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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,2020/11/3,*,颈部断层解剖,2020/11/3,1,一、颈部局部解剖,颈筋膜及筋膜间隙,颈部主要脏器和血管神经,颈根部的主要结构,2020/11/3,2,（一）颈部筋膜及筋膜间隙,颈部筋膜,颈浅筋膜,颈深筋膜浅层（封套筋膜）,颈深筋膜中层（内脏筋膜）,颈深筋膜深层（翼筋膜、椎前筋膜）,颈部筋膜间隙,胸骨上间隙,内脏间隙（如：气管前间隙）,咽后间隙,椎前间隙,危险间隙（第四间隙）,2020/11/3,3,颈筋膜及筋膜间隙,2020/11/3,4,颈筋膜及筋膜间隙,2020/11/3,5,颈部主要脏器和血管神经的配布规律性,支持格：,位于颈部深层结构的后方，包括脊柱颈段（位于中轴部位）及其周围的肌肉。,内脏格：,位于脊柱颈段的前方，包括咽和食管颈段、喉和气管颈段、甲状腺和甲状旁腺等。,血管格：,纵行排列于内脏器官的两侧，包括颈总动脉、颈内动脉、颈外动脉、颈内静脉、颈深淋巴结、迷走神经、颈交感干、颈丛等。,2020/11/3,6,颈阔肌与皮神经,2020/11/3,7,颈浅静脉与舌骨肌群,Investing fascia,2020/11/3,8,胸锁乳突肌与舌骨肌群,Carotid sheath,2020/11/3,9,颈动脉鞘内结构,2020/11/3,10,椎前肌和斜角肌,2020/11/3,11,颈根部结构,2020/11/3,12,二、颈部的选择性横断面解剖,2020/11/3,13,经会厌和舌骨大角的横断层,舌骨体,5,舌骨大角,7,下颌下腺,9,胸锁乳突肌,10,甲状软骨上角,12,会厌,14,喉咽,15,颈外动脉和甲状腺上动脉,20,颈内动脉,21,颈内静脉,22,第,4,颈椎,24,头长肌和颈长肌,25,椎动脉,27,脊髓,32,2020/11/3,14,经舌骨体的横断层,舌骨体,4,会厌前间隙,5,下颌下腺,6,喉咽,8,梨状隐窝,9,胸锁乳突肌,11,颈内静脉,12,甲状软骨上角,13,颈外静脉,18,椎动脉,21,脊髓,26,斜方肌,35,颈总动脉,36,2020/11/3,15,经声门裂和第,5,颈椎体横断面,2020/11/3,16,经甲状软骨上份的横断层,甲状软骨,3,会厌前间隙,4,喉咽,8,杓状会厌襞,9,喉前庭,10,梨状隐窝,11,第,5,颈椎,15,椎动脉,16,颈总动脉,17,胸锁乳突肌,20,颈外静脉,21,脊髓,24,颈内静脉,28,斜方肌,36,2020/11/3,17,经甲状软骨中份的横断层,甲状软骨,3,喉中间腔,4,甲杓肌,6,甲状舌骨肌上腹,7,甲状腺,8,杓状软骨,9,杓横肌,10,喉咽,11,咽下缩肌,12,颈总动脉,13,第,6,颈椎,18,胸锁乳突肌,14,颈外静脉,15,颈内静脉,21,脊髓,24,斜方肌,29,2020/11/3,18,经声襞和环状软骨的横断层,胸骨舌骨肌,1,喉结,2,甲状软骨,3,喉中间腔,4,环甲肌,5,环状软骨板,6,喉咽,7,甲状腺,8,胸锁乳突肌,9,颈内静脉,10,颈总动脉,11,第,6,颈椎椎间盘,12,颈外静脉,13,脊髓,16,椎动脉,18,斜方肌,33,2020/11/3,19,胸锁乳突肌,1,胸骨舌骨肌,2,环状软骨,3,声门下腔,4,甲状腺,5,颈长肌,6,颈内静脉,7,颈总动脉,8,食管,9,迷走神经,10,前斜角肌,11,臂丛,12,颈外静脉,13,第,7,颈椎,14,脊髓,16,斜方肌,27,经环状软骨和声门下腔的横断层,2020/11/3,20,经甲状腺峡和第,1,胸椎体横断面,2020/11/3,21,三、喉的解剖,2020/11/3,22,位置,喉位于颈前中正部，咽腔喉部前方，第,3,6,颈椎之间；向上借喉口通咽的喉部，向下与气管相通。女性略高于男性，小儿比成人高。,喉上方借甲状舌骨韧带和肌连于舌骨，下方借环气管韧带连于气管。,2020/11/3,23,（一）喉软骨,2020/11/3,24,甲状软骨,2020/11/3,25,小角软骨、杓状软骨和,环状软骨,2020/11/3,26,会厌软骨,2020/11/3,27,（二）喉的连结,2020/11/3,28,环甲关节和环杓关节,2020/11/3,29,方形膜和弹性圆锥,2020/11/3,30,环甲正中韧带,2020/11/3,31,（三）,喉肌,2020/11/3,32,环甲肌,2020/11/3,33,喉肌,2020/11/3,34,喉,肌,2020/11/3,35,（三）,喉腔,2020/11/3,36,喉口、前庭襞和声襞,2020/11/3,37,喉腔被声襞和前庭襞分为喉前庭,laryngeal vestibule,、喉中间腔,intermedial cavity of larynx,和声门下腔,infraglottic cavity,。,声襞,前庭襞,喉腔的分部,2020/11/3,38,2020/11/3,39,喉的矢状断面,2020/11/3,40,（四）喉的选择性断层解剖,2020/11/3,41,经舌骨和第,3,颈椎体横断层,舌骨下肌,1,舌骨体,2,舌骨大脚,3,会厌前间隙,18,舌会厌正中襞,17,会厌谷,16,会厌,15,咽腔,14,梨状隐窝,13,咽后间隙,12,横突孔,11,颈前静脉,4,颈阔肌,19,下颌下腺,5,颈外动脉,6,颈内动脉,7,颈内静脉,20,颈长肌,8,斜角肌,10,2020/11/3,42,经第,3,、,4,颈椎间横断层,舌骨下肌,1,甲状舌骨膜,25,会厌前间隙,18,会厌,15,咽腔,14,（喉前庭）,梨状隐窝,13,咽后间隙,12,颈长肌,8,第,3,、,4,颈椎间椎间盘,21,椎间孔,22,第,3,、,4,颈椎关节突关节,23,颈前静脉,4,颈阔肌,19,下颌下腺,5,颈外动脉,6,颈内动脉,7,颈内静脉,20,斜角肌,10,2020/11/3,43,甲状软骨上切迹,11,会厌前间隙,19,甲状软骨板,3,甲状会厌韧带,20,会厌周围韧带,29,会厌,4,喉口,21,（喉前庭）,杓状会厌襞,24,梨状隐窝,15,甲状软骨上角,18,颈前静脉,16,胸锁乳突肌,6,颈总动脉,7,颈内静脉,9,迷走神经,8,颈外侧淋巴结,22,前斜角肌,12,中斜角机,10,经第,4,颈椎体横断层,2020/11/3,44,经第,4,、,5,颈椎间横断层,甲状软骨上切迹,1,会厌前间隙,2,甲状会厌韧带,3,甲状软骨板,4,声门旁间隙,33,前庭襞,29,喉口,20,（喉前庭）,杓状会厌襞,6,杓状软骨尖,7,梨状隐窝,18,颈前静脉,19,胸锁乳突肌,22,颈总动脉,8,颈内静脉,11,迷走神经,9,前斜角肌,10,中斜角机,13,2020/11/3,45,经第,5,颈椎横断层,甲状软骨,23,声门旁间隙,33,前庭襞,29,喉前庭,24,喉室,28,声襞,27,喉口,20,（声门下腔）,甲状软骨板,4,杓状软骨,31,甲状会厌韧带,3,环状软骨板,26,梨状隐窝,18,颈前静脉,19,胸锁乳突肌,22,颈总动脉,8,颈内静脉,11,迷走神经,9,前斜角肌,10,中斜角机,13,2020/11/3,46,2020/11/3,47,经第,5,颈椎横断层,甲状软骨,1,声门下腔,2,环甲间隙,20,环状软骨板,5,甲状软骨下角,21,喉咽,16,咽后间隙,15,颈前静脉,17,颈总动脉,6,颈内静脉,8,迷走神经,9,前斜角肌,7,中斜角机,10,2020/11/3,48,经第,5,、,6,颈椎间椎间盘横断层,舌骨下肌,19,声门下腔,2,环状软骨板,5,甲状腺,23,喉咽,16,颈前静脉,17,胸锁乳突肌,13,颈总动脉,6,颈内静脉,8,迷走神经,9,前斜角肌,7,中斜角机,10,2020/11/3,49,经第,6,颈椎横断层,舌骨下肌,1,环状软骨弓,2,声门下腔,3,环状软骨板,12,甲状腺,4,喉咽,11,颈前静脉,14,胸锁乳突肌,13,颈总动脉,5,颈内静脉,7,迷走神经,9,前斜角肌,8,中斜角机,9,横突孔,16,2020/11/3,50,经第,6,颈椎横断层,舌骨下肌,1,环状软骨弓,2,声门下腔,3,甲状腺,4,食管,17,颈前静脉,14,胸锁乳突肌,13,颈总动脉,5,颈内静脉,7,迷走神经,9,前斜角肌,8,中斜角机,9,横突孔,16,2020/11/3,51,诊断：喉癌,男，,79,岁。喉稍痛一周，间咳，稍声嘶。,查：右侧声门上区可见粗糙不平赘生物。,2020/11/3,52,
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