颈部影像解剖教学教材

1、颈部影像解剖区：位于舌骨下缘环状软骨下缘之间的颈内静脉周围；区：颈内静脉链下组，位于环状软骨下缘至锁骨水平的颈内静脉周围；区：颈后三角区，胸锁乳头肌后缘、斜方肌前缘的三角区;区：中央区淋巴结。包括喉前、气管前和气管旁及气管食管沟淋巴结。区：上纵隔淋巴结；淋巴结病变的 CT 诊断标准：在 CT 扫描一旦发现气管食管沟内淋巴结即可确定为病变性淋巴结，诊断标准：颈部-区以淋巴结最大横径，纵隔（区）以淋巴结最大横径10mm有经验的外科医师仅可以触及表浅的0.5cm大小或深部1.0cm大小的淋巴结，但对位于胸锁乳路突肌深面、气管食管沟及咽后组等深部的淋巴结却难以触及 。pterygoidsstyloph

2、aryngeusstyloid processsuperior phar constrbuccinatorcarotidinternal jugularmasseterparotidretromandib vtonsillar pillarsparapharyngeal space定位标志1下颌骨下缘2茎突3腮腺第一层次nodal stations:1a1b2a2b3456RPbetween pharyngeal muscles and longus colli定位标志1下颌骨下缘2茎突3 腮腺platysmasubmandibular glandsoropharynx epiglottiss

3、up phar constrictorcarotids IJs SCMretromandibular v定位标志1颌下腺2 下颌骨下缘第二层次nodal stations:1a1b2a2b3456RPmedial to anterior bellies of digastric muscleslateral to anterior bellies of digastric musclesback to posterior edge of submandibular glandfrom back of SM gland to back of IJdeep to SCMfrom back of I

4、J to back of SCMplatysmasubmandibular glandshyoid bonevalleculaepyriform sinusesoropharynxintervallecular septumSCMcarotidsIJssup cornu thyroid cartepiglottiss phar constrtrapezius第三层次定位标志1 舌骨nodal stations:1a1b2a2b3456RPfrom back of SCM to front of trapezius, below top of hyoidends at TOP of hyoida

5、ll END at bottom of hyoidplatysma SCMstrap mmthyroid cartint jugularscarotidsvertebralspharyngeal constrictorpyriform sinuseslaryngopharynxperiglottic fatpre-epiglottic fataryepiglottic foldsext jugulars第四层次定位标志1甲状软骨2会厌前间隙nodal stations:1a1b2a2b3456RP(end below hyoid)deep to SCM, below hyoid(ends at

6、 top of hyoid)thyroid cartlaryngeal vestibulepyriform sinusesfalse cords arytenoidspharyngeal constrictorstrapsSCMsIJs carotids第五层次定位标志1 甲状软骨2 室带nodal stations:1a1b2a2b3456RParytenoidstranvs/obliq arytenoid mlaryngeal aditusvocal ligament (cord)vocalis mthyroid cartilagestrap mpharyngeal constrictor

7、SCMcarotid IJEJ tributariesvertebrals第六层次定位标志1 甲状软骨2 声带nodal stations:1a1b2a2b3456RPmanubrium to bottom of thyroid cart., medial to SCM, thyroid glandcricoidthyroid glandstraps SCMcarotidsIJslongus colliscalenestrachea esophagus第七层次定位标志1 环状软骨nodal stations:1a1b2a2b3456RPbelow cricoid, deep to SCMend

8、s at bottom cricoidends at transv cervical vvSCMsstrapscarotidsinternal jugularsesophagusthyroidant scalenesmiddle/post scalenesbrachial plexus第八层次定位标志1 甲状腺2 气管nodal stations:1a1b2a2b3456RPends 2 cm above sternoclav jointends at manubrium1 U 形为舌骨2 V形为甲状软骨3 室带有脂肪4 声带无脂肪5 胸锁乳突肌为颈三角的定位标志6 臂丛位于前中斜角肌之间7 2a和2b淋巴结以颈内