肩胛上神经的应用解剖学研究

发布时间：2018-04-21 10:44

本文选题：肩胛上神经 + 肩胛上横韧带　；参考：《吉林大学》2010年硕士论文

【摘要】： 观测肩胛上神经的起始、走行、分布及其分支的数目、直径及与周围结构的毗邻关系。通过对相关数据的量化分析,探讨肩胛上神经卡压综合症的原因,肩胛上神经行程中的局部解剖学特点与肩胛上神经卡压综合症临床表现的联系及其治疗过程中需要临床医生注意的有关方面,从而为该疾病的诊断和治疗提供解剖学依据。选择20具(40侧)10%甲醛防腐固定的成人尸体标本,其中男性尸体13具,女性尸体7具。尸体标本完好,无肩胛区组织病变。标本于5倍手术显微镜下行肩胛区显微解剖,观测肩胛上神经的走行、分支、分布特点及与周围结构的毗邻关系。结果显示:①肩胛上横韧带质地强韧,韧带长13.93±5.19(7.02～22.84) mm,中部厚2.30±0.57(1.42～2.94) mm;肩胛下横韧带稍松软,呈镰形,该韧带长22.22±5.66(15.46～32.74)mm,中部厚2.27±0.40(1.64～2.72) mm。②肩胛上神经由起点至肩胛上孔之间的长度为:48.07±7.27(39.16～60.28)mm,起点处肩胛上神经的外径为1.49±0.33(0.98～1.92)mm,肩胛上神经由肩胛上孔至肩胛下孔的长度为19.36±3.73(15.32～26.58)mm。③肩胛上神经与肩胛上血管之间关系:神经走在韧带下方进入孔内,动静脉走在韧带外上方,占85%(34例),神经和血管组成血管神经束走在韧带下方,进入孔内,占12.5%(5例),神经和静脉在韧带下方入孔,动脉单独行于韧带上方,占2.5%(1例)。④肩胛上神经在冈盂切迹处的转折角角度变动在32.0°～66.0°之间,平均为50.68°±8.46°(左侧50.5°±9.06°;右:50.85°±7.80°)。结论:肩胛上孔和肩胛下孔处是肩胛上神经潜在的损伤部位,肩胛上、下横韧带的增厚或肩胛上、下孔的变小,都易卡压和损伤肩胛上神经。
[Abstract]:The origin, course, distribution and number of branches, diameters and proximity to the surrounding structure of the suprascapular nerve were observed. The causes of suprascapular nerve compression syndrome were discussed by quantitative analysis of related data. The relationship between the local anatomical characteristics of the suprascapular nerve and the clinical manifestations of the suprascapular nerve compression syndrome and the relevant aspects in the course of its treatment which need the attention of the clinicians are discussed. The anatomical basis for the diagnosis and treatment of the disease is provided. 20 adult cadavers with 10% formalin fixation were selected, including 13 male cadavers and 7 female cadavers. The cadaveric specimens were intact and had no pathological changes in the scapular region. The microanatomy of the scapular region was performed under a 5-fold operation microscope to observe the path, branches, distribution and adjacent relationship of the suprascapular nerve with the surrounding structure. The results showed that the suprascapular transverse ligament was strong and tough, the length of the ligament was 13.93 卤5.19 ~ 7.02 ~ 22.84) mm and the middle part was 2.30 卤0.57 ~ 1.42 ~ 2.94) mm, and the transverse ligament was slightly soft and falciform. The relationship between the nerve and the suprascapular vessels: the nerve walks below the ligament into the foramen, The arteries and veins walked above the ligaments, accounting for 34 cases, and the nerves and blood vessels formed the vascular and nerve bundles under the ligaments and entered the foramen in 5 cases, accounting for 12.5% of the tumors. The nerves and veins entered the foramen below the ligaments, and the arteries went alone over the ligaments. The angle of turning angle of suprascapular nerve at the incisor glenoid was 32.0 掳/ 66.0 掳, with an average of 50.68 掳卤8.46 掳(left 50.5 掳卤9.06 掳; right: 50.85 掳卤7.80 掳). Conclusion: the suprascapular foramen and subscapular foramen are the potential injury sites of suprascapular nerve. The thickening of suprascapular and inferior transverse ligament or the reduction of inferior foramen are easy to compress and injure the suprascapular nerve.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R322

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