本文選題：腋神經(jīng) + 三角肌　； 參考：《延邊大學(xué)》2017年碩士論文

【摘要】：目的:觀測(cè)腋神經(jīng)的解剖學(xué)形態(tài)以及與周圍重要解剖標(biāo)志的關(guān)系,為減少醫(yī)源性的腋神經(jīng)損傷提供解剖學(xué)依據(jù)。方法:選擇16側(cè)用福爾馬林固定的完整的亞洲成人上肢標(biāo)本,其中男性、女性標(biāo)本各8側(cè),所有上肢標(biāo)本無損傷、無疾病及發(fā)育不良。對(duì)腋神經(jīng)及其周圍組織進(jìn)行解剖,觀測(cè)腋神經(jīng)、三角肌的解剖學(xué)形態(tài)以及與周圍重要解剖標(biāo)志的關(guān)系。測(cè)量的指標(biāo)包括(1)腋神經(jīng)自四邊孔處至入三角肌點(diǎn)長(zhǎng)度;(2)腋神經(jīng)入三角肌點(diǎn)與周圍標(biāo)志距離;(3)腋神經(jīng)在三角肌深面分布范圍;(4)三角肌的高度及外徑;(5)三角肌下止點(diǎn)的高度及寬度;(6)肌縫處腋神經(jīng)與周圍標(biāo)志距離測(cè)量;(7)肌縫處腋神經(jīng)寬度。全部標(biāo)本解剖和數(shù)據(jù)的采集均由同一組團(tuán)隊(duì)完成,數(shù)據(jù)使用spss22.0統(tǒng)計(jì)軟件進(jìn)行處理。結(jié)果:通過解剖發(fā)現(xiàn)腋神經(jīng)從臂叢神經(jīng)發(fā)出后,繞過肩胛骨的外側(cè)緣和肩胛下血管一同向下方走形,從肩胛下肌的前下方通過,在其肌腱與肌腹的移行處下潛到達(dá)肩關(guān)節(jié)囊的下后方,通過四邊間隙繞過肱骨外科頸后從外后方進(jìn)入三角肌的深面,在其深面皇放射狀分布。腋神經(jīng)通過三角肌前、中部肌間隙處的上緣與肩峰前角肌縫止點(diǎn)處的距離男性為(60.74±4.88)mm女性為(56.30±4.46)mm,肌縫處神經(jīng)上、下緣之間的距離男性為(5.38±0.56)mm女性為(4.46±0.64)mm,肌縫處神經(jīng)上緣與大結(jié)節(jié)頂點(diǎn)距離男性為(36.02±4.16)mm女性為(33.04±4.58)mm,肌縫處神經(jīng)上緣與喙突頂點(diǎn)距離男性為(44.76±5.24)mm女性為(41.30±4.26)mm。腋神經(jīng)下緣與三角肌粗隆上緣的距離男性為(40.94±4.28)mm,女性為(37.86±3.84)mm。三角肌下止點(diǎn)呈長(zhǎng)條形止于三角肌粗隆,高度男性為(52.02±5.08)mm,女性為(48.86±4.36)mm,寬度男性為(23.46±4.24)mm,女性為(20.56±3.78)mm。結(jié)論:腋神經(jīng)在三角肌的分布屬于橫行區(qū)域分布,針對(duì)這一特點(diǎn)來.選擇合適的手術(shù)入路能夠降低腋神經(jīng)損傷的幾率。
[Abstract]:Objective: to observe the anatomical morphology of axillary nerve and its relationship with important anatomic markers in order to provide anatomic basis for reducing iatrogenic axillary nerve injury. Methods: sixteen Asian adult upper limb specimens fixed with formalin were selected, of which 8 were male and 8 female, all of which were free of injury, disease and dysplasia. The axillary nerve and its surrounding tissues were dissected and the anatomical morphology of axillary nerve and deltoid muscle were observed. The measurements included 1) the length of axillary nerve from the foramen quadrilateral to the deltoid muscle point (2) the distance between the axillary nerve entering the deltoid muscle point and the surrounding marker (3) the axillary nerve distributed in the deltoid muscle deep surface and 4) the height and outer diameter of the deltoid muscle and the height and outer diameter of the deltoid muscle were 5) the deltoid muscle stopped under the deltoid muscle. The distance between the axillary nerve and the peripheral marker at the muscle suture was measured to measure the width of the axillary nerve at the muscle suture. All specimens were dissected and collected by the same team. The data were processed by spss22.0 software. Results: after the axillary nerve emanated from the brachial plexus, it was found that the axillary nerve passed through the anterior and lower part of the subscapular muscle, circumventing the lateral margin of the scapular bone and the subscapular vessels. The tendons and ventriculus of the muscle dived down to the lower rear of the shoulder capsule and passed through the humeral surgical neck through the four sides of the space into the deep surface of the deltoid muscle from the outer posterior to the deep surface of the deltoid muscle and distributed radially in the deep surface. The distance of axillary nerve through deltoid muscle, the distance between upper margin of middle muscle space and suture of anterior horn of acromion was 60.74 鹵4.88)mm in male, 56.30 鹵4.46 mm in female, and 56.30 鹵4.46 mm in female. The distance between the inferior edge and the upper edge of the muscle suture was 4.46 鹵0.64 mm for the female, 36.02 鹵4.58 mm for the female, and 41.30 鹵4.26 mm for the female. The distance between the superior edge of the muscle suture and the vertex of the coracoid process was 44.76 鹵4.26 mm in the female and the distance between the superior edge of the muscle suture and the vertex of the coracoid process was 36.02 鹵4.58 mm in the male and 44.76 鹵4.26 mm in the female. The distance between the inferior edge of axillary nerve and the superior edge of deltoid muscle was 40.94 鹵4.28 mm in male and 37.86 鹵3.84 mm in female. The height of deltoid muscle was 52.02 鹵5.08 mm for male, 48.86 鹵4.36 mm for female, 23.46 鹵4.24 mm for male and 20.56 鹵3.78 mm for female. Conclusion: the distribution of axillary nerve in deltoid muscle belongs to transverse region. The choice of appropriate surgical approach can reduce the risk of axillary nerve injury.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R322;R687
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本文編號(hào)：1888813