副神经和迷走神经、颈神经根交通支的形态学观察及临床意义  

Morphological observation of the communicating branches between accessory nerve,vagus nerve and cervical nerve roots and its clinical significance

作　　者：李海艳 刘英东[1] 宋东帅 杨志鹏 杜心如 Li Haiyan;Liu Yingdong;Song Dongshuai;Yang Zhipeng;Du Xinru(Basic Medical College,Chengde Medical University,Chengde 067000,Hebei Province,China;Hebei Key Laboratory of Nerve Injury and Repair,Chengde Medical University,Chengde 067000,Hebei Province,China;Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]承德医学院基础医学院,承德067000 [2]承德医学院河北省神经损伤与修复重点实验室,承德067000 [3]首都医科大学附属北京朝阳医院,北京100020

出　　处：《中国临床解剖学杂志》2024年第3期241-245,共5页Chinese Journal of Clinical Anatomy

基　　金：承德医学院高层次人才科研启动基金(202203);承德医学院自然科学基金(kyfzjj2021019)。

摘　　要：目的观测副神经与迷走神经、颈神经根交通支的形态特点及副神经在颈静脉孔处的毗邻。方法解剖剥离头颈标本,观测颈静脉孔内的结构毗邻、颈静脉孔下方处副神经与迷走神经间的交通支及副神经脊髓根与颈神经根的交通支。结果在颈静脉孔处,左侧迷走道的面积为(6.99±0.74)mm2,右侧的面积为(5.02±0.37)mm2,差异具有统计学意义(P<0.05);在颈静脉孔下方处,迷走神经和副神经有交通支者29侧(76.3%),交通支有4种分型,左侧交通支的长度为(5.82±1.18)mm,右侧长度为(6.60±1.17)mm,左右侧相比,差异无统计学意义;在22侧标本上观测到副神经脊髓根和C1、C2颈神经后根存在交通支者17侧(77.27%,17/22)。结论副神经和迷走神经在颈静脉孔下方存在交通支,这种解剖结构特点,为临床上避免损伤副神经提供解剖学依据;副神经和颈神经后根存在交通支,说明副神经含有感觉纤维,来源于颈神经后根,其功能可能与维持头部姿势有关。Objective To observe the morphological characteristics of the communicating branches between accessory nerve,vagus nerve,and cervical nerve roots,as well as the adjacent position of accessory nerve at the jugular foramen.Methods The specimens of head and neck were dissected to observe the adjacent structures in the jugular foremen,the communicating branches between accessory nerve and vagus nerve below the jugular foramen,and the communicating branches between the spinal root of accessory nerve and the cervical nerve root.Results The area of the left vagal tract was(6.99±0.74) mm~2,and the area of the right vagal tract was(5.02±0.37) mm~2 at the jugular foramen,with significant difference statistically(P<0.05).Under the jugular foramen,29 sides(76.3%) had communicating branches between the vagus nerve and accessory nerve.There were four types of communicating branches,with the length of the left communicating branch was(5.82±1.18) mm and the length of the right communicating branch was(6.60±1.17) mm.There was no statistical difference between the left and right sides.There were 17 sides(77.27%,17/22) to be observed to have communicating branches between the spinal root of accessory nerve and the posterior branch of the cervical nerve(C1and C2).Conclusions Accessory nerve and vagus nerve have communicating branches below the jugular foramen,which provides anatomical basis for avoiding damage to accessory nerve in clinical practice.The presence of communicating branches between accessory nerve and the posterior root of the cervical nerve indicates that accessory nerve contains sensory fibers,which may originate from posterior root of cervical nerve,and its function may be related to the maintenance of the head posture.

关 键 词：副神经 颈静脉孔 迷走神经 颈神经 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学]