發(fā)布時(shí)間：2018-06-04 05:06

  本文選題：肌內(nèi)神經(jīng)分布 + 血管造影�。� 參考：《第二軍醫(yī)大學(xué)》2006年博士論文

【摘要】：目的 觀察前臂肌內(nèi)神經(jīng)血管分布，明確前臂神經(jīng)各肌支的解剖學(xué)特征，并結(jié)合其肌內(nèi)神經(jīng)和血管的分布關(guān)系對(duì)其進(jìn)行分類，探討前臂肌能否被分割為若干個(gè)功能單位，以提供新的功能性骨骼肌游離移植供區(qū)。方法 解剖5具10％甲醛固定的成年尸體共10側(cè)前臂肌，觀察其肌外神經(jīng)血管的分布形式。5具新鮮成年尸體標(biāo)本共10側(cè)前臂肌，將其每塊肌肉完整剝離后用Sihler's染色法行肌內(nèi)神經(jīng)的染色。4具新鮮成年尸體標(biāo)本共8側(cè)前臂肌，經(jīng)肱動(dòng)脈30％硫酸鋇、乳膠混懸液灌注后，分割切取每塊肌肉并行X線鉬靶攝片。觀察和研究前臂諸肌肌內(nèi)神經(jīng)、血管的分布及其關(guān)系。結(jié)果 肌內(nèi)各級(jí)神經(jīng)分支被染成藍(lán)紫色，清晰可見(jiàn)神經(jīng)在肌內(nèi)的分布。按前臂肌肌內(nèi)神經(jīng)血管分布的特點(diǎn)，分為3類，各類再分為a、b兩個(gè)亞類。Ⅰ類肌肉，為一支主要的神經(jīng)干支配，，可再分為：Ⅰa類：該類肌肉其血供多為優(yōu)勢(shì)血管蒂型，其肌內(nèi)動(dòng)脈分支的走行和分布特點(diǎn)與神經(jīng)分支相似，此類肌肉外形多為扁平形或梯形。Ⅰb類：血供多為節(jié)段血管蒂型，肌內(nèi)血管之間有豐富的吻合支，此類肌肉外形多為紡錘形。Ⅱ類肌肉，均為紡錘形肌，肌內(nèi)神經(jīng)呈多支型分布，有相同的神經(jīng)來(lái)源。此類肌肉可再分為：Ⅱa類：為單羽肌，神經(jīng)偏于肌腱的一側(cè)走行。血供多為節(jié)段血管蒂型，肌內(nèi)血管之間有豐富的吻合支。Ⅱb類：有較明顯的肌內(nèi)腱板，以腱為界可自然分出兩個(gè)部分，每個(gè)部分都有獨(dú)立的神經(jīng)和血管支配，血供多為節(jié)段血管蒂型，與神經(jīng)伴行的動(dòng)脈入肌后往往沿中央腱兩側(cè)走行，分布區(qū)域與神經(jīng)支配區(qū)域大致相同，各血管分支間有良好的吻合。Ⅲ類，主要包括多個(gè)起點(diǎn)和多個(gè)止點(diǎn)的肌肉�？稍俜譃椋骯類：為多個(gè)起點(diǎn)，每個(gè)頭都有獨(dú)立的神經(jīng)支配，血供為節(jié)段血管蒂型，肌內(nèi)血管之間有豐富的吻合支。Ⅲb類：為多個(gè)止點(diǎn)，在肌肉起始處，有神經(jīng)返支支配肌腹的上1／3，部分肌肉接受不同來(lái)源的神經(jīng)支配。血供多為優(yōu)勢(shì)血管蒂型加節(jié)段血管蒂型，且以共干支配形式為主，肌內(nèi)血管之間有豐富的吻合支。結(jié)論 ①明確了前臂諸肌神經(jīng)支配的特點(diǎn)；②前臂肌內(nèi)中Ⅱb類肌肉和某些Ⅲ類肌肉，可將其分為不同的功能單位，供節(jié)段性游離肌肉移植。
[Abstract]:Objective to observe the distribution of nerve and blood vessels in the forearm muscle, to determine the anatomical characteristics of the branches of the forearm nerve, and to classify it according to the distribution relationship between the intramuscular nerve and the blood vessel, and to explore whether the forearm muscle can be divided into several functional units. To provide a new free donor area for functional skeletal muscle transplantation. Methods 10 forearm muscles were dissected from 5 adult cadavers fixed with 10% formaldehyde. The distribution of extramuscular nerve and blood vessels was observed in 5 fresh adult cadavers with 10 forearm muscles. After each muscle was completely stripped, 8 forearm muscles were stained with Sihler's staining method in 4 fresh adult cadavers. The brachial artery was perfused with 30% barium sulfate and emulsion suspension. Each muscle was segmented and taken with X ray molybdenum target. To observe and study the distribution and relationship of intramuscular nerves and blood vessels in forearm muscles. Results the nerve branches were stained blue-purple and the distribution of nerves in the muscle was clearly visible. According to the distribution of intramuscular nerve and blood vessel in forearm muscle, there are three types of muscle, each of which is subdivided into two subgroups of afib. Type I muscle is a main nerve trunk innervation, and can be subdivided into class 鈪

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