解剖學-頸肌群,基礎醫學教室

篇名

解剖學-頸肌群,基礎醫學教室

重要考點

舌骨下肌群和舌骨上肌群各由哪些肌肉所組成，以及其起止點、作用與神經支配等內容是您必須掌握的重點！

說明

(頸肌群重點整理)

肌群		名稱	Origin
淺肌群	--	頸闊肌 platysma	subcutaneous tissue of infraclavicular and supraclavicular regions
	--	胸鎖乳突肌 sternocleidomastoid	manubrium, medial 1/3 of the clavicle
	舌骨下肌群	肩胛舌骨肌 omohyoid	Upper border of the scapula
		胸骨舌骨肌 sternohyoid	manubrium of sternum
		胸骨甲狀肌 sternothyroid	manubrium
		甲狀舌骨肌 thyrohyoid	thyroid cartilage of larynx
	舌骨上肌群	二腹肌 Digastrics (註)起源 (1)前腹： the first pharyngeal arch (2)後腹： the second pharyngeal arch	(1)前腹：digastric fossa (mandible bone) (2)後腹：mastoid process (temporal bone)
		下頜舌骨肌 mylohyoid	Mylohyoid line (mandible)
		頦舌骨肌geniohyoid	Symphysis menti
		莖突舌骨肌 stylohyoid	styloid process (temporal)
深肌群		前斜角肌 scalenus anterior	the transverse processes of the cervical vertebrae
		中斜角肌 scalenus medius
		後斜角肌 scalenusposterior

肌群		名稱	Insertion
淺肌群	--	頸闊肌 platysma	base of mandible; skin of cheek and lower lip; angle of mouth; orbicularis oris
	--	胸鎖乳突肌 sternocleidomastoid	mastoid process
	舌骨下肌群	肩胛舌骨肌 omohyoid	Hyoid bone
		胸骨舌骨肌 sternohyoid	hyoid bone
		胸骨甲狀肌 sternothyroid	thyroid cartilage
		甲狀舌骨肌 thyrohyoid	hyoid bone
	舌骨上肌群	二腹肌 Digastrics (註)起源 (1)前腹： the first pharyngeal arch (2)後腹： the second pharyngeal arch	以中間腱附著於舌骨體(Intermediate tendon)
		下頜舌骨肌 mylohyoid	body of hyoid bone and median raphe
		頦舌骨肌geniohyoid	hyoid bone
		莖突舌骨肌 stylohyoid	greater cornu of hyoid bone
深肌群		前斜角肌 scalenus anterior	the first ribs
		中斜角肌 scalenus medius	the second ribs
		後斜角肌 scalenusposterior	the second ribs

肌群		名稱	Action
淺肌群	--	頸闊肌 platysma	拉口角向下，並使頸部皮膚起皺Draws the corners of the mouth inferiorly and widens it (as in expressions of sadness and fright)
	--	胸鎖乳突肌 sternocleidomastoid	Unilaterally: the head inclining to the same side and the face is rotated to the opposite side. Bilaterally: raise the head
	舌骨下肌群	肩胛舌骨肌 omohyoid	to depress, retract the hyoid bone in swallowing and phonation.
		胸骨舌骨肌 sternohyoid
		胸骨甲狀肌 sternothyroid
		甲狀舌骨肌 thyrohyoid
	舌骨上肌群	二腹肌 Digastrics (註)起源 (1)前腹： the first pharyngeal arch (2)後腹： the second pharyngeal arch	參加口腔底組成；固定舌骨；下拉下頜骨，協助張口說話及吞嚥動作 (to pull the hyoid upward, backward and forward in swallowing and speaking, help to depress the mandible)
		下頜舌骨肌 mylohyoid
		頦舌骨肌geniohyoid
		莖突舌骨肌 stylohyoid
深肌群		前斜角肌 scalenus anterior	to elevate the ribs and flex and rotate the cervical vertebral column
		中斜角肌 scalenus medius
		後斜角肌 scalenusposterior

肌群		名稱	Innervation
淺肌群	--	頸闊肌 platysma	Cervical branch of the facial nerve
	--	胸鎖乳突肌 sternocleidomastoid	Accessory N.
	舌骨下肌群	肩胛舌骨肌 omohyoid	頸攀 (Ansa cervicalis) (C1~3)
		胸骨舌骨肌 sternohyoid
		胸骨甲狀肌 sternothyroid
		甲狀舌骨肌 thyrohyoid
	舌骨上肌群	二腹肌 Digastrics (註)起源 (1)前腹： the first pharyngeal arch (2)後腹： the second pharyngeal arch	前腹：Trigeminal N.的mandibular N.分支後腹：Facial N.
		下頜舌骨肌 mylohyoid	Mandibular N.的mylohyoid nerve分支
		頦舌骨肌geniohyoid	與舌下神經伴行的第1頸神經前支 (C1 via the hypoglossal nerve)
		莖突舌骨肌 stylohyoid	Cervical branch of the facial nerve
深肌群		前斜角肌 scalenus anterior	頸神經前支 (C3~4)
		中斜角肌 scalenus medius
		後斜角肌 scalenusposterior

(註)二腹肌可將頸前三角分割成3塊小三角區(The Digastricus divides the anterior triangle of the neck into three smaller triangles)，參考下圖(圖片摘自網路)：

下頜下三角( Submandibular triangle)：又稱二腹肌三角，上界是下頜骨下緣(the lower border of the body of the mandible)，下界是二腹肌的前後腹(below by the posterior belly of the Digastricus and the Stylohyoideus, in front by the anterior belly of the Diagastricus)，底由下頜舌骨肌(mylohyoid)、舌骨舌肌(hyoglossus)、咽上縮肌構成。此三角內含下颌下腺 submandibular gland、舌下神经、舌神经及下颌舌骨肌支、面动脉、舌动脉。
頸動脈三角(carotid triangle)：or superior carotid triangle位於胸鎖乳突肌(Sternocleidomastoideus)、肩胛舌骨肌(omohyoideus)和二腹肌後腹(posterior belly of the Digastricus)之間。內有迷走神經、副神經、舌下神經、頸內靜脈及其屬支、頸總動脈及其分支、頸深淋巴結等。
舌骨上三角(suprahyoid triangle)：又稱頦下三角(submental triangle), 外側是the anterior belly of the Digastricus，內側是the middle line of the neck from the hyoid bone to the symphysis menti，下界是the body of the hyoid bone所形成的區域。

相關考題

(問題來了) 以下題目摘自考選部公佈醫師專技高考試題

<96-1-22>頸闊肌（platysma muscle）與下列何肌肉受相同神經支配？

解答：A

<98-1-23>下列有關舌下神經（hypoglossal nerve）之敘述，何者為錯誤？

舌下神經發自於延腦之錐體（pyramid）與橄欖（olive）之間
舌下神經行經於頸內與頸外動脈（internal and external carotid arteries）之外側
舌下神經支配頦舌肌（genioglossal muscle）、莖舌肌（styloglossal muscle）及齶舌肌（palatoglossal muscle）
與舌下神經伴行的第一頸神經腹側枝（ventral ramus）支配甲狀舌骨肌（thyrohyoid muscle）

解答：C

<100-1-20>莖突咽肌（stylopharyngeal muscle）由下列何者支配？

解答：A

關鍵詞

頸肌群、舌骨下肌群、舌骨上肌群、二腹肌三角、下頜下三角、頸動脈三角、舌骨上三角