眼外肌Pulley结构的解剖学和影像学观察
发布时间：2018-08-09 07:26
【摘要】： 目的意义:探讨眼外肌Pulley结构解剖学基础及pulley理论在临床眼肌疾病诊治中的应用。 实验方法:Pulley结构的解剖学观察:用骨剪打开眶壁,分离并除去眶内骨膜和脂肪,仔细解剖出眼外肌,小心沿每条眼外肌肌腹向前分离至眼球及眼外肌表面的Tenon氏囊游离缘。仔细剥离和清除Pulley结构周围的结缔组织,测量Pulley结构从巩膜附着点至Pulley的长度并记录。将pulley组织块取下放入4%多聚甲醛液中固定2小时,作石蜡切片,HE染色,Masson三色染色和F-actin染色,证实pulley组织结构。Pulley结构的影像学观察:健康志愿者6名年龄24～37岁,平均29.5岁,无跟球震颤和眼球运动障碍.对受检者原在位和第二限位共5个注视点进行MRI水平位,矢状位,冠状位扫描。在扫描图片上对pulley结果进行观察和分析。 结果:解剖观察到,在直肌穿过Tenon氏囊的部位,Tenon氏囊的结缔组织筋膜反折增厚,非常紧密地附着在眼外肌表面,不易与眼外肌剥离,此结构就是Pulley。Pulley结构在内直肌与下直肌之间和外直肌与上直肌之间结缔组织相对增厚,而在上直肌与内直肌之间以及下直肌与外直肌之间结缔组织相对薄弱。通过H-E染色,Masson三色染色以及F-actin染色证明Pulley结构主要由大量胶原纤维和少量平滑肌组成。MRI扫描动态观察到:两眼平视前方位时,内外直肌与眼方位一至,当眼向左斜视时,左侧的内直肌和右侧的外直肌与眼的方位之间出现了一个角度,即急拐弯现象。眼向右斜视时也出现了与左侧相同的情况。 结论: 1、眼外肌近眼球端有一致密结缔组织纤维包绕,并相互连结形成一个完整结缔组织鞘,鞘的后缘位于眼球后极与赤道平面之间。此结构则是Pulley结构。 2、MRI动态扫描表明眼外肌确实存在Pulley结构样功能,并急拐弯处与本文观察到的结缔组织鞘后缘一致,而与眶壁相连的纤维节制韧带存在于巩膜前缘平面与中纬线平面之间。因此原认为Pulley结构是点作用或纤维滑车作用应修正为Pulley作用是由眼外肌完整纤维结缔组织鞘整体作用的结果。
[Abstract]:Objective: to explore the anatomical basis of Pulley structure of extraocular muscles and the application of pulley theory in the diagnosis and treatment of ocular muscle diseases. Methods Anatomical observation of Pulley's structure: opening the orbital wall with bone scissors, separating and removing the intraorbital periosteum and fat, carefully dissecting the extraocular muscle and carefully dissecting the extraocular muscle, and carefully dissecting the free edge of the Tenon's sac along the abdomen of each extraocular muscle to the eyeball and the surface of the extraocular muscle. The connective tissue around the Pulley structure was carefully stripped and removed, and the length of the Pulley structure from the scleral attachment point to the Pulley was measured and recorded. The pulley tissue mass was removed and put into 4% paraformaldehyde solution for 2 hours. The paraffin sections were stained with HE staining and F-actin staining. The imaging observation of pulley tissue structure and Pulley structure was confirmed: 6 healthy volunteers were 2437 years old with an average age of 29.5 years. No heel ball tremor or eye movement disorder. MRI horizontal, sagittal and coronal scans were performed on 5 fixation points. The pulley results were observed and analyzed on the scanning images. Results: anatomically, the connective tissue fascia of Tenon's sac was thickened at the place where rectus muscle passed through Tenon's sac. It was very closely attached to the surface of the extraocular muscle and could not easily be peeled off from the extraocular muscle. The connective tissue between the inner rectus and the inferior rectus and between the outer rectus and the superior rectus is thicker than that between the superior rectus and the medial rectus and the connective tissue between the inferior rectus and the external rectus is relatively weak. It was proved by H-E staining and F-actin staining that the structure of Pulley was mainly composed of a large number of collagen fibers and a small amount of smooth muscle. There is an angle between the left medial rectus and the right lateral rectus and eye azimuth. The same is true when the eye strabismus to the left. Conclusion: 1. There is a dense connective tissue fiber wrapped in the proximal end of the extraocular muscle and connected with each other to form a complete connective tissue sheath. The posterior edge of the sheath lies between the posterior pole of the eyeball and the equatorial plane. This structure is a Pulley structure. 2the dynamic scanning shows that the extraocular muscle does exist Pulley structure-like function, and the sharp curve is consistent with the posterior edge of connective tissue sheath observed in this paper. The fibrous abstinent ligament associated with the orbital wall exists between the anterior scleral plane and the central weft plane. Therefore, it was thought that the Pulley structure should be modified by the point action or fiber trochlea action to the effect of Pulley, which was the result of the whole function of connective tissue sheath of the complete fiber of the extraocular muscle.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R777.4;R322
本文编号：2173349
[Abstract]:Objective: to explore the anatomical basis of Pulley structure of extraocular muscles and the application of pulley theory in the diagnosis and treatment of ocular muscle diseases. Methods Anatomical observation of Pulley's structure: opening the orbital wall with bone scissors, separating and removing the intraorbital periosteum and fat, carefully dissecting the extraocular muscle and carefully dissecting the extraocular muscle, and carefully dissecting the free edge of the Tenon's sac along the abdomen of each extraocular muscle to the eyeball and the surface of the extraocular muscle. The connective tissue around the Pulley structure was carefully stripped and removed, and the length of the Pulley structure from the scleral attachment point to the Pulley was measured and recorded. The pulley tissue mass was removed and put into 4% paraformaldehyde solution for 2 hours. The paraffin sections were stained with HE staining and F-actin staining. The imaging observation of pulley tissue structure and Pulley structure was confirmed: 6 healthy volunteers were 2437 years old with an average age of 29.5 years. No heel ball tremor or eye movement disorder. MRI horizontal, sagittal and coronal scans were performed on 5 fixation points. The pulley results were observed and analyzed on the scanning images. Results: anatomically, the connective tissue fascia of Tenon's sac was thickened at the place where rectus muscle passed through Tenon's sac. It was very closely attached to the surface of the extraocular muscle and could not easily be peeled off from the extraocular muscle. The connective tissue between the inner rectus and the inferior rectus and between the outer rectus and the superior rectus is thicker than that between the superior rectus and the medial rectus and the connective tissue between the inferior rectus and the external rectus is relatively weak. It was proved by H-E staining and F-actin staining that the structure of Pulley was mainly composed of a large number of collagen fibers and a small amount of smooth muscle. There is an angle between the left medial rectus and the right lateral rectus and eye azimuth. The same is true when the eye strabismus to the left. Conclusion: 1. There is a dense connective tissue fiber wrapped in the proximal end of the extraocular muscle and connected with each other to form a complete connective tissue sheath. The posterior edge of the sheath lies between the posterior pole of the eyeball and the equatorial plane. This structure is a Pulley structure. 2the dynamic scanning shows that the extraocular muscle does exist Pulley structure-like function, and the sharp curve is consistent with the posterior edge of connective tissue sheath observed in this paper. The fibrous abstinent ligament associated with the orbital wall exists between the anterior scleral plane and the central weft plane. Therefore, it was thought that the Pulley structure should be modified by the point action or fiber trochlea action to the effect of Pulley, which was the result of the whole function of connective tissue sheath of the complete fiber of the extraocular muscle.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R777.4;R322
【参考文献】
相关期刊论文 前4条
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