颈静脉孔的应用解剖学VIP免费

#应用解剖#颈静脉孔的应用解剖学肖明,丁炯,韩群颖,王鹤鸣,左国平(南京医科大学解剖学教研室,江苏南京210029)=摘要>目的:为与颈静脉孔相关的影像诊断和临床治疗提供解剖学资料。方法:从颅底内、外面,对80具成年颅骨的颈静脉孔进行观测;并对20具成人尸头进行解剖,观察该区域神经血管解剖关系。结果:¹62.3%右侧颈静脉孔较左侧大,15.9%左侧较大,21.8%两侧大小一致;º14.38%的颈静脉孔有骨桥,85.62%无骨桥;»颈静脉孔内、外侧缘距正中矢状面两侧的平均距离颅外均较颅内大:颅外分别为26.11mm和33.41mm,颅内分别为22.29mm和27.52mm。¼Ù脑神经多沿颈静脉孔前上缘,Ú、Û脑神经沿内侧缘出颅,两者被纤维索(占87.5%)或骨桥(占12.5%)隔开。½Ù脑神经多经颈静脉孔外口前上缘向前下越过颈内动脉表面;Ù脑神经经颈内静脉深面(占57.5%)或其浅面(42.5%)行向后下。结论:右侧颈静脉孔通常较左侧大,左右不对称;影像学观测该区域血管、神经应选择恰当的层面。=关键词>颈静脉孔;颈内静脉;脑神经;应用解剖学=中图分类号>R323.1=文献标识码>A=文章编号>1001-165X(2001)02-0159-03AppliedanatomyofjugularforamenXIAOMing,DINGJong,HANQun-ying,etal.DepartmentofAnatomy,NanjingMedicalUniversity,Nanjing210029,China=Abstract>Objective:Toprovideanatomicdataforimagingdiagnosisandmicrosurgicaltreatmentofjugularfora-men(JF)lesions.Methods:TheJFwasobservedandmeasuredfrominternalandexternalaspectsin80adultskulls.Theanatomicrelationshipsbetweenthenervesandvesslesinthisregionwereobservedindetailbydissecting20adultcephalicspecimens.Results:¹In62.3%ofallthesecasestherightJFwaslargerthantheleft.In15.9%theleftwaslargerandin21.8%theywereequalinsize.ºBonebridgescouldbeseenin14.38%andcouldnotin85.62%.»Measuredfromextracranialaspect,theaveragedistancefrommidsagittalplanetothemedialandlateralborderoftheJF(medial26.11mm,lateral33.41mm),waslargerthanthosemeasuredfromintracramialaspect(medial22.29mm,lat-eral27.52mm).¼ÙcranialnervemadeitsexitthroughtheanteriorsuperiorborderoftheJFinmostcases,meanwhileÚandÛcranialnervethroughthemedialborder,theyweredistinctlyseparatedfromeachotherbyabandoffibroustissue(accountfor87.5%)orabonebridge(12.5%).½JustoutsidetheJF,Ùcranialnerveappearedattheanter-iorborderandmadealoopdownwardandforwardsuperficialtotheinternalcarotidartery.Ùcranialnerverundownwardandbackwarddeep(accountfor57.5%),orsuperficially(42.5%)totheinternaljugularvein.Conclusions:TherightJFisusuallylargerthantheleft,andnotsymmetryonbothsides.Thekeytoimagingdiagnosisofnervesandves-selsintheJFregionistoselectthesectionalplanecorrectly.=Keywords>Jugularforamen;Internaljugularvein;Cranialnerve;Appliedanatomy颈静脉孔为枕骨与颞骨岩部之间的一骨性孔道,位于岩枕缝的后端,被颈内静脉结节分为二部或三部[1]。前部有岩下窦注入,与Ù~Û脑神经通过;后部较大,乙状窦经此延续为颈内静脉。上述诸结构在颈静脉孔内的位置与相互毗邻关系,国内外有关文献描述甚不统一[2,3]。本实验目的是观察颈静脉孔的形态、内容物的相互关系,具体测量其孔径大小两侧对称性,为影像学观测提供相应的形态学资料。1材料和方法材料为教研室标本室提供的80只成年男女颅骨(不分性别),经耳颞线将颅骨锯开。对颈静脉孔大体形态进行观察,并着重观察有无骨桥(完整与否)及其类型与出现率;根据Doclo制定的原则将骨桥进行分类:位于舌下神经管前上方者为Ñ型,位于舌下神经管后方的为Ò型。分别从颅内测量颈静脉孔的最大、最小横径,矢状径(图1);从颅外测量横径与矢状径,并从颅内、外面对颈静脉孔内、外侧缘距正中矢状面距离进行测=收稿日期>2000-03-11=作者简介>肖明(1972-),男,江苏盐城人,硕士,讲师,主要从事临床解剖学研究,Tel:(025)6662879,E-mail:renjie@njmu.edu.cn。量。测量仪器为颅骨测径器。另20例成年尸头标本(男12例,...