颈部(jǐnɡbù)的局部解剖与操作颈部Neck一、概述(ɡàishù)Introduction上界：为下颌骨下缘、下颌角、乳突(rǔtū)、上项线与枕外隆突的连线。Superiorly：anlinelinkingwiththelowerborderofmandible,theangleofmandible,themastoidprocess,thesuperiornuchallineandtheexternaloccipitalprotuberance;2.颈部(jǐnɡbù)分区3.表面(biǎomiàn)标志surfacelandmark表面(biǎomiàn)标志SurfaceLandmarkThelevelatwhichthevertebralarteryentersthetransverseforamenofthe6thcervicalvertebra.Thesiteatwhichthecarotidarterycanbepressedagainstthecarotidtubercleofthe6thcervicalvertebra.Thelevelatwhichtheinferiorthyroidarteryandthemiddlethyroidveinenterorleavethethyroidgland.Thelevelatwhichthesuperiorbellyoftheomohyoidmusclecrossesthecarotidsheath.Thelevelofthemiddlesympatheticganglion.二、颈部(jǐnɡbù)浅层结构Thesuperficialstructuresoftheneck1.颈阔肌Theplatysma2.颈静脉弓3.颈浅淋巴结Superficialcervicallymphnodes4.Superficialcervicalnerves三、颈筋膜(jīnmó)及筋膜(jīnmó)间隙CervicalFasciaandFascialSpace1.颈筋膜(jīnmó)CervicalFascia2.颈筋膜(jīnmó)间隙CervicalFascialSpaces胸骨上间隙的内容(nèiróng)ContentsoftheSuprasternalspace锁骨(suǒgǔ)上间隙的内容Contentsofthesupraclavicularspace四、颏下三角SubmentalTriangle颏下三角(sānjiǎo)Boundarisofsubmentaltriangle颏下三角的内容Contentsofthesubmentaltriangle五、下颌下三角SubmandibularTriangle1.下颌下三角BoundarisofthesubmandibulartriangleAroofofthesubmandibulartriangleisformedbytheskin,superficialfascia,platysmaandinvestingfascia.Afloorofthesubmandibulartriangleisformedbythemylohyoid,hyoglossusandmiddlepharyngealconstrictor.下颌(xiàhé)下三角的底2.下颌(xiàhé)下三角的主要结构Maincontentsofthesubmandibulartriangle1.在下颌下腺的浅面有：面静脉(jìngmài)、面神经的颈支、下颌下淋巴结3.在下颌(xiàhé)下腺的深面：①在下颌(xiàhé)舌骨肌浅面的结构有颏下动脉和静脉、下颌(xiàhé)舌骨肌神经；②在舌骨舌肌浅面的结构有舌静脉、面动脉、舌下神经、下颌(xiàhé)下神经节和舌神经；③在舌骨舌肌深面的结构有舌动脉。4.下颌下腺深部及其导管(dǎoguǎn)的毗邻：自上而下为舌神经、下颌下神经节、下颌下腺及其导管(dǎoguǎn)、舌下神经、舌动脉和静脉。六、解剖(jiěpōu)与观察DissectionandObservation1.Makeamedianskinincisionfromthementalsymphysistothesuprasternalnotch.2.Reflecttheskinflapslaterallytotheanteriorborderofthetrapeziustoexposetheplatysmadirectly.4.Lookforandexposethesuperficialstructuresoftheneck.Lookforthelingualarteryandveinbetweenthehypoglossusnerveandt