系統(tǒng)解剖學(xué)周圍神經(jīng)

1、脊 神 經(jīng)Spinal Nerves,男，24歲，背部被刺傷，立刻跌倒，兩下肢失去運動。數(shù)日右腿稍能活動。又過一周后右下肢幾乎恢復(fù)了運動，但左下肢完全癱瘓。檢查發(fā)現(xiàn)：左下肢無隨意運動，腱反射亢進，Babinski征陽性。右側(cè)軀干胸骨劍突水平以下和右下肢痛、溫度覺喪失，但觸覺、位置和運動覺正常。左側(cè)軀干劍突以下和左下肢痛、溫度覺完好，但觸覺減弱，位置和運動覺喪失。,病例分析,腱反射亢進Babinski征陽性,左下肢完全癱瘓右下肢痛

2、、溫度覺喪失左下肢位置覺、運動覺喪失,上運動神經(jīng)元損傷,,背部被刺傷,,脊髓損傷,,左側(cè)皮質(zhì)脊髓束受損左側(cè)脊髓丘系受損左側(cè)薄束受損,T4胸髓左側(cè)半邊橫斷右側(cè)劍突以下痛溫度覺喪失,提問Answer questions,側(cè)角脊神經(jīng)節(jié),用模型說明及英文名稱,提問Answer questions,側(cè)角脊神經(jīng)節(jié)纖維束脊髓丘腦束,Nervous System,central N.S.,brain,spinal cord,,

3、peripheral N.S.,cranial n.,spinal n.,visceral n.,,,Spinal Cord,,2 enlargements: cervical, lumbar,1 cone: conus medullaris,6 grooves and fissure,2 groups of nerve roots anterior, posterior,31 segments C8

4、, T12, L5, S5, Co1,脊神經(jīng)的區(qū)分Classification,頸神經(jīng) cervical nerves胸神經(jīng) thoracic nerves腰神經(jīng) lumbar nerves骶神經(jīng) sacral nerves尾神經(jīng) coccygeal nerve,8對12對5對5對1對,脊神經(jīng)的組成 formation,,后根posterior root,前根anterio

5、r root,,脊神經(jīng)節(jié)spinal ganglion,,脊神經(jīng)spinal nerve,,,,,,脊神經(jīng)的纖維成分 Components,,,內(nèi)臟感覺纖維Visceral sensory fibers,,軀體感覺纖維Somatic sensoryfibers,,,,軀體運動纖維Somatic motor fibers,,內(nèi)臟運動纖維Visceral motor fibers,,,,脊神經(jīng)纖維成份,軀體感覺纖維soma

6、tic sensory fibers軀體運動纖維somatic motor fibers內(nèi)臟感覺纖維visceral sensory fibers內(nèi)臟運動纖維visceral motor fibers,→皮膚、骨骼肌和關(guān)節(jié) skin,skeletal muscles, joints,→心肌、平滑肌和腺體 cardiac muscles,smooth muscles,glands,,,,,脊神經(jīng)的分支 bran

7、ches,,后支posterior b.,,,前支anterior b.,,脊神經(jīng)節(jié)spinal ganglion,,脊神經(jīng)spinal nerve,,后根（感覺性）前根（運動性）,前支后支脊膜支交通支,椎間孔,脊神經(jīng)（混合性）,,,,,,,Anterior branch,Communicating branch,Posterior branch,Posterior root,脊神經(jīng)的分支 branches,,Anter

8、ior root,,Branches,后支posterior branches,人體后正中線附近的皮膚和肌具節(jié)段性,,前支anterior branch,軀干和前外側(cè)的皮膚和肌僅胸神經(jīng)具節(jié)段性,,頸叢 cervical plexus臂叢 brachial plexus胸神經(jīng) thoracic n.腰叢 lumbar plexus骶叢 sacral plexus,,Spinal nerves,There are 31 pa

9、irs of spinal nerves, which leave the spinal cord and pass through intervertebral foramina. Each spinal nerve is connected to the spinal cord by the anterior root and the posterior root. The anterior root consists of (so

10、matic, visceral) motor fibers. The posterior root consists of (somatic, visceral) sensory fibers. The cell bodies of those nerve fibers are situated in the spinal ganglion. So each spinal nerve is made up of a mixture of

11、 motor and sensory fibers.,Spinal nerves,After emerging through the intervertebral foramen, a typical spinal nerve immediately divides into four branches: the meningeal branch, communicating branch, posterior and anterio

12、r branches. Except in thoracic nerves T2 through T1, the anterior branches of the spinal nerves combine and then slit again to form four plexuses of spinal nerves which are the cervical, the brachial, the lumbar, and the

13、 sacral plexuses.,Composition: C1~4,Location： 胸鎖乳突肌 上部的深面,Cervical plexus,頸叢,淺支：Superficial branches,枕小N.,耳大N.,頸橫N.,鎖骨上N.,,,深支 deep branches→頸部大部分肌,,膈神經(jīng)( C3 ~ 5 )：phrenic n.,,,,Composition：C5~8 + T1,,,,,,

14、,,,C5,C6,C7,C8,T1,,,,,,,,,,,,,上干,下干,中干,,根,支,束,股,干,臂 叢 brachial plexus,Location：,,腋神經(jīng)axillary n.,后束→穿四邊孔→ 繞肱骨外科頸→三角肌深面分布,三角肌、小圓肌，肩部和臂外側(cè)上部皮膚,臂叢分支,肌皮神經(jīng) musculocutaneous n.,外側(cè)束→穿喙肱肌 →肱二頭肌深面至其外側(cè)緣→改名為前臂外側(cè)皮神經(jīng)（肘窩稍下方，穿深筋膜）,喙

15、肱肌、肱二頭肌、肱肌、前臂外側(cè)皮膚,,,,正中神經(jīng)median n.,外側(cè)束、內(nèi)側(cè)束→肱二頭肌內(nèi)側(cè)→穿過旋前圓?。ㄖ飧C）→指深、淺屈肌之間（前臂）→腕管→手掌,大部分前臂屈肌魚際（拇收肌例外）、1，2蚓狀肌,,,,尺神經(jīng)ulnar n.,內(nèi)側(cè)束→尺神經(jīng)溝→伴尺動脈下行（前臂）→腕關(guān)節(jié)近側(cè)5cm處分為手掌支、手背支,尺側(cè)腕屈肌、指深屈肌尺側(cè)半、小魚際肌、骨間肌、3，4蚓狀肌、拇收肌,橈神經(jīng)radial n.,,,,后束→腋動脈后方下

16、行→伴肱深動脈→橈神經(jīng)溝、肱肌與肱橈肌之間。,臂、前臂后群所有伸肌和肱橈肌; 臂、前臂后面皮膚。,,,手掌、背面神經(jīng)分布示意圖,正中神經(jīng),尺神經(jīng),橈神經(jīng),手部神經(jīng)分布手掌正中三指半，剩下尺側(cè)一指半；手背橈尺各一半，正中侵占三指半。,肋間神經(jīng)intercostal n.,肋下神經(jīng)subcostal n.,Thoracic Nerve,胸神經(jīng)前支,12對,T2 – 胸骨角平面T4 – 男性乳頭平面T6 – 劍突平面T8 – 肋

17、弓平面T10– 臍平面T12-恥骨聯(lián)合與臍 連線中點平面,腰叢,lumbar plexus,組成：部分T12 + L1~3+部分L4前支位置：腹后壁，腰大肌深面,閉孔神經(jīng)obturator n.,,,股神經(jīng) femoral n. 髂肌與腰大肌之間下行 → 腹股溝韌帶深面 → 股前部 → 隱神經(jīng)（終支）,髕下、小腿內(nèi)側(cè)面、足內(nèi)側(cè)緣皮膚,隱神經(jīng) saphenous n.,大腿前群肌,股神經(jīng) femoral n.,,閉孔神經(jīng)

18、 obturator n. 腰大肌內(nèi)側(cè)緣 → 循小骨盆側(cè)壁 → 穿閉膜管 → 出小骨盆 （前、后支）→ 股內(nèi)收肌群肌支：閉孔外肌、股內(nèi)側(cè)肌群皮支：大腿內(nèi)側(cè)面皮膚,,,骶叢,sacral plexus,組成：L4，5（腰骶干）+ S1~5 + Co1位置：盆腔后壁，骶骨及梨狀肌前方,臀上神經(jīng) superior gluteal n. 伴臀上動脈 → 梨狀肌上孔 → 臀中、 小肌、闊筋膜張肌 臀下神經(jīng) infe

19、rior gluteal n. 伴臀下動脈→ 梨狀肌下孔 → 臀大肌,,,骶叢分支,? 陰部神經(jīng) pudendal n.,伴陰部內(nèi)動脈 → 梨狀肌下孔 → 坐骨小孔 → 坐骨直腸窩 → 肛門、會陰肌、皮膚,坐骨神經(jīng) sciatic n.,梨狀肌下孔 → 坐骨結(jié)節(jié)、大轉(zhuǎn)子之間→大腿后面，股二頭肌深面 → 腘窩上方→ 脛神經(jīng)、腓總神經(jīng),,脛神經(jīng) tibial n.,腘窩正中→小腿后淺、深肌之間 →內(nèi)踝后方→足底內(nèi)、外側(cè)神經(jīng),小腿后

20、群肌、足底肌小腿后面、足底皮膚,腓總神經(jīng) common peroneal n.,股二頭肌內(nèi)側(cè)向外下→ 繞腓骨頸→ 穿腓骨長肌→ 腓淺神經(jīng)、腓深神經(jīng),腓淺神經(jīng) superficial peroneal n. 腓骨長、短肌及趾長伸肌間下行,腓深神經(jīng) deep peroneal n. 伴脛前動脈→ 脛骨前肌、趾長 伸肌間→ 脛骨前肌、mu長伸肌 間→ 足背,Spinal nerves,Spinal

21、 nerves：connected with the spinal cord by two roots.Thirty-one pairs of spinal nerves：8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal.The anterior （ventral） root ：motor (efferent) fibers from motor neuro

22、ns in the ventral horn of the spinal cord. The posterior （dorsal）root ：sensory （afferent） fibers of cells in the spinal ganglionThe anterior and posterior root： form a spinal nerve in the intervertebral foramen. The s

23、pinal nerve divides into four parts：anterior，posterior，communicating and meningeal branches.,Cervical plexus (C1 – 4) is located deep to the sternocleidomastoid muscle. The phrenic nerve is an important one.Brachial p

24、lexus (C5-T1) supplies nerves to the upper limb. Its five important branches: axillary, musculocutaneous, median, ulnar and radial nerve.,Thoracic nerves supply the skin of the thorax, the intercostal muscles, and the

25、 abdominal and back muscles. Lumbar plexuse (T12-L4) is behind the psoas major. We should pay attention to the following nerve: femoral, obturator nerve.Sacral plexuse (L4-Co) is located to the anterior surface of t

26、he pirifomis. We should pay attention to the following nerve: sciatic, common peroneal, tibial nerve.,The median nerve arises by two roots from the lateral and medial cord of the brachial plexus, which embrace the axilla

27、ry artery and descend with the brachial artery to the cubital fossa. Then it descends in front of the forearm and passes beneath the flexor retinaculum into the palm of the hand. It supply the most of the muscles in

28、front of the forearm except the brachioradialis, the flexor carpi ulnaris, the medial half of the flexor digitorum profundus，the thenar muscles except for the adductor pollicis and the first and second lumbrical muscl

29、es. Its cutaneous branches distribute to the skin of thenar, central part of the palm, the palmar aspect of the thumb, second, third and the lateral half of the fourth fingers, as well as the skin on the dorsum of the

30、 terminal phalanges.,The sciatic nerve leaves the pelvis through the greater sciatic foramen inferior to the piriformis. Then it descends along the posterior compartment of the thigh to enter the popliteal fossa, and ter

31、minates by dividing into the tibial and common peroneal nerves. The branches of the sciatic nerve supply the muscles of the foot, leg and the posterior compartment of the thigh. It also supplies the skin of the leg a

32、nd foot.,小 結(jié),上、下肢肌的神經(jīng)支配,脊神經(jīng)的四種纖維成分及與中樞的聯(lián)系，脊 神經(jīng)前根、后根、前支和后支的區(qū)別,頸、臂、腰、骶叢的組成、位置和重要分支， 各支的名稱、起始、走行特點（穿肌、貼骨、 表淺）和分布,胸神經(jīng)前支（肋間神經(jīng)與肋下神經(jīng)）行于肋下與胸腔穿刺的關(guān)系，胸神經(jīng)前支皮膚分布呈明顯的環(huán)帶狀節(jié)段性及其臨床意義,學(xué)習(xí)脊神經(jīng)時，注意聯(lián)系中樞、骨骼肌和血 管，注意穿肌、貼骨、淺表部位,復(fù)習(xí)思考題,脊神

33、經(jīng)前根與后根、前支與后支的區(qū)別。上、下肢主要神經(jīng)干的走行特點、分布范圍和易受損傷的部位。膝關(guān)節(jié)運動肌的神經(jīng)支配？,膝關(guān)節(jié)運動肌的神經(jīng)支配,屈 ?。嚎p匠肌，股二頭肌，半腱肌，半 膜肌，腘肌，腓腸肌伸 ?。汗伤念^肌旋外?。汗啥^肌旋內(nèi)?。嚎p匠肌，半腱肌，半膜肌，腘肌,Cranial Nerves,腦 神 經(jīng),鄭州大學(xué)解剖學(xué)教研室,腦神經(jīng)概述,名稱及序數(shù),Ⅰ嗅、Ⅱ視、Ⅲ動眼；

34、 Ⅳ滑、Ⅴ叉、Ⅵ外展； Ⅶ面、Ⅷ聽、Ⅸ舌咽； 迷、副、舌下神經(jīng)全。,嗅N,視N,動眼N,滑車N,展N,,,,三叉N,面N,前庭蝸N,舌咽N,迷走N,副N,舌下N,,,,,,,,,,,,,Cranial nerves,The 12 pairs of cranial nerves are attached to the brain and traverse openings in the s

35、kull. The cranial nerves : olfactory nerve (I), optic nerve (II), oculomotor nerve (III), trochlear nerve (IV), trigeminal nerve (V), abducent nerve (VI), facial nerve (VII), vestibulocochlear ne

36、rve (VIII), glossopharyngeal nerve (IX), vagus nerve (X), accessory nerve (XI), and hypoglossal nerve (XII).,纖維成分（七種）,一般內(nèi)臟運動纖維,特殊內(nèi)臟運動纖維,軀體運動纖維,內(nèi)臟運動纖維,運動纖維,,,,一般軀體感覺纖維,特殊軀體感覺纖維,一般內(nèi)臟感覺纖維,特殊內(nèi)臟感覺纖維,軀體感覺纖維,內(nèi)臟感覺纖維,,,感覺

37、纖維,,（嗅器、味器）,（位聽器、視器）,（咀嚼肌、面肌、咽喉肌）,腦神經(jīng)分類,感覺神經(jīng)：Ⅰ嗅神經(jīng)、Ⅱ視神經(jīng)、Ⅷ前庭蝸神經(jīng)運動神經(jīng)：Ⅲ動眼神經(jīng)、Ⅳ滑車神經(jīng)、Ⅵ展神經(jīng)、 Ⅺ副神經(jīng)、Ⅻ舌下神經(jīng)混合神經(jīng)：Ⅴ三叉神經(jīng)、Ⅶ面神經(jīng)、Ⅸ舌咽神經(jīng)、 Ⅹ迷走神經(jīng),含副交感纖維的神經(jīng)：Ⅲ動眼神經(jīng)、Ⅶ面神經(jīng)、Ⅸ舌咽神經(jīng)、Ⅹ迷走神經(jīng),,The cranial nerves provide input to the b

38、rain from (1) the special sense organs of smell (I), sight (II), hearing and balance (VIII), and taste (VII, IX and X); and (2) the general sensory receptors for pain and temperature, simple and fine to

39、uch, pressure, position sense, and vibration (V, VII, IX, and X). The cranial nerves convey output of the brain to the voluntary muscles concerned with movements of the head, eyes, mouth, face, tongue, p

40、harynx, and larynx. The cranial nerves are also the major outlet for the parasympathetic nervous system.,Cranial N.,顱底內(nèi)面觀,腦 Encephalon, Brain,端腦 telencephalon 間腦 diencephalon 中腦 mesencephalon后腦 metencephalon

41、 腦橋 pons 小腦 cerebellum 延髓 medulla oblongata,,,,,,,,感覺神經(jīng),名稱、起源、入顱部位、連腦部位、傳導(dǎo)沖動,上鼻甲上部、鼻中隔上部粘膜內(nèi)嗅細(xì)胞,篩孔cribriform foramen,,嗅球olfactory bulb,Ⅰ嗅神經(jīng) olfactory n.,,Ⅱ視神經(jīng) optic n.,視網(wǎng)膜中的節(jié)細(xì)胞,視神經(jīng)盤optic disc,視神經(jīng),,視神經(jīng)管optic

42、canal,視交叉,,Ⅷ前庭蝸神經(jīng) vestibulocochlear n.,壺腹嵴 球囊斑橢圓囊斑,前庭神經(jīng)節(jié),,前庭神經(jīng),螺旋器,蝸神經(jīng)節(jié),,蝸神經(jīng),,內(nèi)耳門internal acoustic pore,,腦橋延髓溝,,,,,運動神經(jīng),名稱、起源、連腦部位、走行特點、出顱部位、分布,中腦腳間窩,,海綿竇,眶上裂,眶,,軀體運動纖維,,內(nèi)臟運動纖維,,,,眼球外?。ㄉ闲奔　⑼庵奔〕猓?睫狀神經(jīng)節(jié),,睫狀肌、瞳孔括約肌,,,

43、Ⅲ動眼神經(jīng) oculomotor n.,Ⅲ動眼神經(jīng) oculomotor n.,,It enters the orbit through the superior orbital fissure and supplies the superior rectus, the levator palpebrae superioris, the inferior rectus, medial rectus and inferior obliqu

44、us.,From the nerve to the inferior obliquus a short thick branch is given to the ciliary ganglion. This branch contains the parasympathetic（副交感） preganglionic fibers, which pass in the short ciliary nerves to the sphin

45、cter pupillae.,The oculomotor nerve is a motor nerve.,Ⅳ滑車神經(jīng) trochlear n.,中腦背側(cè),,繞大腦腳,,海綿竇,,眶上裂,,眶,,上斜肌,,Ⅵ展神經(jīng) abducent n.,海綿竇,,,外直肌,,眶上裂,眶,延髓腦橋溝,,,眼外肌神經(jīng)支配,,,,,,,展神經(jīng),滑車神經(jīng),動眼神經(jīng),,,,Oculomotor paralysis,Abducent nerve injury,Ⅺ

46、副神經(jīng) accessory n.,延髓根纖維,,,頸靜脈孔,延髓根、脊髓根,脊髓根纖維,,,迷走神經(jīng),,咽喉肌,斜方肌胸鎖乳突肌,,,,,,,,,,Ⅻ舌下神經(jīng) hypoglossal n.,延髓前外側(cè)溝,,舌下神經(jīng)管,頸內(nèi)動靜脈之間,,舌神經(jīng)下方,,,穿頦舌肌,,舌內(nèi)、外肌,,混合神經(jīng),名稱、性質(zhì)、走行、分支、分布,Ⅴ三叉神經(jīng) trigeminal n.,腦橋腹側(cè)與腦橋臂交界處,,三叉神經(jīng)節(jié),,,,眼神經(jīng),上頜神經(jīng),下頜神經(jīng),,V

47、三叉神經(jīng) trigeminal n.（混合性）,眼神經(jīng) ophthalmic n.,,,海綿竇,眶上裂superior obitalfissure,眶 orbit,淚腺N、鼻睫N、額N,淚腺、眼瞼、眼球、篩竇、鼻腔粘膜及鼻背、額部皮膚,,,,,,,眶內(nèi)神經(jīng):Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ,V 三叉神經(jīng) trigeminal n.（混合性）,,,上頜神經(jīng) maxillary n.,海綿竇,眼裂和口裂間皮膚、上頜牙及鼻、口腔粘膜,眶下N、顴N、

48、上牙槽N、翼腭N,,圓孔foramen rotundum,翼腭窩,眶下裂,眶,,下頜神經(jīng) mandibular n.,經(jīng)卵圓孔,,翼外肌深面,,,,,耳顳N,咀嚼肌N,舌N,下牙槽N,,下頜孔,下頜管,,,頦孔,頦N,舌前2/3及口腔底粘膜,,頰N,,耳顳區(qū)皮膚,下頜牙、牙齦,,,頰部皮膚和粘膜,,口裂以下皮膚,,三叉神經(jīng)及其分支,VII 面神經(jīng) facial n. （混合性）,延髓→內(nèi)耳門internal a

49、coustic pore→內(nèi)耳道m(xù)eatus→面N管→莖乳孔stylomastoid foramen →穿腮腺→面部,,膝神經(jīng)節(jié),,,Ⅶ 面神經(jīng) facial n.,顱外的分支（穿腮腺實質(zhì)）,,,,顳支,,,顴支,頰支,下頜緣支,頸支,Injury to the facial nerve,鼓索 chorda tympani,面神經(jīng)管,副交感纖維 --＜下頜下神經(jīng)節(jié)→ 下頜下腺、舌下腺,舌神經(jīng) lingual n.,顳下窩,鼓室ty

50、mpanic cavity,,,VII 面神經(jīng) facial n. （混合性）,,submandibular g.,,味覺纖維 舌前2/3味蕾,,,巖鼓裂,巖大N（副交感纖維）,面N管,淚腺、腭及鼻 粘膜的腺體,∧翼腭神經(jīng)節(jié),翼腭窩,巖大N裂孔,,,VII 面神經(jīng) facial n. （混合性）,,pterygopalatine g.,,,破裂孔,顱底外,翼管,IX 舌咽神經(jīng) glossopharyngeal n.（混合性）

51、,走行延髓→頸V孔→頸內(nèi)A、V之間→弓形向前→舌根,分支 舌支→舌后1/3粘膜和味蕾 咽支→咽肌 頸A竇支→頸A竇、頸A小球 鼓室N tympanic n.,,鼓室N →鼓室叢→巖小N ＜耳N節(jié)→耳顳N →腮腺 咽、咽鼓管、鼓室,,,鼓室Ntympanic n.,鼓室N →鼓室叢→巖小N ＜耳N節(jié)→耳顳N →腮腺

52、 咽、咽鼓管、鼓室,,,鼓室Ntympanic n.,Ⅹ迷走神經(jīng)vagus n.,頸內(nèi)A.V.之間后方,,,頸靜脈孔,延髓,左迷走神經(jīng),右迷走神經(jīng),,主動脈弓前方,左肺根后方,,食管前叢,,,前干,,鎖骨下動脈前方,,右肺根后方,,食管后叢,,后干,,膈食管裂孔,,,膈食管裂孔,胃后支，腹腔支,胃前支，肝支,,,1.喉上神經(jīng)→環(huán)甲肌、聲門裂 以上喉粘膜及會厭、舌根等2.咽支→咽腭肌、咽粘膜3.頸心支→心叢、

53、主A神經(jīng)4.喉返 recurrent laryngeal N 右側(cè)繞鎖骨下A、左側(cè)繞主A 弓→頸部氣管、食管間→喉 肌、聲門裂以下喉粘膜5.支氣管支和食管支 6.胃前支→胃前半7.肝支:隨肝固有A8.胃后支→胃后半9.腹腔支:隨不成對臟支,X 迷走神經(jīng)分支,,左迷走神經(jīng),右迷走神經(jīng),喉返 N,,,,,1.喉上神經(jīng)→環(huán)甲肌、聲門裂 以上喉粘膜及會厭、舌根等2.咽支→咽腭肌、咽粘膜3.頸心支→心

54、叢、主A神經(jīng)4.喉返 recurrent laryngeal N 右側(cè)繞鎖骨下A、左側(cè)繞主A 弓→頸部氣管、食管間→喉 肌、聲門裂以下喉粘膜5.支氣管支和食管支 6.胃前支→胃前半7.肝支:隨肝固有A8.胃后支→胃后半9.腹腔支:隨不成對臟支,X 迷走神經(jīng)分支,,The vagus nerve is a mixed nerve. Its course is the longest and its d

55、istribution is the most extensive in the cranial nerves. It leaves the skull through the jugular foramen. The left vagus nerve forms the left pulmonary plexus, anterior part of the esophageal plexus and the anterior vag

56、al trunk at the lower part of the esophagus. The right vagus nerve forms the posterior part of the esophageal plexus and the posterior vagal trunk at the inferior part of the esophagus.,The anterior and posterior vaga

57、l trunks enter the abdominal cavity through the esophageal hiatus of the diaphragm and are divided into their terminal branches near the cardia of the stomach. The fibers of the vagus nerve carry somatic motor impulses t

58、o pharynx and larynx and sensory fibers from same structure. The very large portion is composed of parasympathetic motor fibers, which supply heart muscles, smooth muscles and glands of abdominal visceral organs; transmi

59、ts sensory impulses from viscera.,Through cavernous sinus and superior orbital fissure:,Oculomotor n.Trochlear n. Abducent n.Ophthalmic n.,Cranial N.,Through jugular foramen:glossopharyngeal n. vagus n.accessor

60、y n.,Cranial N.,小 結(jié),腦神經(jīng)的名稱、順序、性質(zhì)、纖維成分、連腦部位、進出顱的部位及其他走行特點和分布概況。連于端腦、間腦、中腦、腦橋、延髓的腦神經(jīng)。穿眶上裂、內(nèi)耳道、頸靜脈孔的腦神經(jīng)。面部的感覺和運動分別由哪些腦神經(jīng)支配？如何分布？與眶、眼球、舌、喉、上、下頜牙及牙齦有關(guān)的腦神經(jīng)有哪些？如何分布？四對副交感神經(jīng)節(jié)的名稱、位置,復(fù)習(xí)思考題,某病人左眼瞼下垂，經(jīng)檢查發(fā)現(xiàn)：兩眼向前直視時，左眼有外斜視，左眼瞳孔擴