声嘶和杓状软骨脱位和麻醉相关课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,声嘶与构状软骨脱位,与麻醉相关?,沈阳市骨科医院麻醉科,朱云章,声嘶与构状软骨脱位,1,声嘶,声音嘶哑( Hoarseness声嘶)由于声带,的开放或闭合活动的障碍、声带炎症及异,常赘生物等所引起的发音嘶哑,可伴有失,音、呛咳甚至失音。,除了由于麻醉操作所引起如杓状软骨脱位,喉返神经阻滞等导致声嘶,在甲状腺手术,神经外科、骨科、胸科等手术均可出现声,嘶,声嘶,2,原因,声带粘膜病变:当声带缘一侧或双侧病变,无论,炎症、新生物等,声带质量改变:如声带粘膜下水肿、出血,声带,单侧萎缩,声门闭合不全:气流不能较好地被阻塞,而由声,门裂漏出,产生湍流,影响振动周期。,声带麻痹:声带运动受喉上神经外支与喉返神经,支配,尤以后者为主。无论何种原因所致喉返神,经病变,均能影响声门运动,原因,3,原因,喉软骨肌肉因素:舌骨的移动情况影响声,音的质量。舌骨周围的喉外肌活动正常,是咽喉形成良好共鸣管的重要条件。,若舌骨不能正常活动,则会影响构语器官,及发声气管的功能,影响发声,原因,4,喉返神经解剖特点,喉返神经解剖特点,5,声嘶和杓状软骨脱位和麻醉相关课件,6,声嘶和杓状软骨脱位和麻醉相关课件,7,声嘶和杓状软骨脱位和麻醉相关课件,8,声嘶和杓状软骨脱位和麻醉相关课件,9,声嘶和杓状软骨脱位和麻醉相关课件,10,声嘶和杓状软骨脱位和麻醉相关课件,11,声嘶和杓状软骨脱位和麻醉相关课件,12,声嘶和杓状软骨脱位和麻醉相关课件,13,声嘶和杓状软骨脱位和麻醉相关课件,14,声嘶和杓状软骨脱位和麻醉相关课件,15,声嘶和杓状软骨脱位和麻醉相关课件,16,声嘶和杓状软骨脱位和麻醉相关课件,17,声嘶和杓状软骨脱位和麻醉相关课件,18,声嘶和杓状软骨脱位和麻醉相关课件,19,声嘶和杓状软骨脱位和麻醉相关课件,20,声嘶和杓状软骨脱位和麻醉相关课件,21,声嘶和杓状软骨脱位和麻醉相关课件,22,声嘶和杓状软骨脱位和麻醉相关课件,23,声嘶和杓状软骨脱位和麻醉相关课件,24,声嘶和杓状软骨脱位和麻醉相关课件,25,声嘶和杓状软骨脱位和麻醉相关课件,26,声嘶和杓状软骨脱位和麻醉相关课件,27,声嘶和杓状软骨脱位和麻醉相关课件,28,声嘶和杓状软骨脱位和麻醉相关课件,29,声嘶和杓状软骨脱位和麻醉相关课件,30,声嘶和杓状软骨脱位和麻醉相关课件,31,声嘶和杓状软骨脱位和麻醉相关课件,32,声嘶和杓状软骨脱位和麻醉相关课件,33,声嘶和杓状软骨脱位和麻醉相关课件,34,声嘶和杓状软骨脱位和麻醉相关课件,35,声嘶和杓状软骨脱位和麻醉相关课件,36,