颅神经解剖一课件.pptx

颅神经基础

CranialNerves

王新明

CranialNerves:CentralandPeripheralConnections颅神经：中央与周围的联系视中枢：枕叶内侧面距状沟两侧的皮质

cranialnervei(olfactory)

第一对颅神经嗅神经CranialnerveIoriginatesfromsmallolfactoryreceptorsinthemucousmembraneofthenose.UnmyelinatedCNIfiberspassfromthesereceptorsinthenasalcavitythroughthecribriformplateoftheethmoidalboneandentertheventralsurfaceoftheolfactorybulb,wheretheyformthenerve.嗅神经起源于鼻腔粘膜小的嗅觉感受器无髓神经纤维连接嗅觉感受器受体及形成嗅束经过筛孔止于嗅球的腹侧表面

cranialnervei(olfactory)

第一对颅神经嗅神经Theolfactorytractrunsposteriorlyfromthebulb,beneaththefrontallobeofthebraininagroove(orsulcus)andlateraltothegyrusrectus(Fig3-2).Thegyrusrectusformstheanterolateralborderofthesuprasellarcistern.Meningiomasarisingfromthearachnoidcellsinthisareacanproduceimportantophthalmicsignsandsymptomsas-sociatedwithlossofolfaction嗅束中央区域的脑膜瘤会产生相应的眼科症状及嗅觉丧失临床外伤骨折可产生嗅觉丧失并伴有脑脊液漏

嗅球嗅束脑直回视神经视交叉前交叉动脉颈内动脉大脑中动脉后交通动脉视束大脑纵裂大脑前动脉额叶Inferior?surface?of?the?brain大脑下面观

骨孔、动脉、神经的关系前颅窝anterior?cranial?fossa视神经孔颈动脉孔后床突蝶鞍前床突眶上裂卵圆孔未闭合的卵圆孔颅中窝

cranialnerveii(opticnerve)第二对颅神经视神经Theopticnervemaybedividedintothefollowingtopographicareas视神经的区域划分：intraocularregionoftheopticnerve:opticdisc,ornervehead;prelaminararea;andlaminararea（球内段：视盘区、筛板前区、层流区）intraorbitalregion(locatedwithinthemusclecone)眶内段intracanalicularregion(locatedwithintheopticcanal)管内段intracranialregion(endingintheopticchiasm)颅内段至于视交叉

cranialnerveii(opticnerve)第二对颅神经视神经球内段眶内段管内段颅内段Theopticnervevariesinlengthfrom35to55mmandaverages40mm.最容易损伤：管内段。不易损伤眶内段视神经管损伤表现：RAPD眼眶病中的引申：三类疾病，外伤中视神经损伤最为严重血供了解

RAPD

临床病例

引申：视神经损伤的治疗1激素2扩血管3神经营养4视神经管减压、视神经鞘切开（黄金期：伤后72h，目前国内文献伤后28天手术仍有恢复可能性）

intraocularregion球内段Theopticnerveheadcanbedescribedin4parts：视神经乳头分为4部分：1.superficialnervefiberlayer浅层神经纤维区2.prelaminararea筛板前区3.laminararea层流区4.retrolaminararea筛板后区

Thelaminacribrosase