医学英语学习—颈筋膜及筋膜间隙

Fascial Layers of the Neck

颈筋膜层

Fascia is an internal connective tissue which forms bands or sheets that surround and support muscles, vessels and nerves in the body.

筋膜是一种内部结缔组织，它形成束状或片状包绕和支持体内的肌肉、血管和神经。

In the neck, these layers of fascia not only act to support internal structures, but also help to compartmentalise structures of the neck. There are two fascias in the neck – the superficial cervical fascia and the deep cervical fascia.

在颈部，这些筋膜层不仅支持内部结构，而且帮助划分颈部结构。颈部有两层筋膜:颈浅筋膜和颈深筋膜。

In this article, we shall look at the anatomy of the fascial layers of the neck–their attachments, anatomical relationships and their clinical relevance.

在这篇文章中，我们将观察颈筋膜层的解剖-它们的附着，解剖关系和临床意义。

Superficial Cervical Fascia

颈浅筋膜

The superficial cervical fascia lies between the dermis and the deep cervical fascia. It contains numerous structures:

颈浅筋膜位于真皮层和颈深筋膜之间。它包含许多结构:

Neurovascular supply to the skin

皮肤的神经血管供应

Superficial veins (e.g. the external jugular vein)

浅静脉(如颈外静脉)

Superficial lymph nodes

浅表淋巴结

Fat

脂肪

Platysma muscle

颈阔肌

Platysma

颈阔肌

The superficial cervical fascia blends with the‘paper thin’platysma muscle. The platysma is a broad superficial muscle which lies anteriorly in the neck.

颈浅筋膜与“纸一样薄”的颈阔肌附在一起。颈阔肌是一块宽阔的浅表肌，位于颈前部。

It has two heads, which originate from the fascia of the pectoralis major and deltoid. The fibres from the two heads cross the clavicle, and meet in the midline, fusing with the muscles of the face. Superiorly, the platysma inserts into the inferior border of the mandible.

它有两个起点，起源于胸大肌和三角肌表面的筋膜。来自两个起点部位的纤维穿过锁骨，在中线处交叉，与面部的肌肉融合，并向上伸入下颌骨的边缘。

Innervation to the platysma is via the cervical branch of the facial nerve.

颈阔肌的神经支配是面神经的颈支。

Deep Cervical Fascia

颈深筋膜

The deep cervical fascia lies, as its name suggests,‘deep’ to the superficial fascia and platysma muscle. This fascia is organised into several layers. These layers act like a shirt collar, supporting the structures and vessels of the neck.

颈深筋膜，顾名思义，位于浅筋膜和颈阔肌的“深处”。颈深筋膜被分为几层。这些层次就像衬衫领子一样，支撑着颈部的结构和血管。

We shall now look at the layers of the deep cervical fascia in more detail (superficial to deep):

现在我们将更详细地看一下颈深筋膜的各层(从浅到深):

Investing Layer

封套筋膜层（颈深筋膜浅层）

The investing layer is the most superficial of the deep cervical fascia.

封套筋膜层是颈深筋膜的最浅层。

It surrounds all the structures in the neck. Where it meets the trapezius and sternocleidomastoid muscles, it splits into two, completely surrounding them.

它包围了颈部的所有结构。在与斜方肌和胸锁乳突肌相汇处一分为二，完全包围着它们。

The investing fascia can be thought of as a tube; with superior, inferior, anterior and posterior attachments:

封套筋膜可以被认为是一个管状结构;有上、下、前和后附着:

Superior – attaches to the external occipital protuberance and the superior nuchal line of the skull.

上-附着于枕外隆突和枕骨上项线。

Anteriorly – attaches to the hyoid bone.

前-与舌骨相连

Inferiorly – attaches to the spine and acromion of the scapula, the clavicle, and the manubrium of the sternum.

下-附着于脊柱和肩胛骨的肩峰，锁骨和胸骨柄。

Posterior – attaches along the nuchal ligament of the vertebral column

后-附着于脊柱的颈韧带。

Pretracheal Layer

气管前层（颈深筋膜中层）

The pretracheal layer of fascia is situated in the anterior neck. It spans between the hyoid bone superiorly and the thorax inferiorly (where it fuses with the pericardium).

气管前筋膜层位于颈前。向上跨越舌骨，向下跨越胸廓(与心包融合)。

The trachea, oesophagus, thyroid gland and infrahyoid muscles are enclosed by the pretracheal fascia. Anatomically, it can be divided into two parts:

气管前筋膜包裹着气管、食管、甲状腺和舌骨下肌。解剖学上可分为两部分:

Muscular part – encloses the infrahyoid muscles.

肌肉层/壁层-包括舌骨下肌群。

Visceral part – encloses the thyroid gland, trachea and oesophagus.

脏层-包绕甲状腺，气管和食管。

The posterior aspect of the visceral fascia is formed by contributions from the buccopharyngeal fascia (a fascial covering of the pharynx).

脏层的后部是由咽筋膜(覆盖咽的筋膜)形成的。

Prevertebral Layer

椎前筋膜层（颈深筋膜深层）

The prevertebral fascia surrounds the vertebral column and its associated muscles; scalene muscles, prevertebral muscles, and the deep muscles of the back.

椎前筋膜包绕着脊柱及其相关肌肉;斜角肌，椎前肌，以及背部的深层肌肉。

It has attachments along the antero-posterior and supero-inferior axes:

它在前后轴和上下轴上有附着物

Superior attachment – base of the skull.

上附着点-颅底。

Anterior attachment – transverse processes and vertebral bodies of the vertebral column.

前附着点-脊柱的横突和椎体。

Posterior attachment – along the nuchal ligament of the vertebral column

后附着点-沿脊柱的颈后韧带

Inferior attachment – fusion with the endothoracic fascia of the ribcage.

下附着点-与胸内筋膜融合。

The anterolateral portion of prevertebral fascia forms the floor of the posterior triangle of the neck. It also surrounds the brachial plexus as it leaves the neck and subclavian artery as it passes through the lower neck region – in doing so, it forms the axillary sheath.

椎前筋膜的前外侧部分构成颈后三角的底。并向外下方伸展，包绕锁骨下动、静脉及臂丛延入腋窝，形成腋鞘。

Carotid Sheath

颈动脉鞘

The carotid sheaths are paired structures on either side of the neck, which enclose an important neurovascular bundle of the neck.

颈动脉鞘是位于颈部两侧的成对结构，包裹着颈部重要的神经血管束。

The contents of the carotid sheath are:

颈动脉鞘的内容物有：

Common carotid artery

颈总动脉

Internal jugular vein.

颈内静脉

Vagus nerve.

迷走神经

Accompanying cervical lymph nodes.

伴行的颈部淋巴结

The fascia of the carotid sheath is formed by contributions from the pretracheal, prevertebral, and investing fascia layers. The carotid artery bifurcates within the sheath into the external and internal carotid arteries.

颈动脉鞘的筋膜是由气管前筋膜层、椎前筋膜层和封套筋膜层组成的。颈总动脉在鞘内分为颈外动脉和颈内动脉。

The carotid fascia is organised into a column, which runs between the base of the skull to the thoracic mediastinum. This is of clinical importance as a pathway for the spread of infection.

颈动脉筋膜组织成一柱，在颅底和胸纵隔之间。作为感染扩散的途径具有重要的临床意义。

Clinical Relevance: Fascial Spaces of the Neck

颈筋膜间隙的临床意义

The neck fascia compartmentalises structures within the neck. These layers of tough fascia can limit the spread of infection (for example, a superficial skin abscess may be prevented from spreading deeper into the neck by the investing fascia).

颈筋膜将颈部内的组织分隔开来。这些坚韧的筋膜层可以限制感染的扩散（例如，浅表皮肤脓肿可以通过封套筋膜阻止扩散到更深的颈部）。

However, infections that reach the potential spaces between the neck fascia have a well-defined spread:

然而，到达颈部筋膜之间潜在间隙的感染即有明确的扩散:

Retropharyngeal space – located between the buccopharyngeal fascia (posterior aspect of the visceral pretracheal fascia) and the prevertebral fascia.

咽后间隙-位于颊咽筋膜（气管前筋膜的后侧）和椎前筋膜之间。

Extends from the base of the skull to the posterior mediastinum.

从颅底延伸到后纵隔。

Visceral space – enclosed by the visceral pretracheal fascia.

内脏间隙-由气管前筋膜包围。

Extends from the hyoid bone to the superior mediastinum.

从舌骨延伸到上纵隔。

除此之外，还有胸骨上间隙，椎前间隙，危险间隙（第四间隙）。

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