發(fā)布時間：2018-05-29 11:56

  本文選題：上唇 + 肌肉　； 參考：《北京協(xié)和醫(yī)學(xué)院》2012年碩士論文

【摘要】：[目的]通過解剖、組織切片、MRI和連續(xù)切片三維重建方法,全方位的觀察上唇及周圍結(jié)構(gòu),構(gòu)建更完善、精確、立體的上唇肌肉系統(tǒng)模型。 [方法]選取2具正常成人頭顱標(biāo)本,在唇的外周區(qū)由皮膚向深面逐層解剖出放射狀排列的口周肌,顯示上唇鼻翼提肌、上唇提肌、顴小肌、顴大肌、笑肌、口角提肌、頰肌及口輪匝肌,觀察各條肌肉的起止點、纖維方向,顯微解剖下重點觀察口周肌肉與口輪匝肌的交匯點與連接層次。選取8例正常成人上唇部標(biāo)本進(jìn)行軸狀面、矢狀面、冠狀面連續(xù)組織石蠟切片,通過HE和masson染色觀察人中、唇弓、紅唇、鼻檻等處結(jié)構(gòu),并應(yīng)用三維重建軟件3D-DOCTOR對連續(xù)組織切片進(jìn)行三維重建。選取1例正常成人上唇部標(biāo)本進(jìn)行MicroMR(微型磁共振系統(tǒng))進(jìn)行三維重建。綜合各方面圖像提供的信息,構(gòu)建出上唇肌肉系統(tǒng)模型。 [結(jié)果]通過構(gòu)建出的上唇肌肉系統(tǒng)模型對上唇及周圍組織進(jìn)行觀察�？梢娚洗讲康目谥芟嚓P(guān)肌肉由內(nèi)向外、由淺到深主要有上唇鼻翼提肌、上唇提肌、顴小肌、顴大肌、笑肌、口角提肌、頰肌,這些肌肉與口輪匝肌在鼻翼緣外下方、紅唇外翻處及口角等處相互交匯。口輪匝肌深層肌肉除有水平方向環(huán)形的肌纖維外,還有口角斜向內(nèi)上走行的扇形肌纖維,部分終止于鼻小柱下前鼻嵴處,移行為鼻中隔降肌,部分越過中線繼續(xù)走形,在鼻底移行為鼻肌翼部,在鼻底下方移行為上唇鼻翼提肌,在上唇近唇紅緣側(cè)移行為上唇提肌及顴小肌。鼻肌翼部一端移行為口輪匝肌,另一端同鼻翼軟骨外側(cè)角相連,鼻中隔降肌一端移行為口輪匝肌,另一端同鼻翼軟骨內(nèi)側(cè)角相連,他們在鼻底處相互交叉重疊,形成鼻檻機(jī)構(gòu)。上唇提肌、顴小肌從鼻翼外緣向近中走行,最后交匯于口輪匝肌深層靠近紅唇側(cè)外翻處,對唇弓形成有重要意義。軸狀面的口輪匝肌深層發(fā)出的到對側(cè)人中嵴外側(cè)的肌纖維,與冠狀面的上唇鼻翼提肌、上唇提肌、顴小肌與口輪匝肌淺層共同形成的類似SMAS的淺表肌層發(fā)出的到同側(cè)人中嵴內(nèi)側(cè)的網(wǎng)狀肌纖維,兩種肌纖維相互交叉,形成人中嵴結(jié)構(gòu)。 [結(jié)論]在此基礎(chǔ)上構(gòu)建了更完善、精確、立體的上唇肌肉系統(tǒng)模型,發(fā)現(xiàn)了上唇部存在的三個張力平衡結(jié)構(gòu),提出了上唇主張力帶、第一副張力帶、第二副張力帶理論。
[Abstract]:[objective] to observe the upper lip and its surrounding structures in all directions by dissection, MRI and 3D reconstruction of serial sections, and to construct a more perfect, accurate and stereoscopic upper lip muscle system model. [methods] Radially arranged peroral muscles were dissected from the peripheral area of the lip from the skin to the deep surface in 2 normal adult skull specimens, showing the levator muscle of the upper lip, the zygomaticus minor muscle, the zygomaticus major muscle, the laughing muscle and the horn levator muscle. Buccal muscle and orbicularis oris muscle were observed to observe the starting and ending point of each muscle, the direction of fiber, and the meeting point and connecting level of perioral muscle and orbicularis oris muscle were observed under microdissection. Paraffin sections of axial, sagittal and coronal tissues were taken from 8 normal adult upper lip specimens. The structures of human, labial arch, red lip and nasal sill were observed by HE and masson staining. Three-dimensional reconstruction software 3D-DOCTOR was used to reconstruct the continuous tissue sections. A normal adult upper lip specimen was reconstructed with MicroMRs (Micro Magnetic Resonance system). The model of upper lip muscle system was constructed by synthesizing the information provided by all kinds of images. [results] the upper lip and surrounding tissues were observed by the upper lip muscle system model. It can be seen that the peroral muscles in the upper lip are from inside to out, and from shallow to deep there are mainly levator muscle of upper lip and nose, levator muscle of upper lip, zygomaticus minor muscle, zygomaticus major muscle, laughing muscle, levator oris muscle, buccal muscle. These muscles and orbicularis oris muscle are below the outer edge of the nasal wing. Red lip varus and mouth and so on place intersects mutually. In addition to the circular muscle fibers in the horizontal direction, the deep muscle of the orbicularis oris muscle also has the sector muscle fiber which moves diagonally inward, partly terminates at the anterior nasal crest under the columnar nose, moves the descending muscle of the septum, and partly continues to walk across the midline. At the bottom of the nose, the pterygoid of the nasal muscle, the levator muscle of the upper lip and the zygomaticus minor muscle were shifted at the bottom of the nose, the levator muscle of the upper lip near the red edge of the lip and the zygomaticus minor muscle. One end of the pterygoid part of the nasal muscle moves the orbicularis oris muscle, the other end is connected with the lateral angle of the alar cartilage, one end of the descending muscle of the nasal septum moves the orbicularis oris muscle and the other end is connected with the medial angle of the alar cartilage. The upper labial levator muscle and zygomaticus minor muscle walk from the outer edge of the nasal wing to the near middle, and finally intersect in the deep layer of orbicularis oris muscle near the lateral verticus of the red lip, which is of great significance for the formation of the labial arch. The deep muscle fibers from the orbicularis oris muscle on the axial surface to the lateral crest of the contralateral human crest, and the levator muscle of the upper lip and nose, the levator muscle of the upper lip, and the muscle of the upper lip of the coronal plane. The superficial muscle layer similar to SMAS is formed by zygomaticus minor and orbicularis oris muscle. The two kinds of muscle fibers intersect with each other to form the structure of the human mesoceles from the superficial muscle layer of the zygomaticus minor and the orbicularis oris muscle to the medial side of the human middle crest. [conclusion] on this basis, a more perfect, accurate and stereoscopic model of upper lip muscle system is constructed, and three tension balance structures in upper lip are found, and the theory of upper lip force band, first pair tension band and second pair tension band are put forward.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R322

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 張中海;;病理切片制作過程中常見問題及原因探析[J];吉林醫(yī)學(xué);2011年27期

2 焦婷;張富強(qiáng);;應(yīng)用核磁共振(MRI)采集及三維重建面部表面軟組織形態(tài)的研究[J];口腔頜面修復(fù)學(xué)雜志;2007年04期

3 王蕾蕾;趙振民;湯臣;尹寧北;莊強(qiáng);王春燕;吳宏志;劉燦;武星;;鼻唇部連續(xù)組織切片的計算機(jī)三維重建[J];中國美容醫(yī)學(xué);2008年11期

4 張富強(qiáng),焦婷,孫健;應(yīng)用螺旋CT三維重建頜面部軟組織的研究[J];上海口腔醫(yī)學(xué);2005年04期

5 王善良,姚德成,張滌生;口角蝸軸的解剖功能及其對面部表情的影響[J];中國實用美容整形外科雜志;2005年03期

6 路健;王伶;;石蠟切片制作中的問題與解決[J];山西醫(yī)科大學(xué)學(xué)報(基礎(chǔ)醫(yī)學(xué)教育版);2001年03期

7 王治熙，張奎啟，，韓輝，尹曉青，林麗，曹憲臣;唇裂患者口輪匝肌的解剖學(xué)觀察[J];中華口腔醫(yī)學(xué)雜志;1994年01期

8 張挽時,徐家興;多層面螺旋CT和CT三維成像技術(shù)的臨床應(yīng)用[J];中國醫(yī)學(xué)影像學(xué)雜志;2001年05期

本文編號：1950795