Butz James J, Raman Daya V, Viswanath Srikanteswara
Department of Anatomy, American University of Antigua College of Medicine, Coolidge, Antigua, West Indies.
Australas Med J. 2015 Jan 31;8(1):24-7. doi: 10.4066/AMJ.2015.2266. eCollection 2015.
An abnormal course of a nerve either through or around a muscle may yield multiple or anomalous muscle innervation. Further, if nerves are inappropriately trapped within the confines of a muscle or irregular boundaries, variant emergence of a nerve could give rise to symptoms of an entrapment neuropathy. Upon routine dissection in the Department of Anatomy at the American University of Antigua College of Medicine, bilateral variants in the emergence of the sciatic nerve from the pelvis to the gluteal compartment were discovered in an elderly adult female cadaver. In the left gluteal compartment, the sciatic nerve had a high division where the peroneal division exited the pelvis superior to the piriformis muscle while the tibial division exited inferior to the piriformis. In the right gluteal compartment, the peroneal division was observed to have exited the pelvis between a split piriformis muscle before it joined the tibial division of the sciatic nerve. Knowledge of such variations in the course of the sciatic nerve may improve diagnosis and treatment of pathologies in this region.
神经穿过或环绕肌肉的异常走行可能导致肌肉多重或异常支配。此外,如果神经被不恰当地困在肌肉范围内或不规则边界内,神经的异常穿出可能会引发卡压性神经病变的症状。在美国安提瓜医学院解剖学系进行常规解剖时,在一具老年女性尸体中发现了双侧坐骨神经从骨盆至臀区穿出的变异情况。在左侧臀区,坐骨神经高位分支,腓总神经分支在梨状肌上方穿出骨盆,而胫神经分支在梨状肌下方穿出。在右侧臀区,观察到腓总神经分支在分裂的梨状肌之间穿出骨盆,然后与坐骨神经的胫神经分支会合。了解坐骨神经走行的此类变异可能有助于改善该区域疾病的诊断和治疗。