系統(tǒng)解剖學(xué)：腦神經(jīng)

1、,周?chē)窠?jīng)系統(tǒng) Peripheral Nervous System,腦神經(jīng),Cranial nerves,The 12 pairs of cranial nerves (CN) arise from the brain,CN I, olfactory nerve. CN II, optic nerve, CN III, oculomotor nerve; CN IV, trochlear nerve; CN V trigeminal nerve: CN VI, abducent (abducens) nerve; CN VII,facial nerve; CN VIII. vestibuloc

2、ochlear nerve: CN IX, glossopharyngeal nerve, CN X vagus nerve; CN XI,accessory nerve; CN XII, hypoglossal nerve.,I 嗅神經(jīng),視神經(jīng),動(dòng)眼神經(jīng),滑車(chē)神經(jīng),V三叉神經(jīng),展神經(jīng),VII面神經(jīng),VIII前庭蝸神經(jīng),舌咽神經(jīng),X迷走神經(jīng),副神經(jīng),XII舌下神經(jīng),I Olfactory nerve, Optic nerve, Oculomotor nerve, Trochlear nerve,V Trigeminal nerve, Abducent nerve,VII Facial nerv

3、e,VIII Vestibulocochlear nerve, Glossopharyngeal nerve,X Vagus nerve, Accessory nerve,XII Hypoglossal nerve,嗅神經(jīng)olfactory nerve,視神經(jīng)optic nerve,動(dòng)眼神經(jīng)oculomotor nerve,滑車(chē)神經(jīng)trochlear nerve,三叉神經(jīng)trigeminal nerve,展神經(jīng)abducent nerve,面神經(jīng)facial nerve,前庭蝸神經(jīng)vestibulocochlear nerve,舌咽神經(jīng)glossophrryngeal nerve,迷走神經(jīng)va

4、gus nerve,副神經(jīng)accessory nerve,舌下神經(jīng)hypoglosal nerve,嗅神經(jīng)olfactory nerve,視神經(jīng)optic nerve,動(dòng)眼神經(jīng)oculomotor nerve,滑車(chē)神經(jīng)trochlear nerve,三叉神經(jīng)reigeminal nerve,展神經(jīng)abducentnerve,面神經(jīng)facial nerve,前庭蝸神經(jīng)vestibulocochlear nerve,舌咽神經(jīng)glossophrryngeal nerve,迷走神經(jīng)vagus nerve,副神經(jīng)accessory nerve,舌下神經(jīng)hypoglosal nerve,纖維成分： 1軀體

5、感覺(jué)纖維 將來(lái)自頭面部的感覺(jué)沖動(dòng)傳至腦干內(nèi)的軀體感覺(jué)核 2內(nèi)臟感覺(jué)纖維 將來(lái)自人體各部?jī)?nèi)臟等以及味蕾的感覺(jué)沖動(dòng)傳入腦干內(nèi)的內(nèi)臟感覺(jué)核 3軀體運(yùn)動(dòng)纖維 為腦干內(nèi)的軀體運(yùn)動(dòng)核發(fā)出的纖維，支配眼球外肌、舌肌和咽喉肌等頭頸部肌肉 4內(nèi)臟運(yùn)動(dòng)纖維 為腦干內(nèi)的內(nèi)臟運(yùn)動(dòng)核發(fā)出的纖維，在腦神經(jīng)內(nèi)又稱副交感纖維，此種纖維需在顱部副交感神經(jīng)節(jié)或所支配器官附近或器官壁的神經(jīng)節(jié)內(nèi)換神經(jīng)元。節(jié)后纖維，支配平滑肌、心肌收縮和腺體分泌,1 General somatic efferent innervate skeletal muscles of eye and tongue 2 Special visceral effe

6、rent transmit motor impulses from the brain to skeletal muscles derived from brachial (gill) arches of embryo. These include the muscles of mastication, facial expression and swallowing,3 General visceral efferent transmit motor impulses from the general visceral motor nuclei and relayed in parasymp

7、athetic ganglions. The cardiac muscles of the fibers supply of the The postganglionic, the and glands of the smooth muscles,Functional components,4 General visceral afferent ): transmit interoceptive impulses from the viscera to the visceral sensory nuclei 5 Special visceral afferenttransmit sensory

8、 impulses from special sense organs of smell and taste to the brain,6 General somatic afferent transmit exteroceptive and proprioceptive impulses from head and face to somatic sensory nuclei 7 Special somatic afferent transmit sensory impulses from special sense organs of vision, equilibrium and hea

9、ring to the brain,腦神經(jīng)名稱、性質(zhì)、連腦部位及進(jìn)出顱腔部位,Nerve Components Cranial Exit Olfactory (CN I) sensory cribriform foramina Optic (CN II) sensory optic canal Oculomotor (CN III) motor 2 superior orbital fissure Trochlear (CN IV) motor superior orbital fissure Trigeminal (CN V) mixed 2 Ophthalmic (CN V1) super

10、ior orbital fissure Maxillary (CN V2) foramen rotundum Mandibular (CN V3) foramen ovale Abducent (CN VI) motor superior orbital fissure Facial (CN VII) mixed 4 internal acoustic pore stylomastoid foramen Vestibulocochlear (CN VIII) sensory internal acoustic pore Glossopharyngeal (CN IX) mixed 5 jugu

11、lar foramen Vagus (CN X) mixed 5 jugular foramen Accessory (CN XI) motor jugular foramen Hypoglossal (CN XII) motor hypoglossal canal,Classification of cranial nerves 1. Sensory cranial nerves Olfactory nerve Optic nerve Vestibulocochlear nerve 2Motor cranial nerves Oculomotor nerve Trochlear nerve

12、Abducent nerve Accessory nerv Hypoglossal nerve 3. Mixed nerves Trigeminal nerve, Facial nerve, Glossopharyngeal nerve Vagus nerve 4. Carry parasympathetic fibers cn cn cn cn 含副交感纖維,、對(duì)腦神經(jīng): 僅含感覺(jué)纖維的腦神經(jīng) 、對(duì)腦神經(jīng): 僅含運(yùn)動(dòng)纖維的腦神經(jīng) 、對(duì)腦神經(jīng): 為混合性的腦神經(jīng),嗅神經(jīng) Olfactory Nerve (CN I),上鼻甲上部和鼻中隔上部嗅粘膜 嗅細(xì)胞 中樞突聚成20多條嗅絲 嗅神經(jīng) 篩孔 嗅

13、球,上鼻甲上部和鼻中隔上部嗅粘膜 嗅細(xì)胞 中樞突聚成20多條嗅絲 嗅神經(jīng) 篩孔 嗅球,上鼻甲上部和鼻中隔上部嗅粘膜 嗅細(xì)胞 中樞突聚成20多條嗅絲 嗅神經(jīng) 篩孔 嗅球,上鼻甲上部和鼻中隔上部嗅粘膜 嗅細(xì)胞 中樞突聚成20多條嗅絲 嗅神經(jīng) 篩孔 嗅球,上鼻甲上部和鼻中隔上部嗅粘膜 嗅細(xì)胞 中樞突聚成20多條嗅絲 嗅神經(jīng) 篩孔 嗅球,上鼻甲上部和鼻中隔上部嗅粘膜 嗅細(xì)胞 中樞突聚成20多條嗅絲 嗅神經(jīng) 篩孔 嗅球(端腦telencephalon ),olfactory epithelium in the superior part of the lateral and septal walls o

14、f the nasal cavity,central processes of the bipolar olfactory neurosensory cells form about 20 bundles on each side,olfactory nerve,foramina in the cribriform plate of the ethmoid bone,olfactory bulbs,olfactory neurosensory cells,Functions 傳導(dǎo)嗅覺(jué) sense of smell,顱前窩骨折累及篩板時(shí) ，可撕脫嗅絲和腦膜，造成嗅覺(jué)障礙 ，同時(shí)腦脊液也可流人鼻腔

15、 。 鼻炎時(shí)，炎癥延至鼻 上部粘膜，也可造成一時(shí)性嗅覺(jué)遲鈍,Fractured cribriform plate anosmia , cerebrospinal fluid (CSF) rhinorrhea loss of sense of smell,視網(wǎng)膜的節(jié)細(xì)胞軸突,視神經(jīng) Optic Nerve (CN II),節(jié)細(xì)胞,axons of retinal ganglion cells,Optic Nerve,視神經(jīng),視神經(jīng)Optic Nerve,視神經(jīng)管 optic canal,middle cranial fossa,視交叉 optic chiasm(間腦diencephalon ),

16、視神經(jīng)外面包有三層由腦膜延續(xù)而來(lái)的三層被膜，腦的蛛網(wǎng)膜下隙也隨之延伸至視神經(jīng)周?chē)?。所以?dāng)顱內(nèi)壓增高時(shí)，常出現(xiàn)視神經(jīng)盤(pán)水腫 Papilledema,Optic Nerve,Visual Field,Functions 傳導(dǎo)視覺(jué)沖動(dòng) Vision from retina sense,前庭蝸神經(jīng) Vestibulocochlear Nerve (CN VIII),(1)前庭神經(jīng) 起自前庭神經(jīng)節(jié)，周?chē)磺蚰野摺E圓囊斑、壺腹嵴；中樞突內(nèi)耳門(mén)入腦橋，傳導(dǎo)平衡覺(jué)Equilibrium (2)蝸神經(jīng)起自螺旋神經(jīng)節(jié)，周?chē)宦菪鳎恢袠型粌?nèi)耳門(mén)腦橋, 傳導(dǎo)聽(tīng)覺(jué) Hearing,Vestibular gangli

17、on vestibular nerve Internal acoustic meatus Cochlear ganglion cochlear nerve ,前庭蝸神經(jīng)損傷 Vestibulocochlear Nerve Injuries 表現(xiàn)為傷側(cè)耳聾和平衡功能障礙 由于前庭刺激可出現(xiàn)眩暈和眼球震顫 前庭與網(wǎng)狀結(jié)構(gòu)和植物性神經(jīng)的聯(lián)系，所以多同時(shí)伴有嘔吐等癥狀,動(dòng)眼神經(jīng) Oculomotor Nerve (CN III),睫狀神經(jīng)節(jié)Ciliary ganglion,瞳孔括約肌 睫狀肌 sphincter pupillea and ciliary muscl,中腦 Midbrain,眶上裂 su

18、perior orbital fissure,眶 Orbit,上直肌、內(nèi)直肌 下直肌、下斜肌、上瞼提肌superior, medial, inferior rectus, inferior oblique and levator palpebrae superioris muscle,滑車(chē)神經(jīng) Trochlear Nerve (CN IV),中腦 Midbrain,眶上裂 superior orbital fissure,眶 Orbit,上斜肌 superior oblique,損傷：眼不能外下斜視,展神經(jīng) Abducent Nerve (CN VI),外直肌 lateral rectus,眶

19、上裂superior orbital fissure,眶 Orbit,損傷：眼內(nèi)斜視,腦橋 Pons,動(dòng)眼神經(jīng),滑車(chē)神經(jīng),睫狀神經(jīng)節(jié),展神經(jīng),Raise upper eyelid. Turns eyeball superiorly, medially, inferiorly Accommodation of lens. Constriction of pupil,位于眶內(nèi)視神經(jīng)和外直肌之間lies between optic nerve and lateral rectus,睫狀神經(jīng)節(jié)為扁平橢圓形的副交感神經(jīng)節(jié)，有感覺(jué)、交感、副交感3種根,阻滯麻醉此節(jié)及其附近的神經(jīng)根，就可阻斷結(jié)膜、角膜、眼球

20、中膜各部感覺(jué)；同時(shí)可使眼內(nèi)血管收縮降低眼內(nèi)壓，稱球后麻醉,Normal person,正常人,Normal person,正常人,Patient,正常人,Patient,正常人,Patient,Patient,Patient,右動(dòng)眼神經(jīng)損傷,Oculomotor paralysis,Abducens paralysis,副神經(jīng)核,副神經(jīng) Accessory Nerve (CN Xl),sternocleidomastoid,trapezius,延髓,副神經(jīng)脊髓根經(jīng)枕骨大孔入顱與顱根合成一干，經(jīng)頸靜脈孔出顱經(jīng)胸鎖乳突肌深面在該肌后緣淺出頸后三角斜方肌,Injury to the Spinal R

21、oot of CN XI,一側(cè)胸鎖乳突肌癱瘓，可引起頭和頸不能向患側(cè)屈，臉不能轉(zhuǎn)向?qū)?cè)；由于斜方肌癱瘓，可致患側(cè)不能聳肩 paralysis of the sternocleidomastoid muscle, causing the inability to rotate the head to the contralateral side, and paralysis of the upper portion of the trapezius muscle, which is characterized by a wing-like scapula and the inability to

22、 shrug the ipsilateral shoulder.,舌下神經(jīng) Hypoglossal Nerve (CN Xll),延髓 MedullaOblongate,Hypoglossal canal,Muscles of the tongue,經(jīng)舌下神經(jīng)管出顱頸內(nèi)動(dòng)、靜脈間在舌骨上方呈弓狀彎曲向前舌,Functions Motor to muscles of the tongue,舌下神經(jīng)損傷 Injury to the Hypoglossal Nerve 患側(cè)舌肌癱瘓，伸舌時(shí)， 由于患側(cè)頦舌肌癱瘓， 而健側(cè)頦舌肌收縮 使舌尖偏向患側(cè) 若長(zhǎng)時(shí)間舌肌癱 瘓可 造成舌 肌萎縮,paralyz

23、es the ipsilateral half of the tongue. After some time, the tongue atrophies, making it appear shrunken and wrinkled. When the tongue is protruded, its tip deviates toward the paralyzed side because of the unopposed action of the genioglossus on the normal side of the tongue.,三叉神經(jīng)Trigeminal Nerve (C

24、N V),感覺(jué)性頭面部皮膚及粘膜 運(yùn)動(dòng)性咀嚼肌,SVE fibers: supply masticatory muscles GSA fibers: transmit facial sensation to sensory nuclei of trigeminal nerve,三叉神經(jīng)節(jié)(trigeminal ganglion),卵圓孔,眶內(nèi)結(jié)構(gòu)和 眼裂以上 皮膚,鼻粘膜和 鼻背,口裂和 眼裂之間 皮膚 及深面結(jié)構(gòu),口裂以下和 顳區(qū)皮膚 口底結(jié)構(gòu),ophthalmic nerve,maxillary nerve,mandibular nerve,foramen rotundum,superio

25、r orbital fissure,foramen ovale,淚腺神經(jīng) lacrimal nerve,額神經(jīng) frontal nerve,鼻睫神經(jīng) Nasociliary nerve,眼神經(jīng)Ophthalmic nerve ( 1 sensory),leave the skull through the superior orbital fissure, to enter orbital cavity,1)眶下神經(jīng)infraorbital nerve 自眶下溝眶下孔 2)顴神經(jīng)zygomatic nerve 顴部皮膚 3)上牙糟后支posterior superior alveolar br

26、anches 穿上頜骨后面上頜竇、上頜磨牙及牙齦、眼裂與口裂間皮膚 4)翼腭神經(jīng)pterygopalatine nerve 在上頜神經(jīng)與翼腭神經(jīng)節(jié)(位于翼腭窩內(nèi))之間，分布于鼻、腭、咽粘膜,上頜神經(jīng) Maxillary nerve (2 sensory),Leave skull through foramen rotundum,下頜神經(jīng)Mandibular nerve( 3, mixed) Leave the skull through the foramen ovale to enter the infratemporal fossa 1. Masseteric nerve 2.Auricu

27、lotemporal nerve 3. Buccal nerve 4. Lingual nerve 5. Inferior alveolar nerve Mental nerve,(1)耳顳神經(jīng) 起始為二根，夾持腦膜中動(dòng)脈耳屏前 (2)頰神經(jīng) (3)舌神經(jīng) 舌骨舌肌表面舌，分布于口底、舌前23的粘膜 (4)下牙槽神經(jīng) 下頜孔頦孔淺出，稱頦神經(jīng)，分布于下頜牙齒、牙齦、頦部、下唇皮膚及粘膜,(5)咀嚼肌支Innervate the muscles of mastication,(1)眼神經(jīng)：分布于瞼裂以上至矢狀縫中點(diǎn)外側(cè)區(qū)域和鼻背中部的皮膚 (2)上頜神經(jīng)：分布于瞼裂與口裂之間，向后上至翼點(diǎn)處的狹

28、長(zhǎng)區(qū)域和鼻背外側(cè)的皮膚 (3)下頜神經(jīng)：分布于口裂與下頜底之間及面?zhèn)葏^(qū)后上部的皮膚,一側(cè)三叉神經(jīng)損傷時(shí)出現(xiàn) 同側(cè)面部皮膚及眼、口和鼻粘膜一般感覺(jué)喪失； 角膜反射因角膜感覺(jué)喪失而消失； 一側(cè)咀嚼肌癱瘓和萎縮，張口時(shí)下頜偏向患側(cè)。 臨床上常見(jiàn)的三叉神經(jīng)疼可以波及三叉神經(jīng)全部分支或某一分支，此時(shí)，疼痛部位與三叉神經(jīng)3大支的皮膚分區(qū)完全一致，而且壓迫眶上孔、眶下孔或頦孔時(shí)，可以誘發(fā)患支分布區(qū)的疼痛，借此有助于診斷,面神經(jīng) Facial Nerve (CN VII),軀體運(yùn)動(dòng)纖維，支配面肌運(yùn)動(dòng)。 內(nèi)臟運(yùn)動(dòng)纖維，節(jié)后纖維控制淚腺、下頜下腺、舌下腺、及鼻和腭粘膜腺的分泌 內(nèi)臟感覺(jué)纖維，為膝神經(jīng)節(jié)發(fā)出的中樞突

29、，周?chē)环植加谏嗲?/3粘膜的味蕾，司味覺(jué) 軀體感覺(jué)纖維，分布于耳部皮膚 SVE fibers supply facial muscles GVE fibers relayed in pterygopalatine ganglion and submandibular ganglion. The postganglionic fibers supply lacrimal, submandibular and sublingual glands SVA fiber from taste buds of anterior two-thirds of tongue which cell bodies

30、 are in the geniculate ganglion of the facial nerve GSA fibers from skin of external ear,Pons,internal acoustic meatus,facial canal,stylomastoid foramen,parotid gland where it divides into five branches,Internal auditory pore,Stylomastoid foramen,Lacrimal glands,Submandibular glands,sublingual gland

31、s,taste buds of anterior two-thirds of tongue,pterygopalatine ganglion,submandibular ganglion,geniculate ganglion,general somatic afferent special visceral afferent general visceral efferent special visceral efferent,Greater petrosal n.,Chorda tympani,膝神經(jīng)節(jié) geniculate ganglion,鼓索 chorda tympani味覺(jué)纖維（舌

32、前2/3味覺(jué)）和副交感纖維,巖大神經(jīng)副交感纖維 greater petrosal nerve,鐙骨肌神經(jīng) stapedial nerve 鐙骨肌,(一)面神經(jīng)管內(nèi)分支Branches inside of facial canal ：,巖大神經(jīng),Greater petrosal n.,Chorda tympani,鼓索,翼腭神經(jīng)節(jié),（副交感）,淚腺、鼻腔和腭的腺體,巖大神經(jīng),Greater petrosal nerve pass to pterygopalatine ganglion and there relayed through the zygomatic and lacrimal ner

33、ves to lacrimal gland,下頜下神經(jīng)節(jié),鼓索（副交感） ,下頜下腺 舌下腺,Chorda tympani Relayed in submandibular ganglion,the postganglionic fibers supply submandibular and sublingual glands,面神經(jīng)出莖乳孔后入腮腺實(shí)質(zhì)，至腮腺前緣，呈輻射狀穿出，控制面部諸表情肌運(yùn)動(dòng) 1顳支 temporal branches 2顴支 zygomatic branches 3頰支 buccal branches 4下頜緣支 marginal madibular branch

34、5頸支 cervical branch,(二) 面神經(jīng)管外分支 Branches outside of facial canal ：,Functions the motor root -muscles of facial expression Nervus intermedius - taste, parasympathetic, and somatic sensory,面神經(jīng)損傷 面神經(jīng)管外損傷主要表現(xiàn)為損傷側(cè)表情癱瘓，如笑時(shí)口角偏向健側(cè)、不能鼓腮；說(shuō)話時(shí)唾液從口角流出；傷側(cè)額紋消失、鼻唇溝變平坦；眼輪匝肌癱癱使閉眼困難、角膜反射也消失等癥狀。 面神經(jīng)管內(nèi)損傷同時(shí)傷及面神經(jīng)管外段的分支，因此

35、除上述面肌癱瘓癥狀外，還出現(xiàn)聽(tīng)覺(jué)過(guò)敏、舌前23味覺(jué)障礙、淚腺和唾液腺的分泌障礙等癥狀,Injury to the facial nerve,The symptoms and signs depend on the location of the lesion. A lesion in or outside the stylomastoid foramen results in a flaccid paralysis of all the muscles of facial expression in the affected side; this can occur from a stab w

36、ound or from swelling of the parotid gland. A lesion in the facial canal involving the chorda tympani nerve results in reduced salivation and loss of taste sensation from the ipsilateral anterior two-thirds of the tongue. A lesion higher up in the canal can paralyze the stapedius muscle. The nerve o

37、f the components of of the involves all of the middle ear of the A lesion in the, the nerves of the dysfunction of of the can cause of the auditory canal of the internal of the tumor in of the whereas an and ,舌咽神經(jīng) Glossopharyngeal Nerve (CN IX),軀體運(yùn)動(dòng)纖維，支配莖突咽肌 副交感纖維，支配腮腺分泌 內(nèi)臟感覺(jué)纖維，傳導(dǎo)舌后1/3等處的味覺(jué)和其它內(nèi)臟感覺(jué)沖動(dòng)

38、 軀體感覺(jué)纖維，分布于耳后皮膚 SVE fibers: supply stylopharygeus GVE fibers: ralyed in otic ganglion, the postganglionic fibers supply parotid gland SVA fibers: arise from the cells of inferior ganglion, the peripheral processes supply the taste buds on posterior third of tongue GVA fibers: visceral sensation from

39、 mucosa of posterior third of tongue, pharynx, auditory tube and tympanic cavity, carotid sinus and glomus GSA fibers: sensation from skin of posterior surface of auricle,上神經(jīng)節(jié)superior ganglion， 下神經(jīng)節(jié)inferior ganglion,舌咽神經(jīng)出頸靜脈孔后先在頸內(nèi)動(dòng)、靜脈間下降，繼而弓形向前，經(jīng)舌骨舌肌內(nèi)側(cè)達(dá)舌根,舌咽神經(jīng),耳支,頸動(dòng)脈竇支,舌支,咽支,(鼓室N),(鼓室叢),otic ganglio

40、n,腮腺,superior ganglion,inferior ganglion,jugular foramen,莖突咽肌,咽、舌后1/3 一般感覺(jué)和味覺(jué),頸A竇、頸A小球,耳神經(jīng)節(jié),general somatic afferent general visceral afferent special visceral afferent special visceral efferent general visceral efferent,The ganglion of the petrosal nerves of the and lesser of the via tympanic of th

41、e Tympanic nerve to otic, the parotid gland of the auriculotemporal to of the fibers via of the with postganglionic. Stylophayngeal branches Pharyngeal branches form the pharyngeal plexus Tonsillar branches Lingual branches to taste buds and mucosa of posterior third of tongue Carotid sinus branch i

42、nnervations to both carotid sinus and glomus,耳神經(jīng)節(jié) otic ganglion,Lesions of the Glossopharyngeal Nerve 一側(cè)舌咽神經(jīng)損傷表現(xiàn)為 同側(cè)舌后13味覺(jué)消失， 舌根及咽峽區(qū)痛覺(jué)消失 同側(cè)咽肌無(wú)力,Pharyngeal reflex,副交感纖維，在頸、胸、腹多種器官的壁旁或壁內(nèi)交換神經(jīng)元后，節(jié)后纖維支配這些器官的平滑肌、心肌收縮和腺體的分泌 內(nèi)臟感覺(jué)纖維，傳導(dǎo)頸、胸、腹多種器官內(nèi)臟感覺(jué)沖動(dòng) 軀體運(yùn)動(dòng)纖維，支配咽喉肌 軀體感覺(jué)纖維，分布于硬腦膜、外耳道和耳廓皮膚 GVE fibers: synapse in

43、 parasympathetic ganglion, short postganglionic fibers innervate cardiac muscles, smooth muscles and glands of viscera GVA fibers: the inferior ganglion, carry impulse from viscera in neck, thoracic and abdominal cavity SVA fibers: taste from the epiglottis SVE fibers: to muscles of pharynx and lary

44、nx GSA fiber: the superior ganglion, sensation from auricle, external acoustic meatus and cerebral dura mater,迷走神經(jīng) Vagus Nerve (CN X),迷走神經(jīng),右喉返神經(jīng),食管,心叢,食管叢,迷走后干,腹腔叢,頭臂干,膈,迷走前干,胃前支,經(jīng)頸靜脈孔出顱頸血管鞘內(nèi)經(jīng)鎖骨下動(dòng)脈前方進(jìn)入胸腔肺根后方形成食管叢，向下集合成迷走前干(左迷走神經(jīng))和迷走后干(右迷走神經(jīng))穿膈的食管裂孔腹腔 分布：,咽喉肌耳廓外耳道 頸、胸、腹部器官心肌、平滑肌、腺體,jugular foramen,carotid sheath,posterior to the lung root,esophageal plexus,vagal trunk,esophageal hiatus,anterior gastric and hepatic branches posterior gastric