对颈动脉鞘解剖的再认识及其意义  

Recognition of the anatomy of carotid sheath

作　　者：聂政[1] 单建林[2] 姜恒[3] 

机构地区：[1]成都医学院人体解剖实验室,成都610500 [2]北京军区总医院骨科,北京100700 [3]成都医学院检验医学院输血教研室,成都610500

出　　处：《中国临床解剖学杂志》2015年第5期520-522,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的通过对颈动脉鞘与颈筋膜关系的解剖观察,探讨对颈动脉鞘的正确认识。方法福尔马林处理的成人尸体标本20具(40侧)。解剖观察构成胸锁乳突肌筋膜后鞘的颈筋膜浅层与颈动脉鞘是否联结、联结的紧密程度;解剖观察颈动脉鞘与颈筋膜中层、椎前筋膜浅层、深层之间的关系、联结的质地与紧密程度。结果颈筋膜浅层与颈动脉鞘相联结,但较疏松,钝性分离可将二者分开;颈筋膜中层由舌骨下肌群各肌肉筋膜鞘汇合后向外侧续行汇入颈动脉鞘前部;椎前筋膜浅层向外侧分为浅、深两层,浅层包绕颈总动脉、颈内静脉和迷走神经,深层不参与构成颈动脉鞘。颈筋膜中层和椎前筋膜浅层与颈动脉鞘的联结质地韧厚,联结紧密。结论颈动脉鞘与颈筋膜各层存在密切的联系,颈筋膜中层和椎前筋膜浅层是构成颈动脉鞘的主体。Objective To acquire the correct and accurate knowledge of carotid sheath by investiating the relationships between carotid sheath and cervical fascia. Methods 20 adult cadavers （40 sides） were dissected. The posterior part of envelope fascia（superficial layer of cervical fascia）was dissected to observe whether it connected with carotid sheath, and to observe the characteristics of the connection. The relationships of carotid sheath to middle cervical fascia and superficial and deep layers of deep cervical fascia were observed. Meanwhile, the characteristics of connection were observed. Results Envelope fascia connected with carotid sheath loosely could be separated easily by blunt dissection. Middle layer of the cervical fascia was composed of the junction of facial sheath of infrahyoid muscles, joining the anterior carotid sheath. Prevertebral fascia was composed of two parts, the superficial layer and deep layer, the former enveloping the carotid artery, jugular veinand vagus nerve, the latter not forming the carotid sheath. The junction fascia between middle layer of the cervical fascia and superficial layer of prevertebral fascia and carotid sheath was thick and tight. Conclusion Carotid sheath was closely associated with every layer of cervical fascia. Middle layer of the cervical fascia and superficial layer of prevertebral fascia forms the main body of carotid sheath.

关 键 词：颈动脉鞘 颈筋膜 应用解剖 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学]