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目的观察寰枢椎与副神经及第2颈神经的解剖关系,以及观察胸锁乳突肌和斜方肌的神经支配特点,为寰枢关节错位致胸锁乳突肌和斜方肌疼痛提供解剖学依据。方法对3具共6侧成年人颈部尸体标本进行解剖,观察寰椎横突与副神经、寰枢外侧关节与第2颈神经前支、寰枢椎椎间孔外韧带的解剖结构,以及观察胸锁乳突肌和斜方肌的神经支配特点,测量副神经与寰椎横突尖的最短距离。结果(1)胸锁乳突肌和斜方肌均受副神经和颈丛(第2~4)神经支配,并且副神经与颈丛神经存在交通支联系。(2)副神经走行在寰椎横突前方,二者关系密切,副神经与寰椎横突尖的距离为4.84~7.60 mm(左侧)和3.22~6.80 mm(右侧)。(3)寰枢椎存在椎间孔外韧带,该韧带与第2神经相连,并附着在寰椎横突。(4)第2颈神经前支贴着寰枢外侧小关节向前走行。结论寰枢关节错位可能会刺激副神经及第2颈神经或其前支,从而引起胸锁乳突和斜方肌紧张、疼痛。
Objective To observe the anatomic relationship between atlantoaxial and accessory nerves and the second cervical nerve and to observe the innervation characteristics of the sternocleidomastoid and trapezius muscles and to provide sternocleidomastoid and trapezius muscles with atlantoaxial joint dislocation Anatomy basis. Methods A total of 6 adult cadaver heads were dissected to observe the anatomic structures of atlas transverse and accessory atlas, lateral atlantoaxial joint, anterior branch of second cervical nerve and atlantoaxial extra-vertebral foramen ligament. Observe the sternocleidomastoid and trapezius muscles of the innervation characteristics, measurement of accessory nerve and atlas vertebrae sharp tip shortest distance. Results (1) The sternocleidomastoid and trapezius muscles were all innervated by the accessory nerves and cervical plexus (No.2 ~ 4), and there were traffic connections between the accessory nerve and the cervical plexus. (2) The paranasal nerve runs in front of transverse atlas of the atlas, and the two are closely related. The distances between the accessory nerve and the atlas of the atlas are 4.84-7.60 mm (left) and 3.22-6.80 mm (right). (3) there is an extravertebral foramen atlantoaxial ligament, the ligament with the second nerve, and attached to the atlas transverse process. (4) The anterior branch of the 2nd cervical nerve adheres to the lateral joint of the atlantoaxial forearm. Conclusions The atlantoaxial joint dislocation may stimulate the nerve of the accessory nerve and the second cervical nerve or its anterior branch, causing the sternocleidomastoid and trapezius muscles to have tension and pain.