系解教程14周围神经.ppt

The vagus nerve is a mixed nerve. Its course is the longest and its distribution 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 vagal 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 vagal 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 to 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; transmits 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. accessory n. Cranial N. 小 结 脑神经的名称、顺序、性质、纤维成分、连脑部位、进出颅的部位及其他走行特点和分布概况。 连于端脑、间脑、中脑、脑桥、延髓的脑神经。 穿眶上裂、内耳道、颈静脉孔的脑神经。 面部的感觉和运动分别由哪些脑神经支配？如何分布？ 与眶、眼球、舌、喉、上、下颌牙及牙龈有关的脑神经有哪些？如何分布？ 四对副交感神经节的名称、位置 复习思考题 某病人左眼睑下垂，经检查发现：两眼向前直视时，左眼有外斜视，左眼瞳孔扩大；两眼向右方运动时，右眼活动正常，左眼不能向右转动；两眼向下运动时，右眼运动正常，左眼不能向下转动。试分析损伤哪条神经？如何解释上述现象。 中耳鼓室手术不慎伤及面神经与腮腺肿瘤手术不慎伤及面神经时，临床表现有何不同？为什么？ 下列功能障碍，提示什么神经受损？为什么？（1）不能耸肩；（2）伸舌时舌尖偏向右侧；（3）声音嘶哑；（4）张口时口角偏向右侧。 * * 运动神经 名称、起源、连脑部位、 走行特点、出颅部位、分布 中脑脚间窝 海绵窦 眶上裂 眶 躯体运动纤维 内脏运动纤维 眼球外肌（上斜肌、外直肌除外） 睫状神经节 睫状肌、瞳孔括约肌 Ⅲ动眼神经 oculomotor n. 一般躯体运动+一般内脏运动 Ⅲ动眼神经 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 obliquus. From the nerve to the inferior obliquus a short thick branch is given to the ciliary gang