颈部交感神经干及交感神经节受刺激因素的解剖学观察及其临床意义

Anatomical Observation and Clinical Significance of the Stimulating Facts of the Cervical Sympathetic Trunk and Sympathetic Ganglia

目的:了解颈交感神经干及交感神经节的解剖特点及其与颈椎周围组织的解剖关系,为临床诊治椎(间)孔外颈神经卡压提供解剖学基础。方法:解剖20具(40侧)成人尸体标本,观察颈交感神经干及交感神经节与周围组织结构的解剖关系,测量前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带外缘与交感神经干的距离。2具新鲜尸体作Masson染色,了解前斜角肌、头长肌、颈长肌腱性组织成分。结果:颈上交感神经节周围常有肿大的淋巴结,颈下(星状)神经节下端紧贴第一肋椎关节。前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带均为腱性结合。颈交感干在C_5横突处距前斜角肌腱性交叉起点左侧为2.6±0.5cm,右侧为2.1±1.1cm,距头长肌、颈长肌腱性束带外缘左侧为2.4±0.4cm,右侧为2.5±0.8cm。结论:颈上交感神经节周围肿大的淋巴结,颈下(星状)神经节下端增生的第一肋椎关节,前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带是造成颈交感神经干及交感神经节在椎(间)孔外受到刺激的解剖学因素。

Objective:To study the anatomic characteristics of cervical sympathetic trunk and sympathetic ganglia and their anatomic relationship with the adjacent tissue of the cervical vertebrae in order to provide anatomic basis for the diagnosis and treatment of the cervical nerve compression syndrome at external intervertebral foremen. Methods: Both sides of 20 Chinese adult cadavers were dissected to observe the anatomic relationship of cervical sympathetic trunk and sympathetic ganglia with the adjacent tissue. The distance between the tendinous decussating origins of the scalenus anticus, the external edges of the tendinous girdles of the musculus longus capitis and the musculus longus colli and the cervical sympathetic trunk was measured. The other two fresh cadavers were also disseted to examine the histology of the muscles. Results:The tumescent lymph nodes were found around the superior cervical sympathetic ganglia. The inferior extremity of the inferior cervical ganglia(stellate ganglia) was adjacent to the first costovertebral joint. The tendinous decussating origins of the scalenus anticus and the tendinous girdles of the musculus longus capitis and the musculus longus colli were all tendious tissue. The distance between the tendinous decussating origins of the scalenus anticus and the cervical sympathetic trunk at the C5 transverse process was 2.6 ± 0.5cm on the left side and 2.1 ± 1.1cm on the right side. The distance between the tendinous girdles of the musculus longus capitis and the musculus longus colli and the cervical sympathetic trunk at the C5 transverse process was 2.4 ± 0. 4cm on the left side and 2. 5 ± 0. 8cm on the right side. Conclusion: Superior cervical sympathetic ganglia, the hyperplastic first costovertebral joint adjacent to the inferior extremity of the inferior cervical ganglia( stellate ganglia), the tendinous decussating origins of the scalenus anticus and tendinous girdles of the musculus longus capitis and the musculus longus colli were the anatomic factors of the cervical sympathetic trunk and the sympathetic ganglia stimulated at external intervertebral foramen.