摘要
目的观察颈椎椎前筋膜的解剖特点及其与周围结构的关系,优化颈前手术入路。方法成人尸体标本22具,在环状软骨下缘水平横形切断气管、食管,观察椎前筋膜在椎体前方的移行,观察右侧喉返神经、甲状腺下动脉穿出椎前筋膜处与颈椎椎体水平的对应关系和与颈动脉鞘的位置关系。在同水平横行切开椎前筋膜、颈动脉鞘及其内容,横断面观察椎前筋膜的层次、质地、各层次向两侧的移行及与颈动脉鞘的关系,观察颈动脉鞘的形态及体验游离椎前筋膜的难易。结果颈椎椎前筋膜分为深、浅两层,浅层致密,深层薄弱,二层容易相互分离,颈动脉鞘内侧直接与椎前筋膜浅层相移行。右侧喉返神经均在胸1椎体水平自颈动脉鞘内缘穿出椎前筋膜,甲状腺下动脉约在颈6椎体水平自颈动脉鞘内缘穿出椎前筋膜。结论颈椎椎前筋膜的解剖特点及其与周围结构的关系可被利用使颈前手术入路更合理和安全。
Objective To make the anterior cervical approach more reasonable and safer by means of investigating the anatomic features of the prevertebral fascia and its anatomic relationships to surrounding organs. Methods Twenty-two embalmed cadavers were dissected. At the level of cricoid cartilage the trachea and esophagus were divided and pulled aside to observe the lateral transition and continuation of the prevertebral fascia and observe the location and corresponding level to the cervical vertebra where the inferior thyroid artery and the right recurrent laryngeal nerve exit from the prevertebral fascia and its location relationship to the carotid sheath. At the same level the carotid sheath and its content and the prevertebral fascia were cut transversely to observe the layers and texture of the prevertebral fascia and transition of each layer, the morphology of the carotid sheath and its relationship to each layer of the prevertebral fascia were observed. The degree of difficulty of dissecting the superficial layer of prevertebral fascia from the deep layer and dissecting the deep layer prevertebral fascia from the anterior cervical vertebral body was assessed. Remalt~ The prevertebral fascia was composed of the superficial layer and deep layer, the former was thick and dense, forming the anterior and posterior part of carotid sheath., and the former can be dissected from the latter easily. The right recurrent laryngeal nerve exit from the prevertebral fascia at approximately the leval ofT1 vertebrae at the medial margin of the carotid sheath, and the inferior thyroid artery exit from the prevertebral fascia at approximately the leval of C6 vertebrae at the medial margin of the carotid sheath. Conclusions The anatomic features of the prevertebral fascia can be utilized to make the anterior cervical approach more reasonable andsafer.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2011年第1期13-16,共4页
Chinese Journal of Clinical Anatomy
关键词
颈筋膜
颈动脉鞘
颈椎病
解剖
Cervical fascia
Carotid sheath
Cervical spondylosis
Anatomy
