局部解剖学 7head学习资料

Head

BoundariesofheadandneckLinebetween:inferiorborderofmandible,angleofmandible,apexofmastoidprocess,superiornuchalline,externaloccipitalprotuberanceDivisionofhead

Headisdividedintocraniumandfacebylinethrough：superiorborderoforbit,superiorborderofzygomaticarch,superiorborderofexternalacousticpore,

mastoidprocessFaceDivision：eyenosemouthlateralfacialregion:

Boundary:面侧区是指由颧弓、鼻唇沟、下颌骨下缘和胸锁乳突肌上份前缘围成的区域Regions:buccalregionparotideomassetericregiondeeplateralfacialregionLateralfacialregionBoundary面侧区是指由颧弓、鼻唇沟、下颌骨下缘和胸锁乳突肌上份前缘围成的区域Regionsbuccalregion颊区parotideomassetericregion腮腺咬肌区deeplateralfacialregion面侧深区

SkinincisionsSuperficialstructureoffaceSkin：isverythin.薄而柔软，富于弹性，含有较多的皮脂腺、汗腺和毛囊，是疖肿的好发部位。睑部皮肤最薄，浅筋膜组织疏松，易出现水肿。皮纹走向不同。superficialfascia：containFacialm.，a.,v.andn.Facialm.：connectskinandfacialbones

insuperficialfascia.Nodeepfascia.Faciala.Facialv.Facialn.Terminalbranchesoftrigeminaln.LymphdrainageFacialm.—Epicranius颅顶肌

(occipitofrontalis枕额肌)FrontalbellyOccipitalbellyGaleaaponeurotica帽状腱膜—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.内眦动脉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海绵窦

throughophthalmicveins眼静脉viathedeepfacialveins面深静脉andpteygoidveousplexus翼静脉丛cavernoussinusdeepfacialv.

ophthalmicv.pteygoidplexusfacialv.

throughophthalmicv.

throughpteygoidveousplexusviadeepfacialv.Facialv.communicatewithcavernoussinus“Dangerarea”危险三角：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

下颌神经

自卵圆孔出颅进入颞下窝主要分支：Auriculotemporaln.耳颞神经颊神经舌神经下牙槽神经

TerminalbranchesoftrigeminalnerveParotideomassetericregionBoundary上界：颧弓与外耳道下界：下颌骨下缘平面前界：咬肌前缘后界：乳突和胸锁乳突肌上份前缘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穿经腮腺的血管神经的位置关系（由浅入深）：面神经及其分支下颌后静脉颈外动脉和耳颞神经DeeppartoflateralfacialregionBoundary顶：蝶骨大翼的颞下面底：平下颌骨下缘前壁：为上颌骨体的后面后壁：腮腺深部外侧壁：下颌支内侧壁：翼突外侧板和咽侧壁Contentslateralpterygoid、MedialpterygoidPteygoidvenousplexusMaxillaryA.,V.MandibularN.Maxillaryartery上颌动脉

平下颌颈处自颈外动脉发出，经下颌颈的深面进入颞下窝，以翼外肌为标志可分为三段第一段（下颌段）：自起点至翼外肌下缘，主要分支有下牙槽动脉和脑膜中动脉第二段（翼肌段）：位于翼外肌的浅面，主要分支有颊动脉,颞深前、中、后动脉第三段（翼腭窝）：主要分支有上牙槽后动脉和眶下动脉Pteygoidvenousplexus翼静脉丛LocatedbetweenandaroundMasticatorym.Receivesbloodfromallregionssuppliedbymaxillarya.CommunicateswithFacev.bydeepfacialv.,Cavernoussinusbyv.drainingbaseofskullProvidespossiblepathwayforspreadofinfectiontocranialcavityMandibularnerve

下颌神经

自卵圆孔出颅进入颞下窝分支耳颞神经颊神经舌神经下牙槽神经

Spacesoflateralfacialregion面侧区的间隙Masseterspace

咬肌间隙Liesbetweenthemasseter,andramusofmandible内容：咬肌的血管和神经临床：此间隙的前方紧邻下颌第三磨牙，许多牙源性感染如第三磨牙冠周炎、牙槽脓肿和下颌骨骨髓炎等均有可能扩散至咬肌间隙而引起继发感染Pterygomandibualspace

翼下颌间隙Liesbetweenramusofmandibleandmedialpterygoid隔下颌支与咬肌间隙相邻，两间隙经下颌切迹相交通。内容：舌神经、下牙槽神经和同名动、静脉临床：行下牙槽神经阻滞麻醉术时，即注射麻醉药于此间隙内。牙源性感染亦常累及此间隙Sublingualspace

舌下间隙位置：下颌骨体的内侧境界上界：口底粘膜下界：下颌舌骨肌及舌骨舌肌前外侧：下颌舌骨线以下的下颌骨体内侧面后界：舌根Sublingualspace舌下间隙Liesbetweenmucousmembraneoffloorofmouthandmylohyoidandhyoglossus内容：舌下腺下颌下腺深部及腺管下颌下神经节舌神经舌下神经及血管lymphdrainage

ofhead

Lymphnodesofhead:Islocatedatjunctionofheadandneck,Consistofoccipitalln.,

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

Lymphdrainage

面部浅层的淋巴管丰富，吻合成网，通常注入下颌下淋巴结和颏下淋巴结→颈外侧深淋巴结Cranium颅部Calvaria颅顶Frontoparietooccipitalregion额顶枕区Temporalregion颞区Baseofskull颅底Cranialcavity颅腔FrontoparietooccipitalregionBoundaries

境界前：眶上缘后：枕外隆凸和上项线两侧：上颞线Layersoffrontoparietooccipitalregion5Layersfromsuperficialtothedeep：SkinSuperficialfascia：richinfatandfibroustract，a.,v.,n.epicranial(Galea)aponeurosisandoccipitofrontalis帽状腱膜及枕额肌Subaponeuroticspace(looseconnectivetissue)腱膜下隙Pericranium颅骨外膜

Scalp头皮: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垂体ShapeandLocationPea-sizedorganattachedbyinfundibulumtohypothalamus,liesinhypophysialfossaConsistsoftwoparts:AdenohypophysisNeurohypophysisRelationshipAnterior－tuberculumsellaePosterior－dorsumsellaeAnterolateraly－opticcanalAbove－diaphragmsellae,opticchiasmaandopticnerveLaterally－cavernoussinusBelow－sphenoidsinusCavernoussinus海绵窦location:liesoneachsideofsellaturcicaStructurespassingthroughthecavernoussinusinternalcarotida.abducentn.Structurespassalonglateralwallofthecavernoussinusoculomotorn.trochlearn.ophthalmicn.maxillaryn.Tentoriumcerebelli小脑幕Emissaryv.导静脉Parietalemissaryv.顶导静脉穿过顶孔，连接颞浅静脉与上矢状窦Mastoidemissaryv.乳突导静脉穿过乳突孔，连接枕静脉与乙状窦condylaremissaryv.髁导静脉穿过髁管，连接枕下静脉丛与乙状窦Frontalemissaryv.额导静脉穿过盲孔，连接额窦及鼻腔的静脉与上矢状窦Diploicv.板障静脉Frontaldiploicv.额板障静脉连接眼上静脉与上矢状窦Anteriortemporaldiploicv.颞前板障静脉连接颞深前静脉与蝶窦Posteriortemporaldiploicv.颞后板障静脉连接颅外浅静脉与乙状窦Occipitaldiploicv.枕板障静脉连接枕静脉与横窦Communicationsbetweenextracranial

andintracranialveinsCavernoussinus海绵窦Superiorophthalmicv.

眼上静脉Inferiorophthalmicv.

眼下静脉pteygoidveousplexus

翼静脉丛veousplexusofforamenovale卵圆孔静脉丛emissaryv.破裂孔导血管Angularvein内眦静脉Facialvein

面静脉Internaljugularv.颈内静脉Deepfacialvein

面深静脉Youmustidentifyfollowstructures！Faciala.&v.Transversefaciala.Branchesoftrigeminaln.Supratrochleara.v.n.Supraorbitala.v.n.Mentaln.Auriculotemporaln.ParotidglandParotidductBranchesoffaci