颈阔肌

颈阔肌
颈阔肌
	颈阔肌位于图中橘色位置。
	仔细移除颈部皮肤后，会露出颈阔肌。
基本信息
起点（英语：Anatomical terms of muscle#Insertion_and_origin）	锁骨上下方的皮下组织
终点（英语：Anatomical terms of muscle#Insertion_and_origin）	下颔骨底部、脸颊皮肤、下唇皮肤、嘴角、口轮匝肌
动脉	颏下动脉（英语：submental artery）与肩胛上动脉（英语：suprascapular artery）两者的分支
神经	颜面神经颈支（英语：cervical branch of the facial nerve）
相关动作（英语：Kinesiology）	（悲伤或惊吓时）使嘴往下往外，使颈部皮肤往上紧贴牙齿
拮抗肌（英语：Antagonist (muscle)）	嚼肌、颞肌（英语：temporalis muscle）
标识字符
拉丁文	Platysma
TA98	A04.2.01.001
TA2	2147
FMA	FMA:45738
格雷氏	p.387
	《肌肉解剖学术语（英语：Anatomical terms of muscle）》 [在维基数据上编辑]

颈阔肌（Platysma）是颈部前侧的浅层肌肉。它是一块表面肌肉，主要覆盖在胸锁乳突肌表面。颈阔肌收缩时，会使颈部皮肤稍微起皱，产生“弓弦”（Bowstring）的效果。

结构

颈阔肌是一块大片的扇形肌肉，肌肉纤维从盖住胸大肌（Pectoralis major）与三角肌（Deltoid）上段的筋膜出发，构成扇形的宽端，接着肌肉向上越过锁骨，沿着颈部边缘向上向内侧走，留下颈部中线下半段没有被覆盖。一些肌肉纤维在下颔联合（英语：Mandibular symphysis）后下方会合，往后沿斜线（Oblique line）穿过下颔骨，其他肌肉纤维则附着在脸下方的皮肤与皮下组织上，或者与颧大肌（英语：zygomaticus major muscle）、口轮匝肌等肌肉融合^[1]。如果将嘴的外缘尽量向下拉,就会感受到颈部的颈阔肌拉紧。

神经

颈阔肌由颜面神经颈支（英语：cervical branch of the facial nerve）支配。^[1]^[2]

血管

颈阔肌由颏下动脉（英语：submental artery）与肩胛上动脉（英语：suprascapular artery）两者的分支供应血液。

相对位置

颈阔肌浅层有皮下筋膜与组织^[1]^[3]，深层有许多颈部构造，包含由下颔角（英语：angle of the mandible）下至锁骨的颈外静脉（英语：external jugular vein）^[4]，以及更深的颈外动脉（英语：external carotid artery）、腮腺、小枕神经（英语：lesser occipital nerve）、大耳神经（英语：great auricular nerve）^[5]及颜面神经下颔支（英语：marginal mandibular branch）^[6]

变异

颈阔肌变异发生于延展程度，伸展入面部的高度、穿过锁骨或肩部的程度都因人而异。颈阔肌可能会在单侧消失或交叉到对侧，可能附着在锁骨、乳突（Mastoid process）或枕骨上。一小部分的肌束可能会形成枕小肌（Occipitalis minor），从斜方肌（Trapezius）通到胸锁乳突肌（Sternocleidomastoid, SCM）终点。

功能

起皱

颈阔肌整片运动时，颈部表面皮肤会产生斜向的皱纹，有如弓弦（bowstring）一般。^[3]

下颚及下唇

颈阔肌前部（整块肌肉最厚的部分）能够使下颚向下降，并在蹙额撇嘴（frown）时把下唇与嘴角往下拉。平时颈阔肌的降下唇作用很小，该动作主要由降口角肌（英语：depressor anguli oris muscle）与降下唇肌（英语：depressor labii inferioris muscle）负责。只有很少人能够有意识地操纵颈阔肌。皮肤松弛的老年人的颈部前部两侧可以看到两根沟，就是颈阔肌形成的。

临床重要性

颈阔肌可能发生撕裂伤、拉伤或萎缩。

伤害

由于颈阔肌既浅且薄，因此容易发生穿刺伤（英语：Penetrating trauma），它的破坏是颈部穿刺伤的标志，于枪击时搭配CTA，能够有效诊断血管损伤^[7]，有效减少需要手术的个案数。^[8]

颈部手术

颈阔肌在颈部手术中一定会被切开，以便医疗团队处理深层结构^[1]^[6]。若要避免疤痕产生，就必须精准缝合颈阔肌肌肉纤维。^[1]

整形手术

颈阔肌张力下降产生皱纹，可能导致肌肉变薄缩短，可能与正常衰老有关，也可能是颜面神经麻痹（Facial nerve palsy）的续发性并发症^[3]。举重或拉皮手术可能会使颈阔肌张力进一步下降，造成颈阔肌运动障碍（Platysma dyskinesia），英语俗称Turkey neck“火鸡颈”。保守治疗是可行选项之一，也可以注射肉毒杆菌毒素并执行颈阔肌成形术（英语：platysmaplasty）^[9]。症状减缓约需两周。^[10]

脂肪组织分布比颈阔肌表浅，因此抽脂手术很容易刺伤颈阔肌，必须尽力避免，以防出血^[11]。

动物

在宠物中只有食肉目和猪有颈阔肌。这些动物的颈阔肌终点不在喉部，肌肉会向后一直延伸到肩膀。

食肉目还有两块下颌和胸之间的表皮肌肉。它们可以使得颈部下部的皮肤拉紧。

有蹄类没有颈阔肌。它们只有在颈部的背部有两块表皮肌肉。

参考资料

^ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 Eibling, David E. 78 - Neck Dissection. Operative Otolaryngology: Head and Neck Surgery 1 2nd. Philadelphia: Saunders. 2008: 679 – 708. ISBN 978-1-4377-2083-9. OCLC 825780332. doi:10.1016/B978-1-4160-2445-3.50082-0 （英语）.
^ Anatomy & Physiology, 8th Edition, McGraw-Hill Co., 2008.
^ ^3.0 ^3.1 ^3.2 Posnick, Jeffrey C. 40 - Aesthetic Alteration of the Soft Tissues of the Neck and Lower Face: Evaluation and Surgery. Orthognathic Surgery: Principles & Practice. St. Louis: Saunders. 2014: 1746 – 1783. ISBN 978-1-4557-5027-6. OCLC 860861780. doi:10.1016/B978-1-4557-2698-1.00040-X （英语）.
^ Kim, Se-Hoon; Chang, Ung-Kyu; Kim, Daniel H.; Bilsky, Mark H., Kim, Daniel H.; Chang, Ung-Kyu; Kim, Se-Hoon; Bilsky, Mark H. , 编, Chapter 19 - Management of Upper Cervical Spine Tumors, Tumors of the Spine (Philadelphia: W.B. Saunders), 2006-01-01: 378–394 [2021-01-06], ISBN 978-1-4160-3367-7, （原始内容存档于2022-02-06）（英语）
^ Kim, Se-Hoon; Chang, Ung-Kyu; Kim, Daniel H.; Bilsky, Mark H. 19 - Management of Upper Cervical Spine Tumors. Tumors of the Spine. Philadelphia: Saunders. 2008: 378 – 394. ISBN 978-1-4377-2164-5. OCLC 489078564. doi:10.1016/B978-1-4160-3367-7.10019-7 （英语）.
^ ^6.0 ^6.1 Wolfe, Michael J.; Wilson, Keith. 21 - Head and Neck Cancer. Essentials of Surgical Oncology: Surgical Foundations. Philadelphia: Mosby. 2007: 329 – 357. ISBN 0-8151-4385-0. OCLC 608607674. doi:10.1016/B978-0-8151-4385-7.50027-8 （英语）.
^ Cothren, C. Clay; Moore, Ernest E. 19 - Penetrating Neck Trauma. Abernathy's Surgical Secrets 6th. Philadelphia: Mosby. 2009: 110 – 113. ISBN 0-323-07475-8. OCLC 460933202. doi:10.1016/B978-0-323-05711-0.00019-7 （英语）.
^ Bell, RB; Osborn, T; Dierks, EJ; Potter, BE; Long, WB. Management of penetrating neck injuries: a new paradigm for civilian trauma. J. Oral Maxillofac. Surg. 2007, 65 (4): 691–705. PMID 17368366. doi:10.1016/j.joms.2006.04.044.
^ Labb??n a similar fashion to other muscles, the platysma is vulnerable to tears, strains and muscle atrophy among many other possible conditions. The platysma is vulnerable to neck injuries that may penetrate it. A type of medical imaging called CTA (computed tomography angiography), used to visualise arterial and venous vessels, is useful to minimise the number of neck explorations, thus improving the handling of the condition.[3] Another area of importance of the platysma lies in plastic surgery. Neck bands in the area become most noticeable with age, aggravated by weightlifting or facelift. If it doesn't heal with time, there are many options to correct this: Botox/Dysport/Xeomin and platysmaplasty. Platysmaplasty is a surgery in this area, that can be open or closed, in the latter a specialised instrument called plastymotome that allow the surgery to be done without incisions. It takes approximately 2 weeks for the symptoms to be reduced.[4], Daniel; Franco, R G.; Nicolas, J. Platysma Suspension and Platysmaplasty during Neck Lift: Anatomical Study and Analysis of 30 Cases. Plastic and Reconstructive Surgery. May 2006, 117 (6): 2001–2007. ISSN 0032-1052. doi:10.1097/01.prs.0000218972.75144.9c.
^ Daher, JC. Closed platysmotomy: a new procedure for the treatment of platysma bands without skin dissection. Aesthetic Plast Surg. 2011, 35 (5): 866–77. PMC 3192284  . PMID 21847680. doi:10.1007/s00266-011-9782-0.
^ Alam, Murad; White, Lucile E. 1 - Anatomy in Dermatologic Surgery. Complications in Dermatologic Surgery. Philadelphia: Mosby. 2008: 1 – 18. ISBN 0-323-04546-4. OCLC 811786617. doi:10.1016/B978-0-323-04546-9.10001-9 （英语）.

延伸阅读

David Burnie. 新世紀人體學習百科. 台湾: 猫头鹰出版社. 1997-06-30. ISBN 957-9684-11-1 （中文）.

[:1-1] 1.0 ^1.1 ^1.2 ^1.3 ^1.4 Eibling, David E. 78 - Neck Dissection. Operative Otolaryngology: Head and Neck Surgery 1 2nd. Philadelphia: Saunders. 2008: 679 – 708. ISBN 978-1-4377-2083-9. OCLC 825780332. doi:10.1016/B978-1-4160-2445-3.50082-0 （英语）.

[2] Anatomy & Physiology, 8th Edition, McGraw-Hill Co., 2008.

[:2-3] 3.0 ^3.1 ^3.2 Posnick, Jeffrey C. 40 - Aesthetic Alteration of the Soft Tissues of the Neck and Lower Face: Evaluation and Surgery. Orthognathic Surgery: Principles & Practice. St. Louis: Saunders. 2014: 1746 – 1783. ISBN 978-1-4557-5027-6. OCLC 860861780. doi:10.1016/B978-1-4557-2698-1.00040-X （英语）.

[4] Kim, Se-Hoon; Chang, Ung-Kyu; Kim, Daniel H.; Bilsky, Mark H., Kim, Daniel H.; Chang, Ung-Kyu; Kim, Se-Hoon; Bilsky, Mark H. , 编, Chapter 19 - Management of Upper Cervical Spine Tumors, Tumors of the Spine (Philadelphia: W.B. Saunders), 2006-01-01: 378–394 [2021-01-06], ISBN 978-1-4160-3367-7, （原始内容存档于2022-02-06）（英语）

[:3-5] Kim, Se-Hoon; Chang, Ung-Kyu; Kim, Daniel H.; Bilsky, Mark H. 19 - Management of Upper Cervical Spine Tumors. Tumors of the Spine. Philadelphia: Saunders. 2008: 378 – 394. ISBN 978-1-4377-2164-5. OCLC 489078564. doi:10.1016/B978-1-4160-3367-7.10019-7 （英语）.

[:6-6] 6.0 ^6.1 Wolfe, Michael J.; Wilson, Keith. 21 - Head and Neck Cancer. Essentials of Surgical Oncology: Surgical Foundations. Philadelphia: Mosby. 2007: 329 – 357. ISBN 0-8151-4385-0. OCLC 608607674. doi:10.1016/B978-0-8151-4385-7.50027-8 （英语）.

[:4-7] Cothren, C. Clay; Moore, Ernest E. 19 - Penetrating Neck Trauma. Abernathy's Surgical Secrets 6th. Philadelphia: Mosby. 2009: 110 – 113. ISBN 0-323-07475-8. OCLC 460933202. doi:10.1016/B978-0-323-05711-0.00019-7 （英语）.

[:0-8] Bell, RB; Osborn, T; Dierks, EJ; Potter, BE; Long, WB. Management of penetrating neck injuries: a new paradigm for civilian trauma. J. Oral Maxillofac. Surg. 2007, 65 (4): 691–705. PMID 17368366. doi:10.1016/j.joms.2006.04.044.

[9] Labb??n a similar fashion to other muscles, the platysma is vulnerable to tears, strains and muscle atrophy among many other possible conditions. The platysma is vulnerable to neck injuries that may penetrate it. A type of medical imaging called CTA (computed tomography angiography), used to visualise arterial and venous vessels, is useful to minimise the number of neck explorations, thus improving the handling of the condition.[3] Another area of importance of the platysma lies in plastic surgery. Neck bands in the area become most noticeable with age, aggravated by weightlifting or facelift. If it doesn't heal with time, there are many options to correct this: Botox/Dysport/Xeomin and platysmaplasty. Platysmaplasty is a surgery in this area, that can be open or closed, in the latter a specialised instrument called plastymotome that allow the surgery to be done without incisions. It takes approximately 2 weeks for the symptoms to be reduced.[4], Daniel; Franco, R G.; Nicolas, J. Platysma Suspension and Platysmaplasty during Neck Lift: Anatomical Study and Analysis of 30 Cases. Plastic and Reconstructive Surgery. May 2006, 117 (6): 2001–2007. ISSN 0032-1052. doi:10.1097/01.prs.0000218972.75144.9c.

[10] Daher, JC. Closed platysmotomy: a new procedure for the treatment of platysma bands without skin dissection. Aesthetic Plast Surg. 2011, 35 (5): 866–77. PMC 3192284  . PMID 21847680. doi:10.1007/s00266-011-9782-0.

[:5-11] Alam, Murad; White, Lucile E. 1 - Anatomy in Dermatologic Surgery. Complications in Dermatologic Surgery. Philadelphia: Mosby. 2008: 1 – 18. ISBN 0-323-04546-4. OCLC 811786617. doi:10.1016/B978-0-323-04546-9.10001-9 （英语）.

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