Peker Tuncay, Gülekon Nadir, Turgut Basri Hasan, Anil Afitap, Karaköse Mustafa, Mungan Tamer, Danişman Nuri
Department of Anatomy, Gazi University, Ankara, Turkey.
Plast Reconstr Surg. 2006 Jan;117(1):165-76. doi: 10.1097/01.prs.0000186539.80555.27.
There are many gaps in the understanding of the neuroanatomy of skeletal muscles with regards to the nerve distribution pattern and shape of the muscles. This study was designed to examine the entire intramuscular nerve-distribution patterns of various human skeletal muscles.
The relationships among nine skeletal muscles with various architecture (rhomboid major, biceps brachii, flexor pollicis longus, rectus femoris, sternohyoid, trapezius, masseter, digastric muscles) and their nerve-distribution patterns were investigated in four fetal cadavers using the Sihler staining method. The diameter and number of extramuscular (main) and major nerve branches, the number of minor nerve branches, and anastomoses were examined and evaluated statistically.
With regards to the number of extramuscular (main) nerve branches, the rhomboid major muscle resembled the flexor pollicis longus, trapezius, masseter, and sternohyoid muscles, and the anterior belly of the digastricus muscle (p > 0.05), whereas it was significantly different from the rectus femoris, the posterior belly of digastricus, and the long and short heads of the biceps brachii (p < 0.05). Trapezius and masseter muscles were different from all of the skeletal muscles that were studied with regards to the diameter of main branches (p < 0.05). The masseter muscle had the largest diameter (p < 0.05). With regards to the number of minor nerve branches, the sternohyoid muscle was significantly different from all the skeletal muscles that were studied (p < 0.05) except the short head of the biceps brachii, rectus femoris, and the posterior belly of digastricus (p > 0.05). As for the number of neural anastomoses, the sternohyoid muscle was statistically different from all skeletal muscles that were studied (p < 0.05) except the masseter and trapezius muscles (p > 0.005).
A surgeon's thorough knowledge of the relationship between the shape and nerve distribution pattern of skeletal muscles is important in successful reinnervation and regeneration of these muscles. It might also be useful in the field of muscle transplantation.
在骨骼肌神经分布模式和肌肉形状的神经解剖学理解方面存在许多空白。本研究旨在检查各种人类骨骼肌的完整肌内神经分布模式。
使用西勒染色法在四具胎儿尸体中研究了九种具有不同结构的骨骼肌(菱形肌、肱二头肌、拇长屈肌、股直肌、胸骨舌骨肌、斜方肌、咬肌、二腹肌)及其神经分布模式。检查并统计评估了肌外(主要)和主要神经分支的直径和数量、小神经分支的数量以及吻合情况。
关于肌外(主要)神经分支的数量,菱形肌与拇长屈肌、斜方肌、咬肌和胸骨舌骨肌以及二腹肌前腹相似(p>0.05),而与股直肌、二腹肌后腹以及肱二头肌的长头和短头有显著差异(p<0.05)。斜方肌和咬肌在主要分支直径方面与所有研究的骨骼肌不同(p<0.05)。咬肌直径最大(p<0.05)。关于小神经分支的数量,胸骨舌骨肌与所有研究的骨骼肌有显著差异(p<0.05),除了肱二头肌短头、股直肌和二腹肌后腹(p>0.05)。至于神经吻合的数量,胸骨舌骨肌与所有研究的骨骼肌在统计学上有差异(p<0.05),除了咬肌和斜方肌(p>0.005)。
外科医生对骨骼肌形状与神经分布模式之间关系的透彻了解对于这些肌肉的成功再支配和再生很重要。它在肌肉移植领域可能也有用。