正中神经前臂分支与旋前圆肌的关系以及旋前圆肌肌内神经分布研究  

Association of the branches of median nerve to the forearm with pronator teres and the intramuscular innervation patterns in pronator teres

作　　者：杨方玖[1] 周运栏 薛黔[1] 

机构地区：[1]遵义医学院人体解剖学教研室,563000 [2]汇川区高坪镇中心卫生院,贵州省遵义市563002

出　　处：《实用医学杂志》2010年第1期12-14,共3页The Journal of Practical Medicine

摘　　要：目的:为正中神经与旋前圆肌的临床应用提供形态学基础。方法:解剖观察30具成人尸体的正中神经前臂分支,并用Sihler′s肌内神经染色法对5具成人尸体的旋前圆肌进行染色,观察其肌内神经分支分布。结果:(1)正中神经前臂分支密集区最远一个束支距离肱骨内上髁(7.63±1.15)cm,该距离占前臂长的29%。旋前圆肌长(14.01±0.91)cm。旋前圆肌止点中点距离肱骨外上髁(13.31±0.81)cm,该距离占前臂长的52%。(2)正中神经从其两侧各分出1支一级分支从旋前圆肌外上方进入该肌,其中尺侧支分布到旋前圆肌肱骨头近侧半,桡侧支分布到旋前圆肌肱骨头远侧半及其尺骨头。结论:正中神经前臂肌支有近端集中、偏向尺侧以及与旋前圆肌位置关系密切的分布特点,这些分布特点对前臂创伤修复有一定的参考意义。旋前圆肌有来自正中神经的较恒定的分支分布,该肌可分为肱骨头亚部与尺骨头亚部,供肌亚部移植。Objective To provide the morphological basis for clinical application of median nerve and pronator teres （PT）. Methods The branches of median nerve to the forearm are separated and studied in thirty adult cadavers. The innervation pattern of PT was observed in five adult cadavers using the Sihler＇s staining technique. Results In the dense median nerve-branching pattern, the mean length of the farthermost branch to medial epicondyle of humerus is （7.63 ± 1.15） cm,29% of the entire length of the forearm. The mean length of PT is （14.01 ± 0.91 ）cm. The insertion of PT to the lateral epicondyle of humerus is （13.31 ± 0.81）cm,52% of the forearm length. The median nerve gave off a primary branch bilaterally to enter PT from the upper side of the muscle ; the ulnar branch distributed to the proximate half part of the humeral head and the radial branch to the ulnar head and the distal half part of the humeral head. Conclusions The muscular branches of median nerve in the forearm converge in the proximate end, deflect to the ulnar side, and have a close relation with the location of PT. These features have certain referential significance in repairing forearm injury. PT has fixed distribution of nerve branches arising from median nerve and may be divided into the compartments of the humeral head and the ulnar head for neuromuscular transplantation.

关 键 词：肌 骨骼 正中神经 亚部 旋前圆肌 前臂 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]