收肌管下口处隐神经阻滞的应用解剖  

Applied anatomy of saphenous nerve block near to inferior foramen of adductor canal

作　　者：李学谦 卢立荣 李鸿鹏 孙赟 张海东 赵振美 LI Xue-qian;LU Li-rong;LI Hong-peng;SUN Yun;ZHANG Hai-dong;ZHAO Zhen-mei(School of Basic Medical Sciences,Taishan Medical University,Tai'an 271000,Shandong Province,China)

机构地区：[1]山东第一医科大学基础医学院

出　　处：《中国临床解剖学杂志》2020年第1期10-13,共4页Chinese Journal of Clinical Anatomy

基　　金：国家级大学生创新创业训练计划项目（201710439013）

摘　　要：目的探讨收肌管下口处隐神经的精细解剖和体表定位。方法采用12具尸体标本20侧下肢对收肌管及其下口部位进行精细解剖和测量。结果收肌管下份隐神经在前内侧、股动脉居中、股静脉在后。在收肌管下口和稍上位置,膝降动、静脉和隐神经分别穿大收肌腱板出收肌管并伴行下行,隐神经在膝内侧缝匠肌腱和股薄肌腱之间穿深筋膜,伴大隐静脉下降至小腿和足内侧。收肌管下口分别距髌骨上缘(5.85±0.15)cm、髌骨底内侧缘(2.72±0.60)cm、股内侧皮肤表面(4.08±0.66)cm。结论髌骨上缘上5.85 cm、髌骨底内侧缘内2.72 cm、股内侧皮肤表面4.08 cm深处为收肌管下口隐神经阻滞的体表定位;股动脉是收肌管下口上隐神经阻滞的定位标志;膝降动脉的隐支是收肌管下口下隐神经阻滞的识别标志。Objective To explore the details of anatomy and surface localization of saphenous nerve near to inferior foramen of adductor canal.Methods Twenty sides of lower limb from 12 cadaver specimen were dissected to measure the key structures adjacent to the adductor canal.Results Saphenous nerve,femoral artery and femoral vein located in the anteromedial,medial and posterior part of adductor canal,respectively.At the site of the inferior foramen of adductor canal,the descending genicular artery,vein and saphenous nerve penetrated through adductor tendon plate and appeared in adductor canal,which were accompanied by the great saphenous vein.Saphenous nerve passed through deep fascia between sartorius tendon and gracilis tendon on the medial surface of knee,and descended to the medial surface of leg and foot.The distances from inferior foramen of adductor canal to superior border of patella,to medial margin of the patella,and to the medial surface of thigh skin were(5.85±0.15)cm,(2.72±0.60)cm and(4.08±0.66)cm,respectively.Conclusions Surface localization point of saphenous nerve block should be limited to a specific area,which is about 5.85 cm upper to the superior border of patella,2.72 cm internal to medial margin of the patella,and 4.08 cm deep to the medial surface of thigh.For saphenous nerve blocking,femoral artery could be regarded as a localization mark above inferior foramen of adductor canal,while,the saphenous branch of the descending genicular artery as the localization mark below inferior foramen of adductor canal.

关 键 词：收肌管下口 隐神经 膝降动脉 隐神经阻滞 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学]