發(fā)布時(shí)間：2018-06-08 13:56

  本文選題：人 + 肱三頭肌�。� 參考：《遵義醫(yī)學(xué)院》2009年碩士論文

【摘要】： 目的:通過(guò)對(duì)肱三頭肌肌構(gòu)筑學(xué),肌內(nèi)神經(jīng)分布,神經(jīng)入肌點(diǎn)定位,肌梭分布的研究進(jìn)一步探討肱三頭肌的形態(tài)學(xué)特點(diǎn),為深入研究肱三頭肌在肢體關(guān)節(jié)運(yùn)動(dòng)中的作用提供形態(tài)學(xué)依據(jù),并為肌的臨床應(yīng)用提供參考數(shù)據(jù)。 方法:1.用經(jīng)甲醛固定1年以上的成人尸體5具,完整取下兩側(cè)的肱三頭肌,采用大體解剖法觀察肌內(nèi)腱板的位置、形態(tài)、數(shù)量,肌束的走行方向與肌內(nèi)腱板的位置關(guān)系。2.成人尸體6具,用肌構(gòu)筑法測(cè)量肱三頭肌的肌重、肌長(zhǎng)、肌纖維長(zhǎng)、生理橫切面積等肌構(gòu)筑學(xué)指數(shù),探討其構(gòu)筑學(xué)特征。3.用經(jīng)甲醛固定1年以上的童尸3具(5～10歲)及成人尸體2具(30～40歲),取下兩側(cè)肱三頭肌,用改良的Sihler's肌內(nèi)神經(jīng)染色法觀察肌內(nèi)神經(jīng)的分支分布。4.用成尸5具,分別在肱三頭肌的三個(gè)頭的肌腹中部取材,行組織學(xué)HE染色后,采用體視學(xué)方法進(jìn)行肌梭分布的研究。5.用成人尸體10具,共20側(cè)。以肱骨內(nèi)、外上髁的連線為X軸,以肱骨大結(jié)節(jié)外側(cè)并垂直于X軸的垂線為Y軸,分別測(cè)量橈神經(jīng)肱三頭肌肌支的神經(jīng)入肌點(diǎn)距X軸和Y軸的距離。 結(jié)果:1.大體解剖研究外側(cè)頭下段表面有厚的腱膜,外側(cè)頭淺部及深部肌束和長(zhǎng)頭的淺部肌束分別止于該腱膜;長(zhǎng)頭深面有一片狀腱板,長(zhǎng)約(16.7±2.2)cm,最寬處約(4.19±0.46)cm,外側(cè)頭深部肌束和長(zhǎng)頭的深部肌束分別以半羽狀和羽狀形式止于該腱板;內(nèi)側(cè)頭肌質(zhì)內(nèi)有兩條索狀腱板,內(nèi)側(cè)頭的內(nèi)側(cè)肌束止于該腱板的兩側(cè),外側(cè)肌束止于外側(cè)頭表面的腱膜。肱三頭肌是多羽肌。2.肌構(gòu)筑學(xué)特征肱三頭肌長(zhǎng)頭的肌重(163.30±35.19)g,肌纖維長(zhǎng)(7.40±1.17)cm,生理橫切面積(19.53±1.45)cm~2;內(nèi)側(cè)頭的肌重(109.05±27.27)g,肌纖維長(zhǎng)(5.76±0.52)cm,生理橫切面積(19.45±4.31)cm~2;外側(cè)頭的肌重(104.83±20.67)g,肌纖維長(zhǎng)(5.89±0.83)cm,生理橫切面積(16.92±2.12)cm~2。3.肌內(nèi)神經(jīng)分支分布肱三頭肌三個(gè)頭各有一支一級(jí)神經(jīng)支配。長(zhǎng)頭肌支有兩支二級(jí)神經(jīng)支,外側(cè)支粗大,支配范圍廣,肌內(nèi)神經(jīng)分支多,和外側(cè)頭肌支存在交通支。內(nèi)側(cè)頭肌支有兩支二級(jí)神經(jīng)支,下支支配內(nèi)側(cè)頭的大部分,肌內(nèi)神經(jīng)分支多,在其肌內(nèi)部存在豐富的神經(jīng)吻合網(wǎng),與外側(cè)頭肌支間有交通支。外側(cè)頭肌支有兩支二級(jí)神經(jīng)支,分別支配外側(cè)頭的淺、深部。4.肌梭分布長(zhǎng)頭肌梭密度為17.14±2.53個(gè)/cm~3,肌梭指數(shù)為16.24±2.40個(gè)/g;內(nèi)側(cè)頭肌梭密度為21.41±2.87個(gè)/cm~3,肌梭指數(shù)為20.27±2.72個(gè)/g;外側(cè)頭肌梭密度為17.41±2.71個(gè)/cm~3,肌梭指數(shù)為16.49±2.57個(gè)/g。5.神經(jīng)入肌點(diǎn)定位長(zhǎng)頭肌支距X軸和Y軸的距離分別為19.68±2.12cm,6.65±0.84cm;內(nèi)側(cè)頭肌支距X軸和Y軸的距離分別為15.81±3.40cm,5.67±1.32cm;外側(cè)頭肌支距X軸和Y軸的距離分別為18.27±2.90cm,4.8±1.39cm。 結(jié)論:1.肱三頭肌三個(gè)頭內(nèi)都有肌內(nèi)腱板或腱膜,短肌束以羽狀形式排列,肱三頭肌是多羽肌。2.肱三頭肌內(nèi)、外側(cè)頭生理橫切面積/肌重的比值大,提示內(nèi)、外側(cè)頭更傾向于力量型構(gòu)筑;長(zhǎng)頭肌纖維長(zhǎng),更多傾向于速度運(yùn)動(dòng),運(yùn)動(dòng)幅度大于內(nèi)、外側(cè)兩頭。3.肱三頭肌肌每個(gè)頭都有一支一級(jí)神經(jīng),兩支二級(jí)神經(jīng),肌內(nèi)各級(jí)神經(jīng)分支主要分布在腱膜的深面,或在肌內(nèi)腱板的兩側(cè)。肌內(nèi)神經(jīng)分支多,在肱三頭肌的中部,三個(gè)頭的神經(jīng)存在交通支。4.肱三頭肌內(nèi)側(cè)頭肌梭密度比外側(cè)頭、長(zhǎng)頭高且有肌梭聯(lián)合體,推測(cè)內(nèi)側(cè)頭能更敏感地監(jiān)測(cè)關(guān)節(jié)運(yùn)動(dòng)細(xì)微變化,對(duì)肘關(guān)節(jié)的穩(wěn)定性有主要作用。5.肱三頭肌的神經(jīng)入肌點(diǎn)共有三個(gè),三個(gè)頭的神經(jīng)入肌點(diǎn)主要集中在肱骨內(nèi)、外上髁的連線上方15～19cm,肱骨大結(jié)節(jié)的垂線內(nèi)側(cè)4～6cm的范圍內(nèi)。
[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.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R322

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