三院-耳鼻喉鼻應用解剖

鼻及鼻竇解剖吉林大學第三醫(yī)院耳鼻咽喉頭頸外科峰Dr

Anlifeng鼻的解剖

Anatomy

of

nose外鼻external

nose鼻腔nasal鼻竇sinuses外鼻External

nose鼻根Nasal

root鼻梁Nasal

bridge鼻尖Nasal

apex鼻小柱Columella

nasi鼻背Nasal

dorsum鼻翼Alae

nasi前鼻孔Anterial

nares外鼻支架鼻骨鼻外側軟骨鼻中隔軟骨大翼軟骨鼻翼的結締脂肪組織上頜骨

顴骨眶下孔眶上孔淚骨上頜骨額突額骨鼻部外鼻皮膚特點上薄松下厚緊多腺體痤瘡酒渣鼻鼻癤疼痛外鼻靜脈回流特點沒有靜脈瓣雙向流動內眥V面前V面總V頸內V內眥V眼上下V海綿竇鼻腔Nasal前鼻孔anterior

naris后鼻孔posterior

naris鼻中隔nasal

septum鼻閾limen

nasi鼻nasal

vestibule皮膚特點鼻毛腺體連接緊癤痛固有鼻腔nasal

fossa

proper頂壁：鼻骨額骨鼻突蝶竇前壁篩骨水平板底壁：硬腭內側壁外側壁前鼻孔后鼻孔鼻中隔鼻中隔軟骨篩骨垂直板犁骨外側壁下鼻甲Inferior

turbinate下鼻道Inferior

meatus

nasi中鼻甲Middle中鼻道Middle上鼻甲Surperior上鼻道Surperior中鼻道Middle

meatus鉤突uncinate

process半月裂孔semilunarhiatus篩泡ethmoid

bulla額竇frontal

sinus前組篩竇ethmoud

sinus上頜竇maxillary

sinus鼻道竇口復合體Ostiomeatal

complex

OMC篩漏斗及鄰近結構，包括鉤突、篩泡、半月裂孔、篩房、上領竇自然口、鼻囪門、中鼻甲竇口鼻竇復合體的通氣和是發(fā)生各鼻竇慢性炎癥的主要原因粘膜mucous

membrane嗅區(qū)olfactory

region假復層無纖毛柱狀上皮，由支持細胞、基細胞

及嗅細胞組成呼吸區(qū)respiratory

region纖毛朝向鼻咽方向擺動血管頸內A-眼動脈ophthalmic

artery頸外A-上頜內動脈internal

maxillaryartery區(qū)little’s

area篩前篩后上唇鼻中隔后腭大鼻-鼻咽靜脈叢woodruff’s

plexus鼻竇額竇frontal

sinus篩竇ethmoid

sinus上頜竇maxillary

sinus蝶竇sphenoid

sinus鼻竇前組鼻竇：額竇中鼻道前組篩竇中鼻道上頜竇中鼻道后組鼻竇：后組篩竇上鼻道蝶竇蝶篩隱窩鼻竇上頜竇maxillary

sinus前壁(面壁):尖牙窩,眶下孔后外壁:翼腭窩,顳下窩,翼內肌內壁(鼻腔外壁):中鼻道后部有上頜竇裂孔上壁(上頜骨眶板):眶底內側部底壁(牙槽突):低于鼻底上頜竇解剖特點發(fā)育最早竇腔最大(容積13ml)竇底低竇口高竇口在中鼻道外壁的位置—最后最低與牙齒關系密切765567鼻竇發(fā)育SinusDevelopment篩竇ethmoid

sinus前組開口中鼻道Middle

meatus后組開口上鼻道Surperior

meatus額竇frontal

sinus蝶竇sphenoid

sinus蝶竇spenoid

sinusHaller氣房泡狀中鼻甲鼻腔的生理功能呼吸

鼻阻力nasal .鼻周期nasal

cycle過濾清潔鼻毛.噴嚏反射.粘液毯.纖毛.抗體加溫加濕海綿狀血竇33～35℃腺體濕度98%.鼻腔每天

液體1000ml反射鼻肺反射噴嚏反射共鳴嗅覺識別

食欲情緒和免疫鼻腔的生理功能呼吸鼻阻力nasal.鼻周期nasal

cycle加溫加濕海綿狀血竇33～35℃腺體濕度98%鼻腔每天

液體1000ml嗅覺識別食欲情緒鼻腔的生理功能過濾清潔鼻毛噴嚏反射粘液毯抗體鼻竇的生理功能共鳴減輕頭顱重量FESSFunctional

endoscopic

sinus

surgery徹底清除不可逆病灶糾正鼻腔鼻竇解剖學異常暢通竇口鼻道復合體和各竇的竇口保留竇內粘膜和中鼻甲等生理功能Messerklinger

techniqueThe

Messerklinger

technique

is

a

primarilydiagnostic

endoscopic

concept

demonstratingthat

the

frontal

and

the

maxillary

sinuses

aresubordinate

cavities.

Disease

usually

starts

in

thenose

and

spreads

through

the

ethmoidalprechambers

to

t