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1、頸靜脈孔的應(yīng)用解剖陳立華CHINA-INI頸靜脈孔由顳骨巖部和枕骨頸突圍成。顳骨和枕骨向孔內(nèi)的突起分別被稱為顳突和枕突，二者以纖維或骨橋連接，構(gòu)成孔內(nèi)神經(jīng)和血管的分隔。由顳突下方沿頸靜脈球內(nèi)側(cè)緣伸向后方的骨性隆起稱為頸內(nèi)嵴，舌咽神經(jīng)行于其內(nèi)側(cè)。頸靜脈孔為一自顱后窩通向前、外、下方的骨性管道。頸靜脈管（jugularcanal）。osseousrelationships,superiorviewosseousrelationships,posterosuperiorview.Thejugularforamenisbestse
2、eninaposterosuperiorvieworientedperpendiculartotheclivus.thejugularforamenislocatedbetweenthetemporalandoccipitalbonessigmoidgroovedescendsalongthemastoidandcrossestheoccipitomastoidsuture,turnsforwardontheuppersurfaceofthejugularprocess,enterstheforamenfromposter
3、iorandsuperiorshowstheshapeoftheforamenhypoglossalcanalpassesabovethemiddlethirdoftheoccipitalcondyleandopenslaterallyintotheintervalbetweenthejugularforamenandcarotidcanalstylomastoidforamenislocatedlateralandtheanteriorhalfoftheoccipitalcondylemedialtothejugular
4、foramenanteriorandbackwardrevealstheshapeofthejugularforamenlargerlateralpart,thesigmoidpart,whichreceivesthedrainageofthesigmoidsinus,andasmallermedialpart,thepetrosalpart,whichreceivesthedrainageoftheinferiorpetrosalsinusenlargedviewintrajugularprocessprojectsin
5、totheintervalbetweenthesigmoidandpetrosalpartsoftheforamenintrajugularridge,extendsforwardfromtheintrajugularprocessalongthemedialsideofthejugularbulbcochlearaqueductopensabovethepetrosalpartoftheforamen,wheretheglossopharyngealnerveenterstheintrajugularpartofthef
6、oramenonthemedialsideoftheintrajugularprocess.thevestibularaqueductopensontotheposteriorsurfaceofthetemporalbonesuperolateraltothejugularforamenTheinferiorpetrosalsinusextendsalongthepetroclivalfissureandentersthepetrosalpartoftheforamenposterosuperiorviewoftheint
7、rajugularprocessandridge,whichseparatethesigmoidandpetrosalpartsofthejugularforamenRembrandtvanRijn(Dutch,1606-1669).Thispaintingiscalled"TheAnatomyLectureofDr.NicolaesTulp",paintedin1632頸靜脈孔的硬膜結(jié)構(gòu)及分部Hovelacque將頸靜脈孔分為前內(nèi)側(cè)的神經(jīng)部和后外側(cè)的血管部?jī)刹糠?。Katsuta根據(jù)通過(guò)頸靜脈孔的結(jié)構(gòu)將其分為巖部、頸內(nèi)部（
8、或神經(jīng)部）和乙狀竇部。神經(jīng)部的硬膜形成舌咽道和迷走道，分別有舌咽神經(jīng)和迷走神經(jīng)及副神經(jīng)穿過(guò)。舌咽道和迷走道位于頸內(nèi)突內(nèi)側(cè),二者間隔以0.5-4.9mm寬的硬膜。神經(jīng)部上外側(cè)緣的硬膜返折增厚并伸向下內(nèi)覆于舌咽道和迷走道上方，稱頸靜脈孔硬膜返折,是辨認(rèn)顱神經(jīng)的重要標(biāo)志。sigmoidsinusdescend
