Khodulev V I, Nechipurenko N I, Antonov I P
Zh Nevrol Psikhiatr Im S S Korsakova. 2006;106(9):47-51.
Motor fibers of the median nerve innervating the anterior forearm muscles during stimulation of the brachial plexus have been studied. A role of forearm muscles innervated by the cubital and radial nerves in the formation of the M-response recorded from the anterior forearm muscles has been determined. Surface stimulating and recording electrodes have been used, with the active recording electrode being placed on the border between the upper and the middle one third of the anterior forearm surface and the reference electrode--in the area of the lower one third of the forearm. Nerve stimulation was conducted at 5 points: in the region of elbow flexion (median nerve); in the border between the middle and the lower one third of the inner side of the shoulder (median and cubital nerves); in the Erb's point or in the axillary space (brachial plexus); in the sulcus of ulnar nerve (cubital nerve); on the border between the middle and the lower one third of the outer shoulder surface (radial nerve). During stimulation of the brachial plexus, the M-response recorded from the anterior forearm muscles is caused mostly by the median nerve. The radial nerve also exerts a significant influence on development of the M-response. A role of the cubital nerve is minimal (p>0.05). The M-response recorded from the anterior forearm surface during brachial plexus stimulation is a result of summed potentials of motor units both of the anterior forearm muscles innervated by the median and cubital nerves and of the lateral and posterior groups innervated by the radial nerve.
在臂丛神经刺激过程中,对支配前臂前侧肌肉的正中神经运动纤维进行了研究。已确定由尺神经和桡神经支配的前臂肌肉在从前臂前侧肌肉记录的M反应形成中的作用。使用了表面刺激和记录电极,将有源记录电极置于前臂前侧表面上三分之一与中三分之一交界处,参考电极置于前臂下三分之一区域。在5个点进行神经刺激:在肘部屈曲区域(正中神经);在肩部内侧中三分之一与下三分之一交界处(正中神经和尺神经);在Erb点或腋窝间隙(臂丛神经);在尺神经沟(尺神经);在肩部外侧中三分之一与下三分之一交界处(桡神经)。在臂丛神经刺激期间,从前臂前侧肌肉记录的M反应主要由正中神经引起。桡神经对M反应的发展也有显著影响。尺神经的作用最小(p>0.05)。在臂丛神经刺激期间从前臂前侧表面记录的M反应是由正中神经和尺神经支配的前臂前侧肌肉以及桡神经支配的外侧和后侧肌群的运动单位的总和电位所致。