人肱三头肌肌构筑学、肌内神经分布、肌梭分布和神经入肌定位的研究

发布时间：2018-06-08 13:56

本文选题：人 + 肱三头肌　；参考：《遵义医学院》2009年硕士论文

【摘要】： 目的:通过对肱三头肌肌构筑学,肌内神经分布,神经入肌点定位,肌梭分布的研究进一步探讨肱三头肌的形态学特点,为深入研究肱三头肌在肢体关节运动中的作用提供形态学依据,并为肌的临床应用提供参考数据。方法:1.用经甲醛固定1年以上的成人尸体5具,完整取下两侧的肱三头肌,采用大体解剖法观察肌内腱板的位置、形态、数量,肌束的走行方向与肌内腱板的位置关系。2.成人尸体6具,用肌构筑法测量肱三头肌的肌重、肌长、肌纤维长、生理横切面积等肌构筑学指数,探讨其构筑学特征。3.用经甲醛固定1年以上的童尸3具(5～10岁)及成人尸体2具(30～40岁),取下两侧肱三头肌,用改良的Sihler's肌内神经染色法观察肌内神经的分支分布。4.用成尸5具,分别在肱三头肌的三个头的肌腹中部取材,行组织学HE染色后,采用体视学方法进行肌梭分布的研究。5.用成人尸体10具,共20侧。以肱骨内、外上髁的连线为X轴,以肱骨大结节外侧并垂直于X轴的垂线为Y轴,分别测量桡神经肱三头肌肌支的神经入肌点距X轴和Y轴的距离。结果:1.大体解剖研究外侧头下段表面有厚的腱膜,外侧头浅部及深部肌束和长头的浅部肌束分别止于该腱膜;长头深面有一片状腱板,长约(16.7±2.2)cm,最宽处约(4.19±0.46)cm,外侧头深部肌束和长头的深部肌束分别以半羽状和羽状形式止于该腱板;内侧头肌质内有两条索状腱板,内侧头的内侧肌束止于该腱板的两侧,外侧肌束止于外侧头表面的腱膜。肱三头肌是多羽肌。2.肌构筑学特征肱三头肌长头的肌重(163.30±35.19)g,肌纤维长(7.40±1.17)cm,生理横切面积(19.53±1.45)cm~2;内侧头的肌重(109.05±27.27)g,肌纤维长(5.76±0.52)cm,生理横切面积(19.45±4.31)cm~2;外侧头的肌重(104.83±20.67)g,肌纤维长(5.89±0.83)cm,生理横切面积(16.92±2.12)cm~2。3.肌内神经分支分布肱三头肌三个头各有一支一级神经支配。长头肌支有两支二级神经支,外侧支粗大,支配范围广,肌内神经分支多,和外侧头肌支存在交通支。内侧头肌支有两支二级神经支,下支支配内侧头的大部分,肌内神经分支多,在其肌内部存在丰富的神经吻合网,与外侧头肌支间有交通支。外侧头肌支有两支二级神经支,分别支配外侧头的浅、深部。4.肌梭分布长头肌梭密度为17.14±2.53个/cm~3,肌梭指数为16.24±2.40个/g;内侧头肌梭密度为21.41±2.87个/cm~3,肌梭指数为20.27±2.72个/g;外侧头肌梭密度为17.41±2.71个/cm~3,肌梭指数为16.49±2.57个/g。5.神经入肌点定位长头肌支距X轴和Y轴的距离分别为19.68±2.12cm,6.65±0.84cm;内侧头肌支距X轴和Y轴的距离分别为15.81±3.40cm,5.67±1.32cm;外侧头肌支距X轴和Y轴的距离分别为18.27±2.90cm,4.8±1.39cm。结论:1.肱三头肌三个头内都有肌内腱板或腱膜,短肌束以羽状形式排列,肱三头肌是多羽肌。2.肱三头肌内、外侧头生理横切面积/肌重的比值大,提示内、外侧头更倾向于力量型构筑;长头肌纤维长,更多倾向于速度运动,运动幅度大于内、外侧两头。3.肱三头肌肌每个头都有一支一级神经,两支二级神经,肌内各级神经分支主要分布在腱膜的深面,或在肌内腱板的两侧。肌内神经分支多,在肱三头肌的中部,三个头的神经存在交通支。4.肱三头肌内侧头肌梭密度比外侧头、长头高且有肌梭联合体,推测内侧头能更敏感地监测关节运动细微变化,对肘关节的稳定性有主要作用。5.肱三头肌的神经入肌点共有三个,三个头的神经入肌点主要集中在肱骨内、外上髁的连线上方15～19cm,肱骨大结节的垂线内侧4～6cm的范围内。
[Abstract]:Objective: to further study the morphological characteristics of triceps brachii by the study of triceps brachii muscle architecture, the distribution of intramuscular nerve, the location of nerve entry point and the distribution of muscle spindle, so as to provide the morphological basis for the study of the role of triceps in the joint movement of the limbs, and provide reference data for the clinical application of the muscle.
Methods: 1. with 5 adult cadavers fixed with formaldehyde for more than 1 years, the triceps brachii was taken from both sides. The position, shape, quantity, the direction of the muscle tendon and the position of the intramuscular tendon were observed by the gross anatomy method. The muscle weight of the triceps muscle, the length of the muscle, the length of the muscle, the length of the muscle and the physiological transverse of the muscle were measured by the method of muscle construction. 1. The muscular architecture index of the area was cut. The architectural features of.3. were studied in 3 cadavers (5~10 years old) and 2 adult cadavers (30~40 years old) with formaldehyde fixation for more than 1 years. The triceps of the brachial triceps were removed from both sides. The branch distribution of the intramuscular nerve was observed with the modified Sihler's intramuscular nerve staining method, and the muscle of the intramuscular nerve was used as 5, respectively, in the muscles of three head of the triceps brachii. HE staining in the middle part of the abdomen was used to study the distribution of muscle spindle by stereological method. There were 10 adult cadavers with 20 adult cadavers. In the humerus, the line of the outer epicondyle was the X axis. The lateral of the humerus tubercle and perpendicular to the X axis were the Y axis, and the distance between the X axis and the Y axis of the nerve into the brachial triceps muscle branch of the radial nerve was measured respectively.
Results: 1. the lateral head and lower part of the lateral head were thick aponeurosis, and the superficial and deep bundle of the lateral head and the deep part of the long head were stopped at the aponeurosis. The long head had a flake of tendon, which was about (16.7 + 2.2) cm long, and the width was about (4.19 + 0.46) cm. The lateral deep muscle and the deep muscle in the long head were half pinnate and pinnate, respectively. In the tendon plate, there are two tendons in the medial head muscle, the medial myocutaneous tract of the medial head ends on both sides of the tendon and the lateral tract stops at the aponeurosis on the outer surface of the lateral head. The triceps brachii is the muscular weight (163.30 + 35.19) g of the long head of the triceps muscle of the multiple plume muscle, the length of the muscle fiber (7.40 + 1.17) cm, and the physiological transverse area (19.53 + 1.45) cm~2. The muscle weight of the medial head (109.05 + 27.27) g, muscle fiber length (5.76 + 0.52) cm, physiological transverse area (19.45 + 4.31) cm~2, muscle weight of the lateral head (104.83 + 20.67) g, muscle fiber long (5.89 + 0.83) cm, and physiological transverse area (16.92 + 2.12) intramuscular nerve branch distribution of the brachial triceps, each has a primary nerve innervation. The nerve branch of the level, the lateral branch is large, the domination range is wide, the intramuscular nerve branch is many, and the lateral head muscle branch has the traffic branch. The medial head muscle branch has two two grade nerve branches, the lower branch dominates the inside head most, the intramuscular nerve branch is many, there are abundant nerve anastomosis net in its muscle, and the lateral head muscle has the traffic branch. The lateral head muscle is two. The branches of the two grade nerve branches were used to control the superficial lateral head respectively. The long head spindle density of the deep.4. muscle spindle was 17.14 + 2.53 /cm~3, the muscle spindle index was 16.24 + 2.40 /g, the spindle density in the medial head muscle was 21.41 + 2.87 /cm~3, the muscle spindle index was 20.27 + 2.72 /g, the lateral head muscle spindle density was 17.41 + 2.71 /cm~3, and the muscle spindle index was 16.49 + 2.57 /g.5. gods. The distance between the X axis of the long head and the Y axis was 19.68 + 2.12cm and 6.65 + 0.84cm, respectively. The distance between the X axis and the Y axis of the medial head muscle was 15.81 + 3.40cm and 5.67 + 1.32cm, respectively, and the distance between the lateral head muscle and the Y axis were 18.27 + and 4.8 + 1.39cm..
Conclusion: 1. there are intramuscular tendons or aponeurosis in three head of triceps brachii. The short muscle is arranged in the form of pinnately. The triceps brachii is the.2. brachial triceps of the multiple plume muscles. The ratio of the lateral head to the transverse area / muscle weight is large. It is suggested that the lateral head is more inclined to the strength type, and the long head muscle is more inclined to speed movement and the range of movement is greater than that of the inside. Each head of the lateral.3. brachial triceps has one primary nerve and two branches of the two grade nerve. The branches of the intramuscular nerve are mainly distributed in the deep surface of the aponeurosis, or on the sides of the intramuscular tendon. The branches of the intramuscular nerve are more, in the middle of the triceps, and in the three heads of the.4., the density of the medial head of the triceps muscle is more than the lateral head. Head high and muscle spindle conjecture, it is speculated that the medial head can be more sensitive to monitoring the subtle changes of joint movement. The stability of the elbow joint has a main effect on the.5. brachial triceps. The point of the nerve entry of the triceps is three, the nerve entry points of the three head are mainly concentrated in the humerus, the line of the epicondyle is 15 to 19cm, and the inner side of the large humeral tubercle is 4 to 6cm. Within the scope.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R322

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