颞骨解剖训练课件

颞骨解剖训练 王武庆 训练准备 明确目的 根据实际情况 确定训练的内容 熟悉解剖 观看图谱和录像 了解解剖的过程 节省时间 参观别人解剖的过程 总结经验 携带必要的记录设备 训练准备 除饮料外 不要携带过多的个人物品 没有物品保管地方 携带塑料袋 减少甲醛的溢出 体力准备好 注意时间安排 注意标本头位 时间有限 尽快进入正题 It simportantthatthemiddlefossaplate MF andthesigmoidsinus SS plateareidentifiedatthebeginningofthemastoidectomy sincetheydefinethemarginoftheareatobedrilled Thecavityshouldbesaucerized Removalofthebonefromtheareaposterosuperiortothemeatusopenstheantrum A Themiddlefossaplate MF isfollowedanteriorlytowardtheareasuperiortothemeatus Thesinoduralangle SDA hasbeenopened Thearricisopenedfromthemastoidbyextendingthecavityanteriorlyfollowingthemiddlefossaplate SDA Thefacialbridgeisremoved thechordatympaniissaccrificedandthefacialridgeisfullylowered thecavityiscompletelysaucerized LP SP M LSC FR TM annulus Theposteriorcanalwallhasbeendrilledandthetympanicmembraneandossicularchainremoved Thefacialnerveisskeletonized Themedialwallofthetympaniccavityisfullyseenintheopencavity Theneedleispointingtoremovalofthefootplate Thetympanicsegmentofthefacialnerverunsbeneaththeneedle Inthesamespecimen theareainferiortothecochleaandtheeustachiantubehasbeendrilled Retrofacialcellsweredriledtowardtheareaofthejugularbulb leavingthefacialcanalasabonybridge Thecarotidarteryisseenunderthethin transparent bonycoverage Thecarotidarteryhasbeenexposed Thearteryrunsjustanteriortotheapexofthecochlea andinferomedialtotheeustachiantube Thejugularbulbisseenmedialtothefacialnerveandposteriortothecarotidartery Amastoidectomyhasbeencarriedoutandtheposteriorcanalwallisthinned Thesigmoidsinusandthemiddlefossaduraareexposedposteriorlyandsuperiorly respectively Perilabyrinthinecellshavebeenremovedandsemicircularcanalsareskeletonized Thefacialnerverunsneartheposteriorcanalwall Amastoidectomyhasbeenundertaken Thecoloredsigmoidsinusisseenposteriorlytothecavity Thesinusrunsinferomedially theareainferiortothesemicircularcanalsishighlypneumatized andcellsarepartiallyopened Theareainferiorthethelabyrinthhasbeenfurtherdrilledmedially Thejugularbulbisseen coveredwithathinbonyshell Thesigmoidsinusandthejugularbulbareuncovered Thejugularbulbisanextensionofthesigmoidsinus locatedintheposteroinferiorwallofthehypotympanum Theheadofthemalleusandtheincusareremovedinthisspecimentoviewthefacialnerve Notetheproximityofthefacialnervetothelateralsemicircularcanal Thetympanicsegmentofthenervecanalsobeenseen Thelateralsemicircularcanalhasbeenopened Thetympanicsegmentofthefacialnerverunsinferomedially paralleltothecanal Themedialwalloftheattic anteriortothesemicircularcanalsinferiortothemiddlefossaplateandsuperiortothefacialnervehasbeendrilled Notethethreedimensionalanatomicalrelationshipofthelateralsemicircularcanalandthefacialnerve Thesuperiorsemicircularcanalhasalsobeenopened Inthemedialwalloftheposteriorattic ampullaeofthelateralandthesuperiorsemicircularcanalarelocatedsidebysideandareconnectedtotheutricle Thesemicircularcanalsandthevestibulehavebeenremovedandthelabyrinthinesegmentofthefacialnerveexposed Theentirecourseofthe