前、中斜角肌起点与臂丛上干的关系及其临床意义  

The relationship between the origin of anterior and middle scalene muscle and the upper trunk of brachiplex

作　　者：方有生[1] 陈德松[1] 顾玉东[1] 

机构地区：[1]上海医科大学华山医院手外科

出　　处：《中国临床解剖学杂志》1999年第3期225-226,共2页Chinese Journal of Clinical Anatomy

基　　金：卫生部科研基金

摘　　要：目的：了解前、中斜角肌起点的解剖特点及其与上干型胸廓出口综合征的解剖关系，为临床诊治上干型胸廓出口综合征提供解剖学依据及最佳手术方式。方法：２５具成人固定尸体标本解剖观察前、中斜角肌起点的解剖特点及其与臂丛上干的关系。结果：前斜角肌在Ｃ３～６颈椎横突的前、后结节均有起点，中斜角肌起于第２～６或２～７颈椎横突的前后结节。Ｃ５～６神经根出椎间孔后被中斜角肌和前斜角肌交叉的起点腱性纤维而包裹。前斜角肌与Ｃ５～６的关系可分为３种情况。结论：前中斜角肌在颈椎横突的前、后结节均有起点，该交叉起点是上干型胸廓出口综合征的主要病因。术中应于前中斜角肌起点处切断该肌。Objective:To describe the anatomic characteritics of the origin of the anterior and middle scalene muscle and its relationship with the upper trunk thoracic outlet syndrome. Methods: Anatomic study was conducted on both sides of 30 embalmed cadavers, the characteristics of the origin of anterior and middle scalene muscle and its relationship with the upper trunk of brachiplex and surroundings were observed. Results: The anterior and middle scalene muscle originated from both anterior and posterior tubercle of transverse process from C 3 to C 6 and C 2 to C 7 respectively. The nerve roots of C 5～6 might be pinched by this muscular fiber from anterior and posterior tubercle immediately after they emerged from the intervertebral foramen. The relationship between the anterior scalene muscle and the nerve roots of C 5～6 could be divided into three types.Conclusions: The contraction of the posterior components of the anterior and middle scalene muscle may be the main reason of the upper trunk thoracic outlet syndrome. The amputation of these two muscular origins should be the cure for the patient with upper turnk thoracic outlet syndrome.

关 键 词：前斜角肌 中斜角肌 臂丛神经 胸出口综合征 解剖 

分 类 号：R741[医药卫生—神经病学与精神病学] R323.2[医药卫生—临床医学]