正中神经在肘部及前臂上段卡压综合征的解剖基础  

Anatomical bases of median nerve entrapment syndrome at elbow and upper part of forearm

作　　者：舒强[1] 孟凡东[1] 卢敏[1] 凌光烈[1] 徐恩多[1] 

机构地区：[1]中国医科大学附属第一医院外科局解教研室,辽宁沈阳110001

出　　处：《中国临床解剖学杂志》2002年第3期207-209,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:探讨正中神经在肘部及前臂上段卡压综合征的解剖学基础。方法:在50例上肢标本上解剖观察正中神经受压的解剖因素。结果:肱二头肌键膜与正中神经的关系:非覆盖型80％（40侧）,部分覆盖型12％（6侧）和全覆盖型4侧（8％）。64％（32侧）反转筋膜斜过正中神经前方。18.6％（8侧）旋前圆肌肱骨头肌内有明显腱束,94％（47侧）尺骨头浅面有增厚腱膜。指浅屈肌起始两头间的形态结构:88％（44侧）联合腱弓型,4％（2侧）纤维弓,8％（4侧）指浅屈肌腱束。结论:正中神经通过前臂上段及肘部时,肱二头肌腱膜、旋前圆肌肱骨头的反转筋膜和肌内腱束、尺骨头浅面的腱膜、指浅屈肌起始部的联合腱弓和纤维弓等可能是导致其受压的解剖学因素。Objective:To provide anatomical bases for the understanding of pathogenesis of entrapment syndrome of median nerve at elbow and upper part of forearm. Method: Fifty embalmed limbs were dissected. Results: The relationship between bicipital aponeurosis and median nerve:80% non-covered type (40) ,12% partially covered (6) and 8% completely covered type(4). Reflex fasciae of humeral head of pronator were observed across the anterior of median nerve in 64% limbs (32). 18.6% obvious intramuscular tendinous bundles in the humeral heads ( adults, 8) were observed.94% thick aponeurosis in the superficial layer of ulnar head(47) was also observed. The origin between two heads of superficial digital flexor contained 88% conjoined tendious arch (44), 4% fibrous arch (2),8% intramuscular tendinous bundle (4). Conclusion: This study demonstrated that lacertus fibrous, reflex fasciae and intramuscular tendious bundle of humeral head of pronator, aponeurosis on superficial layer of ulnar head, conjointed tendious arch and fibrous arch at origin part of superficial digital flexor around median nerve at upper part of forearm and elbow are anatomical bases of median nerve entrapment.

关 键 词：旋前圆肌 指浅屈肌 正中神经 卡压综合征 解剖 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学] R745.4[医药卫生—基础医学]