頜面部神經(jīng)之面神經(jīng)ppt課件

頜面部神經(jīng)之面神經(jīng),(第七版),第七章口腔頜面頸部神經(jīng),頜面部神經(jīng)之面神經(jīng),面神經(jīng),FacialNerve,頜面部神經(jīng)之面神經(jīng),facialnerveparalysis,頜面部神經(jīng)之面神經(jīng),主要內(nèi)容：一、概述二、面神經(jīng)行程及其分支三、面神經(jīng)解剖特點(diǎn)的臨床意義,問(wèn)題1：面神經(jīng)損傷為什么會(huì)出現(xiàn)這些臨床癥狀？,頜面部神經(jīng)之面神經(jīng),一概述,面神經(jīng)(facialnerve)屬十二對(duì)腦神經(jīng)中的第七對(duì)。,頜面部神經(jīng)之面神經(jīng),為混合性神經(jīng)，含四種神經(jīng)纖維運(yùn)動(dòng)纖維支配面部表情肌、頸闊肌、鐙骨肌、二腹肌后腹、莖突舌骨肌副交感（分泌）纖維支配淚腺、腭腺、舌下腺、下頜下腺的分泌味覺(jué)纖維經(jīng)鼓索加入舌神經(jīng)，司舌前2/3的味覺(jué)。感覺(jué)纖維支配外耳道及小部分耳后皮膚感覺(jué),頜面部神經(jīng)之面神經(jīng),面神經(jīng)的纖維成分示意圖,運(yùn)動(dòng)纖維,副交感纖維,味覺(jué)纖維,頜面部神經(jīng)之面神經(jīng),面神經(jīng)行程及分段示意圖,管段：莖乳孔以上,顱外段：莖乳孔以外,頜面部神經(jīng)之面神經(jīng),（一）面神經(jīng)管段,面神經(jīng)管段,頜面部神經(jīng)之面神經(jīng),面神經(jīng)管段的分支,（一）巖大神經(jīng)(greaterpetrosalnerve)布于淚腺、鼻和腭黏膜的腺體（二）鐙骨肌神經(jīng)(stapedialnerve)在鼓室后壁處發(fā)出至鐙骨?。ㄈ┕乃?chordatympani)穿巖鼓裂至顳下窩并入舌神經(jīng),鼓索,鐙骨肌神經(jīng),巖大神經(jīng),頜面部神經(jīng)之面神經(jīng),(二)面神經(jīng)顱外段,面神經(jīng)顱外段,頜面部神經(jīng)之面神經(jīng),1面神經(jīng)主干,面神經(jīng)主干,莖乳孔至面神經(jīng)分叉處的一段經(jīng)外耳道軟骨與二腹肌后腹間越過(guò)莖突根部的淺面進(jìn)入腮腺新生兒及兒童乳突尚未發(fā)育完全面神經(jīng)位置表淺，手術(shù)時(shí)易受傷,頜面部神經(jīng)之面神經(jīng),2面神經(jīng)腮腺前的分支,（1）耳后神經(jīng)耳支支配耳后肌，枕支支配枕?。?）二腹肌支支配二腹肌后腹（3）莖突舌骨肌支常與二腹肌支共干發(fā)出,耳后神經(jīng),二腹肌支,莖突舌骨肌支,頜面部神經(jīng)之面神經(jīng),3面神經(jīng)腮腺內(nèi)分支,于腮腺深淺兩葉間行至頸外動(dòng)脈外側(cè)于下頜支后方分為顳面干和頸面干兩大分支,顳面干,頸面干,頜面部神經(jīng)之面神經(jīng),面神經(jīng)顱外段分支與腮腺關(guān)系示意圖,顳面干,頸面干,temporalbranches,zygomaticbranches,buccalbranches,marginalmandibularbranches,cervicalbranches,頜面部神經(jīng)之面神經(jīng),面神經(jīng)顱外段及其分支,顳支,顴支,頰支,下頜緣支,頸支,額紋消失眼瞼閉合不全鼻唇溝變淺鼓腮無(wú)力食物存留于頰部口角下垂歪斜,頜面部神經(jīng)之面神經(jīng),三、面神經(jīng)解剖特點(diǎn)的臨床意義：1.如何進(jìn)行面神經(jīng)損傷的定位？2.頜面部的手術(shù)中如何避免損傷面神經(jīng)分支？,頜面部神經(jīng)之面神經(jīng),面神經(jīng)損傷的定位示意圖,鼓索以下受損：同側(cè)面肌麻痹,管段或面神經(jīng)核受損：同側(cè)面肌麻痹+舌前2/3味覺(jué)喪失+唾液分泌障礙+聽(tīng)覺(jué)改變+淚腺分泌障礙,頜面部神經(jīng)之面神經(jīng),周圍性面神經(jīng)麻痹的定位診斷癥狀及體征面神經(jīng)損傷部位單純面癱鼓索以下，莖乳孔以外（面神經(jīng)顱外分支受損）面癱味覺(jué)喪失唾液分泌障礙鼓索與鐙骨肌神經(jīng)之間（鼓索受損）面癱味覺(jué)喪失唾液分泌障礙聽(tīng)覺(jué)改變鐙骨肌神經(jīng)與膝狀神經(jīng)節(jié)之間（鐙骨肌神經(jīng)受損）面癱味覺(jué)喪失唾液淚腺分泌障礙聽(tīng)覺(jué)改變膝狀神經(jīng)節(jié)與腦橋之間（巖大神經(jīng)受損）,面神經(jīng)解剖特點(diǎn)的臨床意義,頜面部神經(jīng)之面神經(jīng),面神經(jīng)應(yīng)用解剖(application),面神經(jīng)的保護(hù)切口選擇頜面部尋找面神經(jīng)的標(biāo)志,頜面部神經(jīng)之面神經(jīng),手術(shù)切口,頜面部神經(jīng)之面神經(jīng),頜面部神經(jīng)之面神經(jīng),vs,centralfacialparalysis,peripher