劲胸交感神经的解剖与临床意义

发布时间：2018-05-20 12:08

本文选题：颈交感神经 + 上胸交感干　；参考：《广西医科大学》2011年硕士论文

【摘要】：目的:通过对颈部交感神经的解剖和显微观察,了解颈部交感神经的位置及其毗邻关系,阐明与临床相关症状的关系;对上胸段交感神经的大体解剖和显微解剖观察,了解颈部交感神经与上胸段交感神经的联系,为临床诊断和治疗提供解剖依据。方法:选择30具60侧(男40侧,女20侧)完整的福尔马林浸泡过的成人尸体标本,对其做颈部交感神经和上胸段交感神经的解剖观察,观察其与周围相邻组织结构的关系及其位置,以及颈交感神经节与胸交感神经节之间的联系。结果:颈交感神经节与椎动脉表面存在着相对应的颈交感神经节交通支,即椎动脉上中下三段分别与颈上交感神经、颈中交感神经、颈下交感神经节发出的分支相对应;臂丛神经与颈中下交感神经节存在广泛交通支;上胸段交感神经多位于相应的肋间,随着节段下移,出现在下一位肋骨上缘或者平下一肋骨的几率逐渐增高;颈部交感神经节与上胸段交感神经节之间除了主干外还存在额外的交通支,即①胸2交感神经节发出上升支至上一位臂丛或者肋间神经②星状神经节发出下降支到下一位肋间神经③肋间神经发出上升支到上一位肋间神经或者臂丛。结论:颈交感神经干存在较为明显的受刺激解剖学基础,颈部任何组织的变化都能引起颈交感神经的兴奋,从而引起周围神经症状及脑部血管的变化。颈胸交感干和颈胸额外交通支可能存在相互代偿作用,相互影响,这使得采用去交感神经支配治疗各种病症时,切除交感神经的范围难以确定。
[Abstract]:Objective: to understand the position of cervical sympathetic nerve and its adjacent relationship, to clarify the relationship with clinical symptoms, to observe the gross anatomy and microscopic anatomy of the sympathetic nerve in the upper thoracic segment, and to observe the relationship between the position and the adjacent relationship of the sympathetic nerve in the cervical region by observing the anatomy and microscopic observation of the sympathetic nerve in the neck. To understand the relationship between cervical sympathetic nerve and superior thoracic sympathetic nerve and to provide anatomic basis for clinical diagnosis and treatment. Methods: a total of 30 adult cadavers with 60 sides (40 male and 20 female) soaked in formalin were selected for anatomic observation of cervical sympathetic nerve and upper thoracic sympathetic nerve. The relation and location of the adjacent tissue structure and the relationship between cervical sympathetic ganglion and thoracic sympathetic ganglion were observed. Results: there were corresponding communicating branches of the cervical sympathetic ganglion on the surface of the cervical sympathetic ganglion, that is, the superior and inferior segments of the vertebral artery corresponded to the superior cervical sympathetic nerve, the middle cervical sympathetic nerve and the branch of the subcervical sympathetic ganglion, respectively. There are extensive communicating branches between brachial plexus and middle and lower cervical sympathetic ganglia, the sympathetic nerve of upper thoracic segment is located in the corresponding intercostal space, and the probability of appearing in the upper edge of the next rib or flat lower rib gradually increases with the segment moving down. In addition to the main trunk, there are additional communicating branches between the sympathetic ganglion of the neck and the sympathetic ganglion of the upper thoracic segment. That is to say, the ascending branch of thoracic 2 sympathetic ganglion is superior to one brachial plexus or intercostal nerve 2 stellate ganglion sends out descending branch to the ascending branch of 3 intercostal nerve of the next intercostal nerve to the superior intercostal nerve or brachial plexus. Conclusion: there is an obvious anatomical basis for the stimulation of cervical sympathetic trunk. Any change of cervical tissue can induce the excitability of cervical sympathetic nerve and the changes of peripheral nerve symptoms and cerebral blood vessels. The sympathetic trunk of the neck and chest and the extra communicating branch of the neck and chest may have mutual compensatory effects and influence each other, which makes it difficult to determine the extent of the removal of the sympathetic nerve in the treatment of various diseases by the use of the desorption of sympathetic nerve innervation.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R322

【引证文献】