臂丛神经与颈筋膜的解剖关系及其在手术中的应用

Relationship between brachial plexus and cervical fascia and its surgical significance

[目的]揭示颈筋膜与臂丛神经的解剖关系,增进臂丛神经显露的安全和简捷。[方法]取福尔马林处理的成人尸体标本21具,解剖观察颈筋膜浅层与颈神经浅丛的位置关系,解剖观察颈筋膜浅层、深层之间的脂肪层的结构,颈筋膜深层的质地及其与臂丛神经的解剖关系。[结果]在颈中部及其以下的颈筋膜浅、深两层之间的脂肪层中无颈神经浅支,在此脂肪层中除颈横动脉和肩胛舌骨肌无重要结构,颈筋膜深层质地致密,臂丛神经紧位于其深面。[结论]利用颈筋膜深层紧位于臂丛神经浅面、致密清晰,其浅面脂肪内无重要结构的特点,可使颈部臂丛神经的显露更简捷、安全。

[Objective] To investigate the relationship between brachial plexus and cervical fascia, and to make the exposure of brachial plexus safer and more convenient. [Method] Necks of 21 embalmed adult cadavers were dissected to observe the locating relationship between superficial layer of cervical fascia and superficial cervical plexus. The texture of deep layer of cervical fascia and its relationship with brachial plexus were also analyzed. [Result]No superficial branch of cervical plexus was found in the fat-layer between the superficial and deep layer of cervical fascia below the middle neck. In this area, there was no important structure except omohyoid muscle and transverse cervical artery. The deep layer of cervical fascia was dense and was directly above the brachial plexus.[Conclusion] The brachial plexus is directly below the deep layer of cervical fascia, and there is no important structure in the fat layer. Exposure of brachial plexus in the neck would be safer and more convenient if this physiological character could be utilized properly.