Vessels and nerves of the neck
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Vessels and nerves of the neck. 陳建榮. http://web.nchu.edu.tw/~chenjr/index.htm. Fascia 筋膜 Superficial fascia 淺筋膜 Deep fascia 深筋膜. Fascia of cervical: Superficial fascia Deep fascia Superficial lamina Prevertebral lamina Pretracheal lamina Common carotid sheath 總頸動脈鞘 Vagosympathetic n.

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Vessels and nerves of the neck

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Vessels and nerves of the neck

Vessels and nerves of the neck

陳建榮

http://web.nchu.edu.tw/~chenjr/index.htm


Vessels and nerves of the neck

  • Fascia筋膜

  • Superficial fascia淺筋膜

  • Deep fascia深筋膜


Vessels and nerves of the neck

  • Fascia of cervical:

  • Superficial fascia

  • Deep fascia

    • Superficial lamina

    • Prevertebral lamina

    • Pretracheal lamina

    • Common carotid sheath總頸動脈鞘

      • Vagosympathetic n.

      • Common carotid a.

      • Internal jugular v.


Vessels and nerves of the neck

  • Spinal nerve脊神經

  • Root segment

    • Dorsal root背根

      • Dorsal root ganglion背根神經節 (spinal ganglion脊神經節)

    • Ventral root腹根

  • Meningeal branch脊膜支

  • Communicating branch交通支

  • Dorsal ramus背支 (dorsal branch)

  • Ventral ramus腹支 (ventral branch)


Vessels and nerves of the neck

x

x


Vessels and nerves of the neck

Area innervated by spinal n.

Lateral br.

Ventral br.

Dorsal br.


Vessels and nerves of the neck

Dermatomes皮節

Refer pain


Vessels and nerves of the neck

Refer pain反射痛

phantom pain幻肢痛


Nerves in cervical region

Nerves in cervical region

  • C1~C5 spinal nerves

  • Accessory nerve (CN XI)

  • Vagus nerve (CN X)


Vessels and nerves of the neck

  • C1 (lateral vertebral foramen)

  • Dorsal ramus  suboccipital n.枕骨下神經  m. of suboccipital area

  • Ventral ramus  ansa cervicalis頸環  sternothyroideus, sternohyoideus, thyrohyoideus m.


Vessels and nerves of the neck

  • Suboccipital region:

  • Rectus capitis dorsalis major背大頭直肌 (C2  occipital)

  • Rectus capitis dorsalis intermedius背小頭直肌 (C1 occipital)

  • Obliquus capitis cranialis前頭斜肌 (occipital  C1)

  • Obliquus capitis caudalis後頭斜肌 (C1C2)

Occi

C1

C2


Vessels and nerves of the neck

Ansa cervicalis頸環

C1

- No cutaneous br. of dorsal

and ventral branches


Vessels and nerves of the neck

  • C2 (first intervertebral forament)

  • Dorsal ramus

  •  greater occipital n.大枕骨神經

  • Ventral ramus

  •  great auricular n.大耳殼神經

  •  transverse cervical n.橫頸神經


Vessels and nerves of the neck

Innervation of C2 spinal n.


Vessels and nerves of the neck

Spinal n. of C2


Vessels and nerves of the neck

C3 – C5


Vessels and nerves of the neck

Accessory n. (CN XI) 副神經

  • CN XI:

  • Sternocephalicus m.胸骨頭肌

    • Sternomastoideus m.胸骨乳突肌

    • Sternooccipitalis m.胸骨枕骨肌

  • Cleidomastoideus m.鎖骨乳突肌

  • Cleidocervicalis m.鎖骨頸肌

  • Trapezius m.斜方肌

Cleidobrachialis m.鎖骨肱肌

-(brachiocephalicus n.)


Vessels and nerves of the neck

  • Brachiocephalicus肱頭肌

  • Cleidobrachialis

  • Cleidomastoideus

  • Cleidocervialis

Human:

Sternocleidomastoid m.

Dog:

Sternocephalicus

- sternooccipitalis

- sternomastoideus

Cleidomastoideus

Cleidocervicalis


Vessels and nerves of the neck

  • Vagus n. (CN X)迷走神經

  • Vagosympathetic trunk

  • Carotid sheath

  • Cranial laryngeal n.

  • Recurrent laryngeal n. (caudal laryngeal n.)


Vessels and nerves of the neck

Recurrent laryngeal n. (caudal laryngeal n.)

-Left recurrent laryngeal n.

-Right recurrent laryngeal n.


Vessels and nerves of the neck

  • Vessels in cervical region

  • Common carotid a.總頸動脈 ( brachiocephalic a.)

  • Subclavian a.鎖骨下動脈

    • Vertebral a.脊椎動脈

    • Costocervical a.肋頸動脈

    • Superficial cervical a.淺頸動脈

    • Axillary a.腋動脈

    • Internal thoracic a.內胸動脈

  • Internal jugular v.內頸靜脈

  • External jugular v.外頸靜脈


Vessels and nerves of the neck

  • Branches of Subclavian a.

  • Internal thoracic a.

  • Vertebral a.

  • Costocervical a.

  • Superficial cervical a.

  • Axillary a.


Vessels and nerves of the neck

  • Common carotid a.總頸動脈

    • Caudal thyroid a.

    • Cranial thyroid a.

    • External carotid a.

    • Internal carrotid a.


Vessels and nerves of the neck

  • Blood supply of cervical vertebrae

  • Vertebral a. (subclavian a.)

  • Blood supply of brain:

  • Veterbral a.

  • Internal carotid a.


Vessels and nerves of the neck

Superficial cervical a.淺頸動脈

  • Superficial cervical a.

  • Deltoideus br.

  • Suprascapular a.

  • Prescapular br.

  • Ascending br.

Superficial cervical lymph nodes 淺頸淋巴結


Vessels and nerves of the neck

Costocervical trunk肋頸動脈幹

  • Costocervical trunk

  • Deep cervical a.

  • Thoracic vertebral a.

  • Dorsal scapular a.


Vessels and nerves of the neck

  • External jugular v.外頸靜脈

    • Linguofacial v.舌顏靜脈

    • Maxillary v.上頜靜脈

    • Omobrachial v.肩肱靜脈

    • Superficial cervical v.淺頸靜脈

    • Cephalic v.頭靜脈

  • Internal jugular v.

  • Caudal thyroid v.

  •  Brachiocephalic v.


Vessels and nerves of the neck

Thyroid gland

Parathyroid gland

Medial retropharyngeal lymph node內咽後淋巴結


Vessels and nerves of the neck

  • Blood supply of thyroid gland

  • Cranial thyroid a.

  • Caudal thyroid a.


Vessels and nerves of the neck

  • 將右側頸部及肩胛上方之皮膚掀開。

  • 2. 注意以下幾個構造:

    • 1. C2、C3及C4的背側枝及腹側枝。

    • 2. 外頸靜脈


Vessels and nerves of the neck

  • 3. 將闊頸肌移除,清理以下幾個構造:

    • 1. C2的腹側枝(great auricular n. and transverse cervical n.)

    • 2. 清理肱頭肌及斜方肌間的空隙,找出淺頸淋巴結、(副神經)及(淺頸動脈)

    • 3. 找出跨過肱頭肌的肩肱靜脈及其頭端的分枝舌顏靜脈及上頜靜脈。

    • 4. 辨認出下頜腺。


Vessels and nerves of the neck

在肱頭肌表面可找到肩肱靜脈。


Vessels and nerves of the neck

4. 將鎖骨頸肌及胸骨枕骨肌於中段剪開,找出副神經,並確認其支配之肌肉有那些。

1. 認出匯入外頸靜脈的頭靜脈、淺頸靜脈。

2. 清理淺頸動脈的分枝。


Vessels and nerves of the neck

5. 剪開鎖骨乳突肌及胸骨乳突肌,找出頸環之構造及其支配肌肉。

找出咽後淋巴節


Vessels and nerves of the neck

6. 清理總頸動脈鞘,找出總頸動脈、迷走交感神經鏈、內頸靜脈。

1. 找出甲狀腺及其周圍的動靜脈。

2. 清理氣管及食道,注意喉返神經。

Splenius m. 夾肌


Vessels and nerves of the neck

7. 剪開夾肌找出:Biventer cervicalis 頸二腹肌、

Complexus 複合肌、

Longissimus capitis 頭最長肌


Vessels and nerves of the neck

Nuchal lig.

Deep cervical a. (costocervical a.)

8. 剪開頸二腹肌、複合肌、頭最長肌,找出項韌帶及肋頸動脈,並辨認C2、C3及C4背側枝


Vessels and nerves of the neck

9. 清理枕骨下三角找出背大頭肌、背小頭肌、前斜肌及後斜肌,並找出枕骨下神經


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