解剖颅骨.ppt

解剖颅骨,Frontalbone,Zygomaticbone,Nasalbone,Maxilla,Mandible,Sphenoidbone,parietalbone,Temporalbone,Occipitalbone,Skull颅,Cerebralcranium脑颅(8)larger,upperandposteriorpart,containsandprotectsthebrainSinglebones:frontalbone额骨ethmoidbone筛骨sphenoidbone蝶骨occipitalbone枕骨Pairedbones:temporalbone颞骨parietalbone顶骨,frontalbone额骨,parietalbone顶骨,temporalbone颞骨,occipitalbone枕骨,sphenoidbone蝶骨,ethmoidbone筛骨,ethmoidbone筛骨,筛骨迷路ethmoidallabyrinth,筛骨垂直板perpendicularplateofethmoid,鸡冠cristagalli,筛板cribriformplate,sphenoidbone蝶骨,翼突pterygoidprocess,greaterwingofsphenoidbone蝶骨大翼,lesserwingofsphenoidbone蝶骨小翼,蝶骨体Corpussphenoidale,temporalbone颞骨,颞骨鳞部squamouspartoftemporalbone,颞骨岩部petrouspartoftempordlbone,鼓部Tympanicpart,Lateralview,Medialview,Skull颅,Facialcranium面颅(15)smaller,lower,andanteriorpart,containsbonesthatsurroundedtheeye,noseandmouthSinglebones:mandible下颌骨vomer犁骨hyoidbone舌骨,Skull颅,Facialcranium面颅Pairedbones:maxilla上颌骨nasalbone鼻骨lacrimalbone泪骨palatinebone腭骨zygomaticbone颧骨inferiornasalconcha下鼻甲,Bonesoffacialcranium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,Bodyofmandible下颌体Alveolararch牙槽弓Baseofmandible下颌底Mentalprotuberance颏隆凸Mentalforamen颏孔Mentalspine颏棘Digastricfossa二腹肌窝,Mandible下颌骨,Ramusofmandible下颌支Coronoidprocess冠突Condylarprocess髁突headofmandible下颌头neckofmandible下颌颈Mandibularnotch下颌切迹Mandibularforamen下颌孔Mandibularlingula下颌小舌Angleofmandible下颌角Masseterictuberosity咬肌粗隆pterygoidtuberosity翼肌粗隆,Theskullasawhole颅的整体观,Superiorsurfaceofskull,Bones:frontalbone额骨pairedparietalbone顶骨occipitalbone枕骨Sutures缝:Coronalsuture冠状缝Sagittalsuture矢状缝Lambdoidsuture人字缝parietaltuber顶结节parietalforamen顶孔,Posteriorsurfaceofskull,Externaloccipitalprotuberance枕外隆凸Superiornuchalline上项线Inferiornuchalline下项线,Internalsurfaceofcalvaria,Sulcusforsuperiorsagittalsinus上矢状窦沟Granularfoveola颗粒小凹Sulcusformiddlemeningealartery脑膜中动脉沟,Internalsurfaceofbaseofskull,BaseofskullformsthreefossaeAnteriorcranialfossa颅前窝Middlecranialfossa颅中窝Posteriorcranialfossa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。,Anteriorcranialfossa颅前窝,Formedbyorbitalpartoffrontalbone,cribriformplateofethmoid,andlesserwingsofsphenoidfrontalcrest额嵴foramencecum盲孔cristagalli鸡冠cribriformplate筛板cribriformforamina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。,Middlecranialfossa颅中窝,Formedbythebodyandgreaterwingsofsphenoid,petrouspartoftemporalBodyofsphenoidbone蝶骨体Hypophysialfossa垂体窝Opticcanal视神经管Anteriorclinoidprocess前床突Tuberculumsellae鞍结节Dorsumsellae鞍背Posteriorclinoidprocess后床突Sellaturcica蝶鞍Carotidsulcus颈动脉沟,Meddlecranialfossa颅中窝,Superiororbitalfissure眶上裂Foramenrotundum圆孔Foramenovale卵圆孔Foramenspinosum棘孔Sulcusformiddlemeningealartery脑膜中动脉沟Foramenlacerum破裂孔Internalopeningofcarotidcanal颈动脉管内口Trigeminalimpression三叉神经压迹Arcuateeminence弓状隆起Tegmentympani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910mm。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。,Posteriorcranialfossa颅后窝,Formedbyoccipitalandthepetrouspartoftemporalboneforamenmagnum枕骨大孔clivus斜坡internalopeningofhypoglossalcanal舌下神经管内口internaloccipitalprotuberance枕内隆凸internaloccipitalcrest枕内嵴sulcusfortransversesinus横窦沟sulcusforsigmoidsinus乙状窦沟jugularforamen颈静脉孔internalacousticpore内耳门internalacousticmeatus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。,Internalsurfaceofbaseofskull,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。,Externalsurfaceofbaseofskull,alveolararch牙槽弓bonypalate骨腭medianpalatinesuture腭中缝incisiveforamina切牙孔incisivecanal切牙管greaterpalatineforamen腭大孔posteriornasalapertures鼻后孔lateralpterygoidplate翼突外侧板medialpterygoidplate翼突内侧板Pterygoidfossa翼突窝mandibularfossa下颌窝articulartubercle关节结节styloidprocess茎突stylomastoidforamen茎乳孔occipitalcondyle枕髁jugularforamen颈静脉孔externalopeningofcarotidcanal颈动脉管外口externalopeningofhypoglossalcanal舌下神经管外口,Lateralsurfaceofskull,Externalacousticpore外耳门Mastoidprocess乳突Zygomaticarch颧弓Temporalfossa颞窝Superiortemporalline上颞线Pterion翼点apointnearthesphenoidfontaneloftheskull,atthejunctionofthegreaterwingofthesphenoid,temporal,frontal,andparietalbones.Itissituatedalittleabovethelevelofthezygomaticprocess.Itisknownastheweakestpartoftheskull,andalsointersectsthecourseoftheanteriordivisionofthemiddlemeningealartery,Lateralsurfaceofskull,Infratemporalfossa颞下窝Pterygomaxillaryfissure翼上颌裂Pterygopalatinefossa翼腭窝Sphenopalatineforamen蝶腭孔,Anteriorsurfaceofskull,Frontalregion:Frontalsquama额鳞Frontaltuber额结节Superciliaryarch眉弓Glabella眉间,Orbit眶,pyramid-shapedpairedcavitiesBase:supraorbitalnotch/foramen眶上切迹/眶上孔infraorbitalforamen眶下孔Apex:opticcanal视神经管WallsSuperior:fossaforlacrimalgland泪腺窝Superiororbitalfissuer眶上裂Medial:fossaforlacrimalsac泪囊窝Inferior:Inferiororbitalfissure眶下裂infraorbitalgroove眶下沟infraorbitalcanal眶下管,left,眶上孔或眶上切迹supraorbitalnotch/foramen,眶下孔infraorbitalforamen,视神经管opticcanal,泪腺窝fossaforlacrimalgland,泪囊窝fossaforlacrimalsac,眶下裂inferiororbitalfissure,眶上裂Superiororbitalfissure,眶下沟infraorbitalgroove,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。,Bonynasalcavity骨性鼻腔,RoofcribriformplateofethmoidboneFloorbonypalateMedialwallbonyseptumofnoseLateralwallNasalconchae鼻甲Anteriorpiriformaperture梨状孔Posteriorposteriornasalaperture鼻后孔,LateralwallSuperior,middleandinferiornasalconchae上、中、下鼻甲Superior,middleandinferiornasalmeatus上、中、下鼻道(underlyingeachconcha)Sphenoethmoidalrecess蝶筛隐窝Sphenopalatineforamen蝶腭孔,Paranasalsinuses鼻旁窦,Aircontainedspaceinbonesaroundthenasalcavity.Frontalsinus额窦Maxillarysinus上颌窦Sphenoidalsinus蝶窦Ethmoidalsinus/cellules筛窦/筛小房,Paranasalsinuses鼻旁窦,Sphenoidalsinus蝶窦LiesinbodyofsphenoidboneDrainintosphenoethmoidalrecess,Paranasalsinuses鼻旁窦,Frontalsinus额窦Liesinfrontalbone,deeptosuperciliaryarchDraintoanteriorpartofmiddlenasalmeatus,Paranasalsinuses鼻旁窦,Maxillarysinus上颌窦Largestpairedsinus,lieinthebodyofmaxilla;Openingintomiddlenasalmeatus,Paranasalsinuses鼻旁窦,Ethmoidalsinus/cellules筛窦/筛小房Lieinethmoidalbone,containslargenumberofaircells,dividedintoanterior,middleandposteriorgroupsAnteriorandmiddlegroupsdrainintomiddlenasalmeatus,whileposteriorgroupdrainsintosuperiornasalmeatus,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