系统解剖学英文阅读材料.doc

The cervical plexus Formation and location of the cervical plexus The cervical plexus is formed by union of the anterior branches of the first four cervical nerves (C1-C4) and a portion of C5 (Fig.18-2). It lies deep to the sternocleidomastiod muscle, on the levator scapulae and scalenus medius. Branches of the cervical plexus are divided into superficial (cutaneous) and deep branches. Branches of the cervical plexus Superficial branches They emerge around the middle of the posterior border of the sternocleidomastoid muscle and supply the skin of the neck and scalp (Fig 18-3). In a cervical plexus block, an anesthetic agent is injected at several points along the posterior border of the sternocleidomastoid muscle, mainly at its midpoint. The superficial branches are as follows: The lesser occipital nerve (C2) It ascends along the posterior border of the sternocleidomastoid muscle and supplies the skin of the neck and scalp posterosuperior to the auricle. The great auricular nerve (C2-3) It ascends across the sternocleidomastoid muscle onto the parotid gland and supplies the skin over the parotid gland and around the auricle. The transverse nerve of neck, or transverse cervical nerve (C2-3) It curves around the middle of the posterior border of the sternocleidomastoid muscle and passes forward across it. It supplies the skin on the anterior and lateral surfaces of the neck. The supraclavicular nerves (C3-4) They emerge from beneath the posterior border of the sternocleidomastoid muscle and descend across the side of the neck. They are divided into the medial, intermediate and lateral supraclavicular nerves and supply the skin over shoulder as well as the upper portion of the chest. Deep branches They supply the deep muscles of the neck, levator scapulae, infrahyoid muscles and diaphragm. The most important branch is the phrenic nerve. Fibers from the third, fourth, and fifth cervical nerves unite to become the phrenic nerve (Fig18-4). The nerve descends across the f