枕动脉和枕部肌层的解剖学观察  

Anatomical observation of occipital artery and occipital muscularis

作　　者：程进超 荣军 李陈 李廷政 王其福 CHENG Jin-chao;RONG Jun;LI Chen;LI Ting-zheng;WANG Qi-fu(Department of Neurosurgery,Xuancheng Central Hospital,Xuancheng Anhui 242000,China;Translational Research Institute for Neurological Disorders,Wannan Medical College,Wuhu Anhui 241000,China;Department of Neurosurgery,First Affiliated Hospital of Wannan Medical College/Yijishan Hospital of Wannan Medical College,Wuhu Anhui 241000,China;Department of Neurosurgery,Maanshan People's Hospital,Maanshan Anhui 243000,China)

机构地区：[1]宣城市中心医院神经外科,安徽宣城242000 [2]皖南医学院神经系统疾病转化医学中心,安徽芜湖241000 [3]皖南医学院第一附属医院/皖南医学院弋矶山医院神经外科,安徽芜湖241000 [4]马鞍山市人民医院神经外科,安徽马鞍山243000

出　　处：《局解手术学杂志》2023年第6期467-471,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：马鞍山市科技计划(NO.YL-2021-05)。

摘　　要：目的逐层显露枕部肌层及枕动脉的解剖结构,为临床医师进行后颅窝开颅手术提供参考,以减少血管及神经损伤。方法对10例尸头标本进行由浅入深的解剖,观察各重要结构的关系并拍照记录,测量枕动脉和枕部肌层相关参数。结果枕动脉起源于二腹肌后腹的颈外动脉处,进入二腹肌后腹深面后穿过头最长肌,在二腹肌沟内侧的枕动脉沟向上向内侧横行于头夹肌和头半棘肌之间。枕动脉距枕外隆突的距离为(28.17±2.87)mm,在此范围内可以安全地游离出枕动脉。枕部肌层解剖由浅入深分别为胸锁乳突肌、斜方肌、头夹肌、头半棘肌、头后小直肌,以及构成枕下三角的头后大直肌、上斜肌、下斜肌。枕下三角是椎动脉及枕下静脉丛的重要标志。结论熟悉颅颈交界区解剖及相关数据,可以有效避免手术过程中损伤枕动脉及枕部肌肉,减少手术并发症,提高手术安全性。Objective The anatomical structures of the occipital muscularis and occipital artery were exposed layer by layer to provide reference for clinicians to perform posterior fossa craniotomy and reduce vascular and nerve injury.Methods A total of 10 cadaveric head specimens were dissected from shallow to deep,the relationships between the important structures were observed and photographed.The related parameters of occipital artery and occipital muscularis were measured.Results The occipital artery originates from the external carotid artery in the posterior abdomen of the digastric muscle.After entering the deep surface of the posterior abdomen of the digastric muscle,it passes through the longissimus capitis muscle and runs transversely between the splenius capitis muscle and the semispinalis capitis muscle upward and inward in the occipital artery groove on the medial side of the digastric groove.The distance between the occipital artery and the external occipital protuberance was(28.17±2.87)mm,within which the occipital artery can be safely dissociated.The occipital muscularis from shallow to deep were sternocleidomastoid muscle,trapezius muscle,splenius capitis muscle,semispinalis capitis muscle,rectus capitis posterior minor muscle,as well as rectus capitis posterior major muscle,superior obliquus muscle and inferior obliquus muscle which constitute the suboccipital triangle.The suboccipital triangle is an important sign of vertebral artery and suboccipital venous plexus.Conclusion Familiarity with the anatomy and related data of craniocervical junction area can effectively avoid the injury of occipital artery and muscle during operation,reduce the surgery complications,and improve the surgical safety.

关 键 词：枕动脉 枕部肌肉 枕部开颅术 显微解剖 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]