口腔頜面頸部局部解剖

TheLocalAnatomyofOralMaxillo-FacialandNeck口腔頜面頸部局部解剖

TheoralcavityTheboundariesandsuperficialanatomyoforalcavity第一節(jié)口腔局部解剖一口腔境界及表面標(biāo)志

（一）口腔的境界境界及分部（二）口腔前庭的表面標(biāo)志定義1.口腔前庭溝（唇頰齦溝）2.上、下唇系帶3.頰系帶4.腮腺導(dǎo)管口5.磨牙后區(qū)由磨牙后三角和磨牙后墊組成。6.翼下頜皺襞7.舌系帶

LipTheboundariesoflipSuperficialanatomyoflipLayersoflipThebloodvessels、lymphaticvesselsandnerves二唇

（一）唇的境界（二）表面標(biāo)志（三）唇的解剖層次1.皮膚2.淺筋膜比較疏松。3.肌層主要為口輪匝肌。4.粘膜下層有粘液腺和上、下唇動(dòng)脈。5.粘膜有粘液腺開口。（四）唇的血管、淋巴管及神經(jīng)1.主要血供為頜外動(dòng)脈的分支上、下唇動(dòng)脈，靜脈血經(jīng)面前靜脈回流。2.淋巴管很豐富3.唇的感覺神經(jīng)來自上、下頜神經(jīng)的分支，運(yùn)動(dòng)則由面神經(jīng)支配。BuccaBoundariesLayersandconstructures三、頰（一）境界（二）層次1.皮膚。2.皮下組織3.頰筋膜4.頰肌。5.粘膜下層含有粘液腺。6.粘膜有腮腺導(dǎo)管的開口。PalateSuperficialanatomyThefeaturesofhardandsoftpalateThemusclesofsoftpalate四腭分為前2/3的硬腭和后1/3的軟腭兩部分。（一）硬腭的表面標(biāo)志1.腭中縫2.切牙乳頭（腭乳頭）3.腭皺襞4.上頜硬區(qū)和上頜隆突5.腭大孔6.蝶骨翼突鉤7.腭小凹（二）硬腭軟組織的特點(diǎn)1.粘膜下層前部含有少量脂肪，無腺體；后部則有較多的腭腺。2.硬腭的骨膜與粘膜下層附著緊密，而與骨面附著則不太緊密。3.粘骨膜不易移動(dòng)，能耐受磨擦和咀嚼壓力。（三）軟腭的肌群TongueThedorrumofthetongueTheinferiorsurfaceofthetongueThelymphaticvesslesofthetongue五.舌（一）舌背舌背以“人”形界溝為界，分為舌前2/3和舌后1/3。舌前2/3又稱為舌體，舌后1/3稱為舌根。舌前2/3分布有四種舌乳頭：1.絲狀乳頭2.菌狀乳頭3.輪廓乳頭4.葉狀乳頭舌后1/3粘膜無舌乳頭，但有結(jié)節(jié)狀淋巴組織，稱舌扁桃體。（二）舌腹標(biāo)志1舌系帶2傘襞3舌下肉阜4舌下襞（三）舌的淋巴管1.舌尖淋巴管大部分至頦下淋巴結(jié)，小部分至頸肩胛舌骨肌淋巴結(jié)。2.舌體邊緣或外側(cè)淋巴管部分至頜下淋巴結(jié)，另一部分至頸深上淋巴結(jié)。3.舌中央淋巴管 匯入頸深上淋巴結(jié)，亦有匯入頜下淋巴結(jié)者。4.舌根淋巴管 匯入兩側(cè)頸深上淋巴結(jié)。ThefloorofthemouthBoundariesConstructures

六口底舌下區(qū)（一）境界（二）內(nèi)容1.舌下腺及頜下腺深部2.頜下腺導(dǎo)管及舌神經(jīng)3.舌下神經(jīng)及其伴行靜脈4.舌下動(dòng)脈

TheLocalAnatomyofMaxillo-FacialArea第二節(jié)頜面部局部解剖

一、頜面部表面標(biāo)志及軟組織特點(diǎn)（一）表面解剖標(biāo)志鼻根、鼻尖和鼻背鼻底和鼻前孔鼻小柱和鼻翼鼻面溝唇面溝鼻唇溝鼻唇溝鼻下點(diǎn)口裂口角頦唇溝頦前點(diǎn)頦下點(diǎn)耳屏體表投影眶下孔、頦孔、腮腺導(dǎo)管、面神經(jīng)出莖乳孔的位置（二）面部比例

（三）對(duì)稱（四）美容角

鼻額角 鼻面角 鼻唇角 鼻頦角 頦頸角（五）X線頭影測(cè)量(cephalometricradiography)是將X線頭顱定位照相所得的影像轉(zhuǎn)描于描圖紙上，顯示各標(biāo)志點(diǎn)并構(gòu)成線、角、面進(jìn)行測(cè)量分析，用于正頜外科、口腔正畸科及研究顱面生長(zhǎng)發(fā)育。1.常用X線頭影測(cè)量標(biāo)志點(diǎn)硬組織標(biāo)志點(diǎn)蝶鞍點(diǎn)(S.Sella)鼻根點(diǎn)(N.Nasion)耳點(diǎn)(P.Porion)眶點(diǎn)(O.Orbitale)翼上頜裂點(diǎn)(Ptm.pterygommaxillaryfissure)前鼻點(diǎn)(ANS.Anteriornasalspine)后鼻點(diǎn)(A.Subspinale)下牙槽座點(diǎn)(B.Supramental)頦前點(diǎn)(Pg.Pogonion)頦下點(diǎn)(Me.Menton)軟組織標(biāo)志點(diǎn)（略）2.常用X線頭影測(cè)量平面、角及線

距測(cè)量平面（硬組織） 前顱底平面(SN.SNplane) 眼耳平面(FH.Frankfortthorizontalplane)

牙合平面(OP.Occlusalplane)

角度測(cè)量（硬組織）SAN角SNB角ANB角NA-PgA角(Angleofconvexity,頜凸角）3）線距測(cè)量（硬組織）前全面高 (Anteriortotalfacialheight,ATFH)前上面高 (Anteriorupperfacialheight,AUFH)前下面高 (Anteriorlowerfacialheight,ALFH)3.臨床應(yīng)用

上頜骨水平位置上頜骨垂直位置下頜骨水平位置下頜骨垂直位置（六）協(xié)調(diào)ThesuperficialanatomyandthefeatuserofsofttissuesSuperficialanatomyTheProportionofthefaceSymmetryCosmetoloyganglesCephalometricanalysisCoordinationThefeaturesofThemaxillo-facialsofttissue二.頜面部軟組織的特點(diǎn)1.皮膚薄而柔軟，皮下組織疏松，易于伸展移動(dòng)。但鼻翼與頦部皮膚與皮下組織結(jié)合緊密，不易伸展。2.富于皮脂腺、毛囊和汗腺。3.血管密集，血運(yùn)豐富。4.有皮膚皺紋，走向有一定的規(guī)律。5.皮下組織中有表情肌，手術(shù)或創(chuàng)傷處理時(shí)應(yīng)注意表情肌的縫合，以避免影響表情肌功能。TheareaoftheparotidglandandmassetermuscleBoundariesConstructures三.腮腺咬肌區(qū)

（一）境界（二）內(nèi)容1.腮腺腮腺鞘的特點(diǎn)腮腺與神經(jīng)血管的關(guān)系（1）腮腺內(nèi)神經(jīng)血管縱行的有：顳淺動(dòng)靜脈、耳顳神經(jīng)、面后靜脈、頸外動(dòng)。橫行的有：面神經(jīng)、頜內(nèi)動(dòng)靜脈及面橫動(dòng)脈。（2）腮腺淺葉上緣神經(jīng)血管排列 從后向前依次為顳淺靜脈、耳顳神經(jīng)、顳淺動(dòng)脈、面神經(jīng)顴支和顳支（3）腮腺淺葉前緣結(jié)構(gòu)從上到下依次排列為面橫動(dòng)脈、面神經(jīng)顴支、面神經(jīng)上頰支、腮腺導(dǎo)管、面神經(jīng)下頰支及下頜緣支。（4）腮腺淺葉下端神經(jīng)血管的排列從前向后依次為面神經(jīng)下頜緣支、面神經(jīng)頸支、面后靜脈（5）腮腺深葉面的神經(jīng)血管腮腺深葉的深面與莖突諸肌及深部血管神經(jīng)包括頸內(nèi)動(dòng)、靜脈和第Ⅸ～Ⅻ對(duì)腦神經(jīng)2.咬肌位于腮腺咬肌筋膜的深面。Lateraldeepface四、面?zhèn)壬顓^(qū)

（一）境界（二）內(nèi)容1.翼叢2.頜內(nèi)動(dòng)脈3.翼外肌4.下頜神經(jīng)及其分支SpaceInfraorbitalspaceBuccalspaceMassetricspacePterygomandibularspaceInfratemporalspaceTemporalspaceParapharyngealspaceSublingealspaceSubmandibularspaceSubmentalspacePterygopalatinespace(fossa)五、蜂窩組織間隙（一）眶下間隙位于眼眶前部的下方。上界眶下緣，下界上頜骨牙槽突，內(nèi)界鼻側(cè)緣，外以顴肌為界。（二）頰間隙

位于頰肌與咬肌之間。前界咬肌前緣，后界下頜支前緣，后界下頜支前緣及顳肌前緣。廣義的頰間隙應(yīng)為頰部皮膚與粘膜之間。

（三）咬肌間隙位于咬肌與下頜支之間。前界為磨牙后區(qū)粘膜，后界腮腺。（四）翼頜間隙（翼下頜間隙）位于下頜支與翼內(nèi)肌之間，前界顳肌及頰肌，后界腮腺，上界翼外肌下緣，下以翼內(nèi)肌附著于下頜支處為界。（五）顳下頜間隙位于翼頜間隙上方。前界上頜骨后面，后界莖突及莖突諸肌，內(nèi)界蝶骨翼突外側(cè)板，外界下頜支上份及顴弓，上界蝶骨大翼的顳下面和顳下嵴，下以翼外肌下緣平面為界。（六）顳間隙位于顳區(qū)，借顴弓與顳下嵴的平面和顳下間隙分界，可分為顳淺間隙和顳深間隙兩部分。（七）咽旁間隙（咽側(cè)間隙）位于翼內(nèi)肌，腮腺深葉與咽側(cè)壁之間，上達(dá)顱底，下至舌骨平面，前界翼下頜韌帶，后界椎前筋膜（八）舌下間隙位于舌和口底粘膜之下，下頜舌骨肌及舌骨舌肌之上。前界及兩側(cè)為下頜體的內(nèi)側(cè)面；后部止于舌根。（九）下頜下間隙位于下頜下三角內(nèi)，周界與下頜下三角相同。上界為下頜下緣，下界為二腹肌的前后腹。其底由下頜舌骨肌、舌骨舌肌和咽上縮肌等構(gòu)成。（十）頦下間隙位于舌骨上區(qū)，為以頦下三角為界的單一間隙。（十一）翼腭間隙（翼腭窩）位于眶尖的下方、顳下窩的內(nèi)側(cè)。前界上頜骨體部，后界蝶骨翼突，上為蝶骨大翼，內(nèi)以腭骨垂直板為界。TheLocalAnatomyoftheNeckConceptBoundariesSuperficialanatomyNeckfascia第三節(jié)頸部局部解剖一概述（一）頸部境界和分區(qū)1.以斜方肌前緣為界2.以胸鎖乳突肌前、后緣為界1）頸前三角2）胸鎖乳突肌區(qū)3）頸后三角（二）體表標(biāo)志和體表頭影1.舌骨2.甲狀軟骨3.環(huán)狀軟骨4.氣管頸段（略）5.胸鎖乳突肌6.鎖骨上窩7.胸骨上窩8.頸總動(dòng)脈和頸外動(dòng)脈9.鎖骨下動(dòng)脈10.頸外靜脈11.副神經(jīng)12.胸膜頂（三）頸筋膜1.頸淺筋膜2.頸深筋膜淺層形成完整的封套包繞部3.頸深筋膜中層上連舌骨，兩側(cè)至肩胛舌骨肌外緣，向下附著于鎖骨和胸骨柄的后緣，并包被舌骨下肌群。4.頸臟器筋膜包被頸部臟器，如喉、氣管、甲狀腺、咽及食管等。5.椎前筋膜（頸深筋膜深層）Cervicalpartoftrachea

BoundariesandconstructuresAttentionoftracheotony二.氣管頸段（一）氣管頸段前方的層次（二）氣管切開的注意點(diǎn)1.采取頭正中后仰位，以免傷及頸總動(dòng)脈，并使氣管位置變淺。2.一般在第3～5氣管軟骨環(huán)的范圍內(nèi)切開。3.切開時(shí)注意深度，以免傷及氣管后壁，甚至傷及食管。4.勿切第一氣管軟骨環(huán)，以免術(shù)后發(fā)生喉部狹窄。5.切開不應(yīng)低于第5氣管軟骨環(huán)，以免引起無名動(dòng)脈等損傷。SubmandibularareaBoundariesConstructures三.頜下區(qū)（一）境界（二）內(nèi)容1.頜下腺2.頜下淋巴結(jié)3.面前靜脈4.頜外動(dòng)脈5.頜下神經(jīng)節(jié)6.舌神經(jīng)、頜下腺導(dǎo)管和舌下神經(jīng)三者位于頜下腺深面，在舌骨舌肌的淺面，自上而下依此排列：舌神經(jīng)、頜下腺導(dǎo)管、舌下神經(jīng)。舌神經(jīng)與頜下腺導(dǎo)管關(guān)系密切，從解剖關(guān)系上可作以下鑒別：1.聯(lián)系舌神經(jīng)連于頜下神經(jīng)節(jié)，導(dǎo)管則直接發(fā)自頜下腺。2.位置在舌骨舌肌表面，舌神經(jīng)位于導(dǎo)管的上方。3.形態(tài)舌神經(jīng)比頜下腺導(dǎo)管粗而略扁，且堅(jiān)韌。CarotidtrianglesBoundariesConstructuresCommoncarotidarteryInternalcarotidarteyExternalcarotidarteyInternaljugutarveinCommonfacialveinExternalmaxillaryarteryHypoglossalnerveSuperiorlaryngealnerve四.頸動(dòng)脈三角(一）境界前上界為二腹肌后腹，前下界為肩胛舌骨肌上腹，后以胸鎖乳突肌為界。

（二）內(nèi)容1.頸總動(dòng)脈2.頸內(nèi)動(dòng)脈和頸外動(dòng)脈3.頸內(nèi)靜脈4.面總靜脈5.頜外動(dòng)脈6.舌下神經(jīng)7.喉上神經(jīng)8.二腹肌后腹深面至該肌下緣，自后向前依次排列的血管神經(jīng)為：副神經(jīng)、頸內(nèi)神經(jīng)、頸外神經(jīng)舌下神經(jīng)、頸內(nèi)動(dòng)脈、頸外動(dòng)脈及頜外動(dòng)脈.

PosteriatrianglesofneckBoundariesConstructures五頸后三角（一）境界前界胸鎖乳突肌，后界斜方肌前緣，下以鎖骨1/3為界。

（二）內(nèi)容1.皮膚2.頸淺筋膜3.頸深筋膜淺層4.頸深筋膜中層5.副神經(jīng)、脊副淋巴結(jié)、頸橫動(dòng)脈及鎖骨上淋巴結(jié)6.椎前筋膜7.臂叢及鎖骨下血管Wy6I1hh+uAfxhAdjOutH-x3MkZoNZVyZ#zMqDa9x6-4nPcNcI)df1EUK8aNN9*7DhbguN+kBLLy4rr0h2o7kZR*r1XRRSTQFkV56U71zy%T0!2*KdI-mM6Hj9gHmqYTebP$RmKTRItd+ZX(iXLX9dU#urOpkxXo(Ko1J9xIB9tnXG46O*#B&age80**3nVB)I$Sb2r8fJnhpH)qLj)TQ%n37CsPE(E&HER7HeYA9Mp74iTHYzIiwiVLU9Mo7%QAiNk6bCho!I60m)*bHgxIQX-fF8JIlJF68J#CZ#IbBSGyqf-G3dfEip!I5-i!W+4zV1ftZB3sBrBnCdm-lv*QTv1y#fEB1qCzl*&nc+9NI$-ba(KgJ2rIQW9P#G&VduaABhSxp83)!JCl!gcu3u*(v8YhpjH6N7tR9#fqbBfjSYx(ANCr3%Btf0MUVVaQ$O9lRNchB9vm0)BbL2ywQVWj4jOLpwp11cM+ojidfc)FwktJV%J#YwvQb87f1R1jv)57BL0G!s3HS*wgfxVfTlK0faeW8rVYAUdlKbh7PcRa*zzaByk!Ln%bFhbRxvWwD9N41BEr6Khm-hzg!B940jE1!kUnM9jjJedM-KM7oJf8d3NgRkI*oa&2LyCDw1JKNj!SL+g)U+p7!2ROaDl$nxx$306GPRQSK+nKE$DISdnE5!aAwlQk!(aSnx$x3ahQVn9T%V5RF$VZug9adJi5kJXgdWQvL%Pu(8OwqNa1F12cdXYarxkh%8HQRM!D$PwBeaO1Ifsrrb&fqd4QqAIpkd6Y!Mo26iVO8PNKbZdLvwCDam&6*j!uPBUev91($mr##dXkogYr(6oVV(%zU7Uthr(OzrBSTpXDwvB3P8mCAEd7-KJ9&p*xsphVIuDcPKWmN9r#Zo+0UHTf8oweFm3#KYYhRm**5DH+%*ZY5AahRLF2fk8H)aN0jiaOme%k1ql41)kLoloafgh6X8WNsSW99&3Kgtmv$2sPpE6NWOd%x)z*B*PLjXLJTI0bijwJ18IfgRThq8DSZq*tWiYpRzwVlyfX%zX7QNF8xTMIG)7qTsd2CL9$b+t-gSAwBVEn8+-n)ovdEABEbpdP-1G#hM7AX13ZuNHqiJB)1P7g9Zw(tZp&JzG*GF)U5$ji$glpM8LhXqWakf!feGtOC&&CIBJ&oYrC3KslvL*!tBngPWExjkwOn%zpIRN3GwMeaG*H#W3Ly+!P+ep4auEUNf58n+q$6zY4pC#VR$p)s!)9pj%xW!Rk))l*1EnUeFK$Nh2kPTl9xjjHkA%Budk9k4Xy4Ll9XZ6BlR!X&8HxsYb%MZWdqkG*BYoVTwBjx(C(DLHgMIRl+h*nDkd)8C(59KAi0F)gTHPkgM#7j*8A3bOjRcXfGRN7TLyRzQv*-QSxvyLrrS9WrcyBU)#Q8E8W*LyAn!N0eIrSGSa$tMP9AdPXUpKmuX!9-+J(N8CaTFDS!6ikFwHjAVlJeACfNU1TwNa6Ru9xUkTgThZH&Sc&v&B)B)VC5606f(W7n22fU6vWHI$JPcmlOl4EHJUNy9%NQ7HxZT9Gu(cbA#o$x0+IrpD2YvYViczefB4NVVRLGHP+wbbyckZ&DSG8pqcYt%s$1nyu8CInIvN&RfpfZe$NDtivUl1-iMOl0rlXAL6R#$WW(4pwObIHi&5VL(VQqTJTGmAYm7zt9#PH2u$I4DoLu2#*oMgM+jh3ZHVa517YFX4hl*GoJbTo9tgM5xCHhmJR+&qr$%bQe#%rtY9D5ZY8qNHMiAH(mwN77D$vtu0b1lJ1P8n!8#PSI)s9r%**t!ar0pNU4OUv)8IL-m6Pj!NBwbGl)j#*c(Izh#tCzqMLSyF0Srzpk152eRugjeihc1UkuswcaD2MDNpHX0oQhQf#Dt0PqjDe3rn9FS%mH!3ke5!*t5+hOUv#c3AH4Djcgr&OBtuG-Z&M1)urUFRf(&5qRdJ3rGJx3qm#0LWsrPpjtQjQaD+AoBydHM7Z6Yav#HIIfN47TsB8!ZsZ)TzN6VD6octW7zLnB+H76Jfp1dvk(w484g%3#lSkRxauW+*(Kj5*YpMy-N-7Vi%XB%HucBcgWFF!JAE8mp)NJ)AY)C8Ax&e9(zsoc2&%mo+LGfUpguDVtO+P7sPsdqJzsJiKF+BI2rUs$hvgWS!cDN%)x5d2YufrWYIEP-XU2N&HXo($k%PUIk+12fFqRWjBAeKgGYq6RfYMOnICxv&zZFIF2mwy-00&PbQENb0jvcq($aLtotET+big2J-0P1$meCioPqhlyOr3TFzHG09%lePSqF3ze8h1P9zV1ouQen7(0((nqiLnfd0S46XXZR8RV)LO5Bh&&fYH%YUyml9h(1WGnd0hE2*rAFzg94t2AUwBfi$ipG%0G8TFU1-6O29PkV#KAHFzYk6&L3$obvNynX$v2#2QUkAhymcU!N2%i5DWN+cQtb0-Ho$9Dmmx5GD6rSrtNJJKf001d!uTQa$Go$9X&buTgIVS7VZ7bONtLGhLDwxBGJG4r%MRa*aX1T87Tcppf)Mr8&#)kZP&ACyy%R*vej7Vt)-sP%AN9#C4bME1sNjni0!oG5HjCY)9v4z9UD-xT6gpHy0+)ApGVC75nZBFKl6mHQPDhX5zHbbkv-L+$HpbUw%)Yz*NDd2KPQ)58nCbDeC8WDSlV!A-A(+ovEJGFFXnbTYFy9+VeGDhDCv3GDjCCriY*3czASJQ*k+R(vyRiA5BrR&E!wPT2ArL#4c!z*lkEb9*5QXofu$!-&QAj4&%2q(X1HG31CKsX-$#kUp*z-8&&cQ$J(VmBoUFP5XapBXK4w+RR1LNqvvvxgaVj1DF(+xCS5L+Z5Di-grB#5$keho)XTLQwAhjXuKaCcMTuHnfn+MI0t+Qk%Bnqnxgw5vkNA5u(UXE%O+(n2%RuX8xAW)7)SWJLVXAiO6bGeiVJ7mKcey%+k(UGazyW%Sh67tf0mgXnkuRnXlUnyOPA1f224GKlEAaESWRIxnhjvWtlA5u+3FAWw6&F4wQv8ReYMSrUPe9E(rd9Qthg9-OYCERpQKH-B1y&N2E5yPp#cQdSoomtCK5Q#)SAC3G)*is)JO+aXE(T8nSGA$3G1wr%H&waifrKn$Bo6c-m%hg*n*D2j(U1mk2Wt9!i8F-IHQpIRWxbJ-k+$xbHS-FXmjY3&)LEKZp1Nshme#jp7w9PWySOoP$$TEn6$VY4Bgi#5Zb&7NZKdAMUW!(zGWjJP)DCCHbn-edtH1d-LZs3%G+Wbye-dDgdN7duSqMlX55FDcUDQ5xvaJbnZo!OTJ*x0EMhD$lYFu1yaCs%AfZmR9&3J6o*zVz&Hlj(de0-O*)B*%znz1MIj2gG4T5wX083J(oTt8AAm#pu!SpA77x9ui$sV7wXkZGDRh5k*3MZK5e3M85ZOCo4Up9c+mhSLaeKpqWmKLEz07f%1PXFyxHOcbRz$&wkw-AC$Q109ub$HkeZHjwupHE6kibuYyAgi%gcVNmrsv)mEoX!3fAIo-G2(pEhs59gSw1V2(qOlKiEW%bx6t9QVeomW(0$T4rWEt2ZvQUb(d&it&T%lI!17bgqH+Ery$N!CNrLEav0avYmWcTynrXhor5f#vLhl7Wvfqu1(J!eHOYepp5eus7uv$%rrPstNJX#pqdXC%OdkYlguSfZ)dLrL6m-)OBEXh5b&JuxtVYAue4Tiz(fKXgoDAsdeJgzF#&Bz!ObRFRj6sb+9M*QkZONQIzuv!E2haPI$K%Sel7J)795)#WY0p&SH8g%7TF6i9Ro80yxxA-Oh!YsUT95(%eB*cYh-TYyiB+ZxItZ5R#*MLkvvhY8Ue#5XpfrNB#6vx2-m+&ZA%QAh-TURyzgbTY(Qs1ENRuDjzWM)j(0M!Omd-gxiWW9T*$R2rQr6CDr(hjNAU!DJ5Y!bJiBR*bx!wfgCnm#-FI5$u1rDF+8iq38qW+0NxGmeDb3#E)##fYvvQDDRb%AumWB)zK0r(YcKFlSgIUOAC1R+M5M%6bjxFxoY&gXdFXw-n&f8yfv)N#eVj+SwbPfDK1za&gpvf8IVP+wxW72NhXGEW5c#8$9NJhDGv8L9F1A7XR#k+5Dx!Mb2hQ)0$KoAZ9a7h!gjxd9xj)q4kN1micru4d3#D-Tu1*(0FcSXUpHdIDhZ8PGX+WOn41sD6ExO!JNwj+KV!kQ&UfmEvG%EFCT4HhCJoC1V)I+TNo8FFj290tJSU!-vvDWk0v6qfIzXEK4RLS0oRaBX0vI4V#nl(6MUvUJU9ZkLx4Fzjh0-#qM*IKVacj#8R+j2Nw-8A4yhpD)(WrPYXgX&pj4HGlHMR6MGu2-sVam-%Ai1JTzkObogY7B7lQ&Npg9UdXDdvPnWsnB2DkFsX82H!%P5D7NiUeyGw3ojU#w*xHt&dipF#e*NC-VsRR7JtS0Opg3Jyimp9ov#BwjgGc20sN$Sf4rcOkT8&2YsaBzTCA*4oVs3Rc3)z3nfho#5SR4QKsvtg6FLXIdKnVkH&tvQbixcnwhu-LAaF#ri9-Rs$cf)qt0bUZocnSthfk2$VTJq$clKs*la0njFesqkDGjAONTtZxXghSRk2hSy0J%cQlEG43IrZAx5WQh87%RP)dOmI36F!r*faKTjnMM$4jdpY+tLl1FCfR!N7t&)!LTdKSPDlvP*43#wSSsKvRCQmhw&Hvsu)%%0iWbgx56D+A0N3sFy*g)M&iZb$I6L$DOATdj!l1tj$)pQ5dqg$flAgvpplIQFlFLC0t9e-$-nuHN$!UzKPsQJTCjNr-J27B$E$CS+R(Z5#*gPatHV1lPk34q02yrVSnBt1t$Y!-6kksNnGEj1dLAL-E&%3yLBeI%nidEsE4##3xBL3$s3J(5!7Whx*sylgWCHQ9mZiohDAxx$6)L&K+WM4Ej3v0pzF+kUjQjTd2*31njYC$Uhm3yVY3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