腋神经的解剖学特点及临床意义

发布时间：2018-05-14 17:26

  本文选题：腋神经 + 三角肌　； 参考：《延边大学》2017年硕士论文

【摘要】：目的:观测腋神经的解剖学形态以及与周围重要解剖标志的关系,为减少医源性的腋神经损伤提供解剖学依据。方法:选择16侧用福尔马林固定的完整的亚洲成人上肢标本,其中男性、女性标本各8侧,所有上肢标本无损伤、无疾病及发育不良。对腋神经及其周围组织进行解剖,观测腋神经、三角肌的解剖学形态以及与周围重要解剖标志的关系。测量的指标包括(1)腋神经自四边孔处至入三角肌点长度;(2)腋神经入三角肌点与周围标志距离;(3)腋神经在三角肌深面分布范围;(4)三角肌的高度及外径;(5)三角肌下止点的高度及宽度;(6)肌缝处腋神经与周围标志距离测量;(7)肌缝处腋神经宽度。全部标本解剖和数据的采集均由同一组团队完成,数据使用spss22.0统计软件进行处理。结果:通过解剖发现腋神经从臂丛神经发出后,绕过肩胛骨的外侧缘和肩胛下血管一同向下方走形,从肩胛下肌的前下方通过,在其肌腱与肌腹的移行处下潜到达肩关节囊的下后方,通过四边间隙绕过肱骨外科颈后从外后方进入三角肌的深面,在其深面皇放射状分布。腋神经通过三角肌前、中部肌间隙处的上缘与肩峰前角肌缝止点处的距离男性为(60.74±4.88)mm女性为(56.30±4.46)mm,肌缝处神经上、下缘之间的距离男性为(5.38±0.56)mm女性为(4.46±0.64)mm,肌缝处神经上缘与大结节顶点距离男性为(36.02±4.16)mm女性为(33.04±4.58)mm,肌缝处神经上缘与喙突顶点距离男性为(44.76±5.24)mm女性为(41.30±4.26)mm。腋神经下缘与三角肌粗隆上缘的距离男性为(40.94±4.28)mm,女性为(37.86±3.84)mm。三角肌下止点呈长条形止于三角肌粗隆,高度男性为(52.02±5.08)mm,女性为(48.86±4.36)mm,宽度男性为(23.46±4.24)mm,女性为(20.56±3.78)mm。结论:腋神经在三角肌的分布属于横行区域分布,针对这一特点来.选择合适的手术入路能够降低腋神经损伤的几率。
[Abstract]:Objective: to observe the anatomical morphology of axillary nerve and its relationship with important anatomic markers in order to provide anatomic basis for reducing iatrogenic axillary nerve injury. Methods: sixteen Asian adult upper limb specimens fixed with formalin were selected, of which 8 were male and 8 female, all of which were free of injury, disease and dysplasia. The axillary nerve and its surrounding tissues were dissected and the anatomical morphology of axillary nerve and deltoid muscle were observed. The measurements included 1) the length of axillary nerve from the foramen quadrilateral to the deltoid muscle point (2) the distance between the axillary nerve entering the deltoid muscle point and the surrounding marker (3) the axillary nerve distributed in the deltoid muscle deep surface and 4) the height and outer diameter of the deltoid muscle and the height and outer diameter of the deltoid muscle were 5) the deltoid muscle stopped under the deltoid muscle. The distance between the axillary nerve and the peripheral marker at the muscle suture was measured to measure the width of the axillary nerve at the muscle suture. All specimens were dissected and collected by the same team. The data were processed by spss22.0 software. Results: after the axillary nerve emanated from the brachial plexus, it was found that the axillary nerve passed through the anterior and lower part of the subscapular muscle, circumventing the lateral margin of the scapular bone and the subscapular vessels. The tendons and ventriculus of the muscle dived down to the lower rear of the shoulder capsule and passed through the humeral surgical neck through the four sides of the space into the deep surface of the deltoid muscle from the outer posterior to the deep surface of the deltoid muscle and distributed radially in the deep surface. The distance of axillary nerve through deltoid muscle, the distance between upper margin of middle muscle space and suture of anterior horn of acromion was 60.74 卤4.88)mm in male, 56.30 卤4.46 mm in female, and 56.30 卤4.46 mm in female. The distance between the inferior edge and the upper edge of the muscle suture was 4.46 卤0.64 mm for the female, 36.02 卤4.58 mm for the female, and 41.30 卤4.26 mm for the female. The distance between the superior edge of the muscle suture and the vertex of the coracoid process was 44.76 卤4.26 mm in the female and the distance between the superior edge of the muscle suture and the vertex of the coracoid process was 36.02 卤4.58 mm in the male and 44.76 卤4.26 mm in the female. The distance between the inferior edge of axillary nerve and the superior edge of deltoid muscle was 40.94 卤4.28 mm in male and 37.86 卤3.84 mm in female. The height of deltoid muscle was 52.02 卤5.08 mm for male, 48.86 卤4.36 mm for female, 23.46 卤4.24 mm for male and 20.56 卤3.78 mm for female. Conclusion: the distribution of axillary nerve in deltoid muscle belongs to transverse region. The choice of appropriate surgical approach can reduce the risk of axillary nerve injury.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R322;R687
，

本文编号：1888813