterior, middle and posterior groupsAnterior and middle groups drain into middle nasal meatus, while posterior group drains into superior nasal meatus,鼻旁窦(或称副鼻窦),鼻旁窦(或称副鼻窦)由骨性鼻旁窦衬以粘膜而成，能调节吸入空气的温湿度，对发音起共鸣作用。 鼻旁窦包括上颌窦、额窦、筛窦和蝶襄四对，分别位于同名的颅骨内。 上颌窦、额窦和前筛窦、中筛窦都开口于中鼻道； 后筛窦开口于上鼻道； 蝶窦开口于蝶筛隐窝。 由于鼻旁窦粘膜与鼻腔粘膜褶延续，故鼻腔炎症易引起鼻旁窦发炎。 上颌窦是鼻旁窦中最大的一对，因开口位于其内侧壁最高处，远高于窦底，故引流不畅，同时窦腔大，