摘要
目的 :探讨枕大神经痛发病的解剖学基础。方法 :防腐固定 10例 ( 2 0侧 )和新鲜标本 5例 ( 10侧 ) ,以经骨性外耳门中点的水平线和后正中线为轴建立坐标系 ,定位枕大神经浅出点 ,观察枕大神经走行分布及其与枕动脉的毗邻关系。结果 :( 1)枕大神经皮下浅出点位于坐标原点旁开 17～ 2 0mm ;以浅出点为界 ,枕大神经可分为皮下段和肌内段。 ( 2 )皮下段与浅筋膜紧密附着 ,活动度小 ,为固定区 ;肌内段走行于半棘肌和斜方肌腱膜间 ,神经活动度大 ,为活动区。结论 :颈部运动使活动区和固定区交界部位的神经处于“扭折”状态 ;浅出点腱膜组织对神经的固定作用造成了神经的“卡压” 。
Objective: To investigate the anatomic basis of the greater occipital neuralgia and discuss its clinical significance. Methods: The distrbution of the greater occipital nerves were observed on 30 halves of the fifteen candaver head specimens (ten antiseptic cadaver specimens and five fresh cadaver specimens). landmarks used as follows, for making drawings and topographic measurements of the dissected nerves: the transverse line between the central of the bony external acoustic meatus and the posterior midline. Results: The greater occipital nerve passed through trapezius muscle or semispinal muscle of head, the inclination between the nerve and the posterior midline was 55～70 degrees. A strong, fibrotic occipital aponeurosis presented at the point where the great occipital nerve emerged from the nuchal muscles to the subcutis of the scalp, the nerve interwove with the filaments of this tissue. The course of the nerve could be divided into two parts at its exit point to the subcuits: inactive part, which ran and anchored to the subcuits of the scalp, and active part, which laid in the nuchal muscles, where there seemed to be an ample space for cutting through of the nerves. Conclusions: The anatomic basis of the greater occipital neuralgia rely on the below: during the movement of the neck, the boundary between the active part and inactive part of the greater occipital nerve is in the condition of twisting. The fibrotic occipital aponeurosis or the filaments also raise the pressure and the possibility of irritation to the nerve. The position where infection and operation could be applied safely is 3～4 cm lower to the exiting point and 1.5cm lateral to the posterior midline.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2003年第6期578-579,共2页
Chinese Journal of Clinical Anatomy
关键词
枕大神经
枕大神经痛
应用解剖
greater occipital nerve
greater occipital neuralgia
applied anatomy
