The boundary and division of lateral skull base, along suborbital fissure and petrooccipital fissure, is the extension line of the lower part of skull, and the inward angle is at the top of nasopharynx.
They point outward to the cheekbone and the posterior margin of mastoid respectively, and the intersection angle of the two lines is about 90 degrees. The triangular area between the two lines is called the lateral skull base. The lateral skull base is divided into six regions according to the main structure: ① Nasopharyngeal region: also called pharyngeal region.
The boundary is the line between the pharyngeal wall and the skull base, and the parapharyngeal recess is the pharyngeal recess. Adjacent to levator veli palatini and inferior carotid orifice, along the bottom wall of carotid canal to the medial pterygoid plate, and then to the anterior edge of occipital condyle and foramen magnum.
② Eustachian tube area: On the outside of nasopharyngeal area, it is the attachment of eustachian tube bone and tensor eustachian tube (levator palatini and tensor veli palatini), and the navicular fossa formed at the base of pterygoid process is in front. ③ Neurovascular area: There are external orifice of internal carotid artery, jugular foramen, hypoglossal foramen and stylomastoid foramen behind the eustachian tube area.
④ Auditory area: the tympanic part of the temporal bone, with styloid process in the posterior boundary and petrosal fissure in the anterior boundary, through which the chorda tympani nerve and the anterior tympanic artery pass. ⑤ Joint area: There is mandibular condyle in the temporomandibular joint capsule bounded by the attachment line.
⑥ Subtemporal region: between the eustachian tube region and the joint region, it is equivalent to the middle cranial fossa, with infraorbital fissure in front, infratemporal crest on the outside and styloid process on the inside. There are foramen ovale and spinous foramen in the area, and the boundary and division of the skull base on the sphenoid ridge behind the spinous foramen: 1. Subtemporal region 2. Eustachian tube region 3. Nasopharyngeal region 4. Temporomandibular joint area 5. Auditory area 6. Neurovascular area. Vascular nerve of lateral skull base 1. Anatomical structures of vascular nerves in jugular foramen include internal jugular vein, inferior petrosal sinus, meningeal branch of occipital artery, meningeal branch of ascending pharyngeal artery, glossopharyngeal nerve (ⅸ), vagus nerve (X), accessory nerve () and other important structures.
The anatomical structure of this area is complex and has important clinical significance. The internal jugular vein is connected with the sigmoid sinus at the jugular foramen, where the internal jugular vein expands to form an upward bulging spherical structure called jugular bulb.
Adjacent relationship of jugular bulb: ① The upper part is adjacent to the inner end of external auditory canal, middle ear, lower arm of posterior semicircular canal, vestibule and outer end of internal auditory canal. ② The anterior part of jugular bulb is adjacent to internal carotid artery, cochlear aqueduct, inferior petrosal sinus, meningeal branch of ascending pharyngeal artery, cranial nerves ⅶ, X, ⅶ and posterior meningeal artery.
③ The posterior part is adjacent to the horizontal segment of sigmoid sinus. ④ The medial side is adjacent to the occipital base plate.
⑤ The lateral side is adjacent to the vertical segment (mastoid segment) of facial nerve. ⑥ The jugular vein moves downwards to act as the internal jugular vein.
2. The petrous part of the internal carotid artery passes through the periosteum-covered internal carotid artery tube and is located in the petrous part of the temporal bone, with its external opening in front of the jugular foramen and its internal opening at the petrous tip. The internal carotid artery is easily separated from the connective tissue in carotid canal, except that there is a dense fibrous band in its population, which makes it fixed with petrous bone and difficult to separate.
The petrosal part of the internal carotid artery is vertical (or ascending) and horizontal. The vertical segment is adjacent to jugular fossa in the back, eustachian tube in the front, and tympanic bone in the front and outside. The horizontal segment starts from the knee, goes forward to the anterior medial side of the cochlea, reaches the petrous apex, and passes through the petrous bone.
Separated from the cochlea by a thin bone plate. The medial part of the top wall of the horizontal segment is formed by dura mater or thin bone plate, which separates the internal carotid artery from the trigeminal ganglion.
3. Middle meningeal artery The middle meningeal artery generally originates from the internal maxillary artery, passes through the spinous foramen, runs along the dura mater, branches out and distributes in most areas of the dura mater. 4. The oculomotor nerve, trochlear nerve and abducens nerve are located in the anterolateral part of the posterior clinoid process, that is, they pass through the dural cavernous sinus at the forefront of the posterior clinoid process and the free edge of the tentorium cerebelli.
The trochlear nerve passes through the dura mater just behind the posterior clinoid process and just below the free edge of the tentorium cerebelli. Abducens nerve starts at the junction of pons and medulla oblongata, reaches the front of pons, passes through petrous apex and enters cavernous sinus.
These three pairs of motor nerves pass through the cavernous sinus and then through the supraorbital fissure. The oculomotor nerve innervates levator palpebral muscle, superior rectus muscle, medial rectus muscle, inferior rectus muscle and inferior oblique muscle, in which sympathetic and parasympathetic nerve fibers innervate mydriasis muscle and sphincter muscle through ciliary ganglion respectively.
What is the inclination of the trochlear nerve? Nbsp5. Trigeminal nerve Trigeminal nerve is the largest of all cranial nerves except optic nerve. The sensory root of trigeminal nerve is connected with trigeminal ganglion.
The motor root is located in the deep layer of trigeminal ganglion. The posterior edge of the ganglion is depressed, connected with the sensory root, and the anterior edge is raised, giving off the ophthalmic nerve, maxillary nerve and mandibular nerve.
The oculomotor nerve innervates the skin above fissure, lacrimal gland, mucosa in front of nasal cavity and skin in lower part of nasal dorsum. The maxillary nerve innervates the sensation of skin, mucosa and teeth in the range below the palpebral fissure and above the oral fissure.
Mandibular nerve is a kind of mixed nerve, which dominates the sensation of the skin below the oral fissure, temporal skin, oral mucosa, mandibular teeth and so on. It also dominates the movement of masseter muscle, temporal muscle, medial pterygoid muscle and lateral pterygoid muscle. Trigeminal neuralgia most often invades maxillary nerve and mandibular nerve.
The pterygoid space, infratemporal fossa and pterygopalatine fossa were 1. The pterygoid space is located beside the pharynx, and its inner side is adjacent to nasopharynx and oropharynx. The lateral mandibular branch, deep lobe of parotid gland and styloid mandibular ligament; The upper boundary is the middle cranial fossa, including the sphenoid wing, infraorbital fissure, foramen ovale, spinous foramen, carotid canal, jugular vein, temporomandibular joint fossa and transverse process of upper cervical vertebra; The lower bound is the posterior abdomen of digastric muscle and submandibular gland. There are pterygoid muscle, maxillary and mandibular branches of trigeminal nerve, internal maxillary artery, facial nerve, styloid process and its ligaments and muscles in the pterygoid space.
2. The infratemporal fossa is an irregular cavity behind the maxilla and a part of pterygoid space. The upper boundary is the same as the wing clearance; The lower bound is the medial pterygoid muscle; The inner boundary is the wing outer plate; The lateral upper part is the inferior temporal crest and the lower part is the mandibular branch; The anterior part is the posterior outer wall of maxilla and buccal muscle; The posterior part is levator palatini, tensor palatini and sphenomandibular ligament.
There are lateral pterygoid muscle, medial pterygoid muscle, pterygoid vein plexus, chorda tympani nerve, mandibular branch of trigeminal nerve and maxillary artery branch in the infratemporal fossa. The lateral pterygoid muscle starts from the underside of the sphenoid wing and the lateral plate of pterygoid process, and ends at the mandibular neck.
The medial pterygoid muscle starts from the pterygoid fossa and ends at the pterygoid muscle tuberosity on the inner surface of mandible. Pterygium muscle, temporalis muscle and masseter muscle (starting from the lower edge and inner surface of temporal arch and ending at the outer side of mandibular masseter rotor and mandibular branch) participate in chewing movement together.
The development degree and shape of pterygoid vein plexus between temporal muscle and lateral pterygoid muscle are quite different, and some of them are well developed and rare. It communicates with intracranial veins through the foramen ovale venous network.
There are many static anastomosis branches.
2. Otolaryngology
Otolaryngology was originally named "Otolaryngology", which was officially named "Otolaryngology" after the reform of the Ministry of Health. The classification of otolaryngology diseases is mainly divided into some diseases that are common in the ear, nose and throat.
The common otolaryngology diseases mainly include: otology diseases: otitis media, tinnitus, otitis externa, deafness, tympanic membrane perforation, tympanic membrane repair and hearing impairment; Nasal diseases: acute rhinitis, chronic rhinitis, sinusitis, nasal polyps, allergic rhinitis, rhinoplasty and laryngology diseases: laryngitis, chronic pharyngitis, tonsillitis, snoring, vocal cord polyps and acute pharyngitis are common diseases in the classification of otorhinolaryngology diseases, except these.
pressing
First, if you are using cosmetics, it may be the ingredients of cosmetics that make your skin allergic. I suggest you stop using cosmetics.
Second, if you don't use cosmetics, it may be your facial cleanser that causes skin allergies.
Third, if you are useless, you may be allergic to pollen, milk and so on.
Your problem is mainly caused by allergies, and allergic people are caused by excessive or insufficient immunity. I give you the following advice:
Stop using all cosmetics, skin care products, facial cleanser, etc. If all else fails, stay away from milk.
If not, improve immunity and correct acidic constitution. Eat more alkaline foods, such as methylcholine and colostrum.