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大收肌的内收肌部分由闭孔神经和坐骨神经共同支配。

The adductor part of the adductor magnus is innervated by both obturator and sciatic nerves.

作者信息

Takizawa Megumi, Suzuki Daisuke, Ito Hajime, Fujimiya Mineko, Uchiyama Eiichi

机构信息

Department of Physical Therapy, School of Health Science, Ibaraki Prefectural University, Ami-machi, Ibaraki, Japan; Department of Physical Therapy and Occupational Therapy, Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Hokkai-do, Japan.

出版信息

Clin Anat. 2014 Jul;27(5):778-82. doi: 10.1002/ca.22274. Epub 2013 Jun 27.

Abstract

The hip adductor group, innervated predominantly by the obturator nerve, occupies a large volume of the lower limb. However, case reports of patients with obturator nerve palsy or denervation have described no more than minimal gait disturbance. Those facts are surprising, given the architectural characteristics of the hip adductors. Our aim was to investigate which regions of the adductor magnus are innervated by the obturator nerve and by which sciatic nerve and to consider the clinical implications. Twenty-one lower limbs were examined from 21 formalin-fixed cadavers, 18 males and 3 females. The adductor magnus was dissected and was divided into four parts (AM1-AM4) based on the locations of the perforating arteries and the adductor hiatus. AM1 was supplied solely by the obturator nerve. AM2, AM3, and AM4 received innervation from both the posterior branch of the obturator nerve and the tibial nerve portion of the sciatic nerve in 2 (9.5%), 20 (95.2%), and 6 (28.6%) of the cadavers, respectively. The double innervation in more than 90% of the AM3s is especially noteworthy. Generally, AM1-AM3 corresponds to the adductor part, traditionally characterized as innervated by the obturator nerve, and AM4 corresponds to the hamstrings part, innervated by the sciatic nerve. Here, we showed that the sciatic nerve supplies not only the hamstrings part but also the adductor part. These two nerves spread more widely than has generally been believed, which could have practical implications for the assessment and treatment of motor disability.

摘要

髋内收肌群主要由闭孔神经支配,占据下肢的很大一部分。然而,关于闭孔神经麻痹或失神经支配患者的病例报告描述的步态紊乱都不超过轻微程度。鉴于髋内收肌的结构特征,这些事实令人惊讶。我们的目的是研究大收肌的哪些区域由闭孔神经支配,哪些由坐骨神经支配,并考虑其临床意义。对21具福尔马林固定尸体的21条下肢进行了检查,其中男性18例,女性3例。解剖大收肌,并根据穿动脉和收肌腱裂孔的位置将其分为四个部分(AM1-AM4)。AM1仅由闭孔神经供应。在2具(9.5%)、20具(95.2%)和6具(28.6%)尸体中,AM2、AM3和AM4分别接受闭孔神经后支和坐骨神经胫神经部分的支配。超过90%的AM3存在双重支配尤其值得注意。一般来说,AM1-AM3对应于传统上被认为由闭孔神经支配的内收肌部分,而AM4对应于由坐骨神经支配的腘绳肌部分。在这里,我们表明坐骨神经不仅供应腘绳肌部分,还供应内收肌部分。这两条神经的分布比一般认为的更广泛,这可能对运动功能障碍的评估和治疗具有实际意义。

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