桡神经前臂伸肌支分布的解剖学研究  

An forearm anatomical study on muscular branches of radial nerve

作　　者：陈刚[1] 江华[2] 党瑞山[3] 姜会庆[1] 胡心宝[1] 洪志坚[1] 

机构地区：[1]南京军区南京总医院烧伤整形科,江苏南京210002 [2]上海长征医院整形外科,上海200003 [3]上海第二军医大学解剖学教研室,上海200433

出　　处：《医学研究生学报》2007年第6期574-577,共4页Journal of Medical Postgraduates

基　　金：上海市科学技术发展基金资助项目(批准号:024119057)

摘　　要：目的:观察桡神经前臂伸肌各肌支的解剖学特征。方法:选用成人上肢标本30侧,在肉眼及放大镜(3.5倍)下,找出桡神经,沿其主干游离,暴露桡神经深支,同时解剖其前臂后群肌肉,仔细分离出各肌支及其入肌点。显露并观察其神经肌外走行和入肌门处的分支情况。以肱骨外上髁为定点,分别测量神经发出点和入肌点至定点的距离以及神经走行的实际长度。并进行统计学分析。结果:肌支数目最多的是指伸肌、旋后肌、尺侧腕伸肌、桡侧腕长伸肌和桡侧腕短伸肌等体积较大的肌肉。而一些细小的肌肉,如拇长展肌、拇短伸肌、拇长伸肌和示指伸肌等,均以单干神经支配较多。指伸肌与小指伸肌、拇长展肌、拇短伸肌、拇长伸肌和示指伸肌4肌之间均存在不同程度的共干现象。各肌支的长度变化较大,在旋后肌上缘之前发出的肌支长度自下向上依次递减;其下缘以下至浅层伸肌的肌支长度呈现递减趋势,在发出尺侧腕伸肌肌支后,肌支长度又呈现增长趋势。桡侧腕短伸肌支起自桡神经深支、浅支及桡神经干者分别为60%(18/30)、30%(9/30)和10%(3/30)。结论:指伸肌、小指伸肌及尺侧腕伸肌肌支较短,距离桡神经深支穿出旋后肌下缘的位置较近,是医源性桡神经损伤的重要原因,不同肌支数目的差异与其支配肌肉的结构,体积和功能有关。不同报道中桡侧腕短伸肌肌支起源差异较大,这可能与人种及解剖过程中人为的误差有关。Objective： To observe the forearm anatomical features of muscular branches of radial nerve. Methods： Thirty formaldehyde-fixed adult cadaver arms were dissected under naked eye and 3.5 × loupe magnification. The muscular ranches of radial nerve in forearm extensors were dissected and observed. The foream extensors were used in the study for observing the radial nerve of extramuscular distribution. The number of branches entering the muscles and length of muscular branches was counted and the following measurement were performed along the radial nerve and branches： distances from the origin point and muscle entry point of each branch all specimens, the muscles with the highest branch to LHE （ lateral humeral epicondyle）. Results ： In number were extensor digitorum, supinator, extensor carpi radialis brevis and extensor carpi radialis longus. There was a single neural bundle before entering into the muscles in some small muscles, for example, abductor pollicis longus, extensor pollicis brevis extensor pollicis longus and extensor indicis. The common branches come from the nerve trunk among some muscles. There was a large variation in length of muscular branches. Some muscular branches decreased progressively before superior border of supinator. The muscular branches entering into superficial extensor increased progressively after permeateing supinator, but some branches decreased progressively crossing extensor carpi ulnaris（ECU）. In 18 of 30（60% ）, extensor carpi radialis brevis（ECRB） branch originated from the the deep branch of the radial nerve. In 9 of 30（30% ）, the branches emanated from superficial branch of radial nerve and the others branches originated from the trunks of radial nerve. Conclusion ：The deep branch of the radial nerve may be damaged iatrogenicly with the following reasons ： branches lengthes of extensor digitorum （ ED）, extensor digiti minimi （EDM） and extensor carpiulnaris（ECU） are too short relatively, and origin points of these branches are more

关 键 词：前臂伸肌 桡神经 解剖学 

分 类 号：R323.71[医药卫生—人体解剖和组织胚胎学]