肱三头肌外侧头神经肌支和血供的应用解剖  

Applied anatomy of radial nerve branches and blood supply on the lateral head of triceps brachii

作　　者：王斌[1] 邵新中[2] 郑桓[3] 卢爱东 李淑芹[1] 李康华[5] 

机构地区：[1]唐山市第二医院手外科,河北唐山063000 [2]河北医科大学附属第三医院手外科,河北石家庄050051 [3]华北煤炭医学院解剖学教研室,河北唐山063000 [4]开滦矿务局总医院,河北唐山063000 [5]中南大学湘雅医学院湘雅医院骨科,湖南长沙410008

出　　处：《中国临床解剖学杂志》2003年第6期586-588,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的 :为肱三头肌外侧头的神经肌支移位和游离肌皮瓣移植提供解剖学基础。方法 :在 3 0侧成人上肢标本上对肱三头肌外侧头的神经肌支和血管进行详细解剖观测。结果 :外侧头肌支数 2～ 4支 ,一般为 3支。入肌部位位于大圆肌腱下缘 ( 5 .3 1± 2 .0 1)、( 6.0 6± 1.2 1)、( 5 .96± 1.0 )cm ,横径分别为( 1.4± 0 .5 )、( 1.2± 0 .2 )、( 1.9± 0 .9)mm。肌皮神经肱二头肌平均 2个肌支 ,入肌部位分别在大圆肌下缘以下 ( 4 .2 1± 1.66)和 ( 4 .5 8± 1.3 2 )cm ,横径为 ( 1.4± 0 .6)和 ( 1.2± 0 .8)mm。腋神经入肌部位在大圆肌下缘以上发出。肱三头肌外侧头血供来源于肱深、旋肱后及部分近侧肌支 ,且均与肱深血管有关。结论 :肱三头肌外侧头肌支有足够长度和横径 ,在肌门处可无张力移位至肌皮神经肱二头肌支及部分腋神经肌支。Objective: To provide anatomical basis for transferring of free musculocutaneous flap and muscular nerve branches of lateral head of triceps brachii(LHT). Methods: The observation and measurement of radial nerve branches and nutrient blood vessels to LHT were made on 30 adult cadaver upper extremity specimens. Results: LHT possessed 3(2～4) nerve branches commonly .The sites of entering the muscle were 53.1±20.1, 60.6±12.1, and 59.6±10 mm below the distal rim of the larger round muscle ,while diameters are 1.4±0.5, 1.2±0.2 and 1.9±0.9 mm respectively. There are averagely 2 nerve branches of musculocutaneous nerve to biceps brachii.The sites of entering the muscle are respectively 42.1±16.6 mm and 45.8±13.2 mm below the distal rim of the larger round muscle with the diameter 1.4± 0.6 mm and 1.2±0.8 mm; The entering sites of axillaris nerve are all above the distal rim of the larger round muscle. The blood supplies of LHT originated from profound brachii blood vessel, circumflexa humeri posterior blood vessel and some proximal blood vessel branches and were associated with profound brachii blood vessel. Conclusions: Radial nerve branches of LHT have both enough length and diameter to anastomose nerve branches of musculocutaneous nerve and partial axillaris nerve; The free musculocutaneous flap of LHT relying on profound brachii blood vessel is a good donor in repairing skin and muscle defect of forearm.

关 键 词：肱三头肌外侧头 神经移位 肌皮瓣 应用解剖 

分 类 号：R323.71[医药卫生—人体解剖和组织胚胎学] R322.74[医药卫生—基础医学]