大圆肌的应用解剖  

An anatomical study of teres major muscle

作　　者：陈琳[1] 陈德松[1] 顾玉东[1] 

机构地区：[1]上海医科大学附属华山医院手外科,上海200040

出　　处：《实用骨科杂志》2000年第3期160-162,共3页Journal of Practical Orthopaedics

摘　　要：目的 :研究大圆肌的形态特点及血管神经蒂特点。方法 :对 44侧固定尸体的大圆肌的肌腹、肌肉起止点以及血管神经蒂进行解剖与测量。结果 :大圆肌肌腹上缘长 11～ 18cm,下缘长 6～ 8cm,肌性起点占 6 3.6 % ,半腱半肌性起点 36 .4% ,腱性止点占 79.5 % ,半腱半肌性止点 2 0 .5 %。血供来自旋肩胛动脉 72 .% ,胸背动脉 6 .8% ,肩胛下动脉2 0 .5 % ,血管蒂呈多级分支 ,自起点至入肌点可分离长度 2 .1～ 7.6 cm ,直径 1.0～ 2 .9mm ,若分离至腋动脉 ,可分离长度 6 .6～ 18.1cm。神经支配来自肩胛下神经下支 ,与血管伴行 ,呈多级分支 ,自发出点至入肌点可分离长度 3.43～ 10 .90 cm ,直径 0 .86～ 2 .11mm。结论 :大圆肌的肌肉及血管神经蒂的特点 ,可用于肩肘功能重建手术中的动力肌 ,且手术切口隐蔽 。Objective:To study the morphological character of teres major muscle and its pedicel of vessel and nerve.Methods:44 upper extremities of fixed human cadavers were dissected.The bellies,the origins and the insertions of teres major muscle were measured respectively.The pedicels of vessels and nerves were also measured.Results:The length of upper side of the bellies was 11-18 cm,the length of lower side of bellies side 6-18 cm.Muscular origins of total origins were 63.4%,semimuscular origins were 36,6%.Tendinous insertions of total insertions were 79.5%,semitendinous insertions were 20.5%.The blood supply of teres major muscle from circumflex scapular artery was 72.7%,from thoracodorsal artery 6.8%,from subscapular artery 20.5%.The vessel pedicle had multiple grade branches.The length of vessle was from 2.1 cm to 7.6 cm,the diameter was from 1.0mm to 2.9mm.And if the the vessle was separated to the axillary artery,the length of pedicel was 6.6-18.1cm.The teres major muscle was innervated by lower subscapular nerve.The nerve was accompany with the vessle and also had multiple grade branches.The length of nerve was from 3.4cm to 10.9cm,the diameter was from o.9mm to 2.2mm.Conclusions:According to the character of teres major muscle and pedicel of vessel and nerve,the muscle was suitable to apply for reconstruction surgery of shoulder and elbow.And incision was covert.

关 键 词：大圆肌 解剖学 形 特点 血管神经蒂 

分 类 号：R322.74[医药卫生—人体解剖和组织胚胎学]