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冈下肌和小圆肌的解剖结构及毗邻关系:一项新鲜尸体解剖研究

Anatomy and relations of the infraspinatus and the teres minor muscles: a fresh cadaver dissection study.

作者信息

Bacle Guillaume, Gregoire Jean-Marc, Patat Frédéric, Clavert Philippe, de Pinieux Gonzague, Laulan Jacky, Lakhal Walid, Favard Luc

机构信息

Department of Orthopaedic Surgery, Hôpital Universitaire Trousseau, Tours, France.

Unité Mixte de Recherche Imagerie et Cerveau, Inserm U930, Université François-Rabelais, Tours, France.

出版信息

Surg Radiol Anat. 2017 Feb;39(2):119-126. doi: 10.1007/s00276-016-1707-9. Epub 2016 Jun 10.

Abstract

PURPOSE

Despite their functional importance, the infraspinatus (ISP) and teres minor (TM) muscles have been little investigated. This study aimed to describe the macroscopic morphology, innervation, and inter-relations of the ISP and TM muscles.

METHODS

Forty fresh cadaver dissections and histologic analysis were performed. Three groups of specimens were distinguished according to the rotator cuff tendon status: (1) intact rotator cuff; (2) supraspinatus tendon tears with intact ISP tendon; and (3) both supraspinatus and ISP tendons torn. Muscle fiber organization and muscle and tendon length were recorded. ISP and TM innervation and fiber structure were studied.

RESULTS

ISP muscles were composed of three groups of fiber organized in two planes: two superficial groups, with mean pennation angles of, respectively, 27° ± 4° and 23° ± 3° with respect to the axis of the central tendon of the underlying group. TMs were thick fusiform muscles showing a parallel organization; 26 specimens (67 %) had aponeuroses isolating the TM, with a mean length of 5.2 ± 2.7 cm. Rotator cuff lesions were associated with relatively greater ISP tendon than muscle length. Innervation of the ISP muscle comprised 2-4 main branches from the suprascapular nerve and that of the TM 1 branch from the axillary nerve.

CONCLUSION

ISP muscle body morphology derives from three groups of fibers in two planes. The TM has a parallel organization. Several nerve branches innervate the ISP muscle, whereas only one supplies the TM. The limits between the two muscles bodies consist of an aponeurotic fascia in two-thirds of cases.

摘要

目的

尽管冈下肌(ISP)和小圆肌(TM)功能重要,但对其研究较少。本研究旨在描述ISP和TM肌肉的宏观形态、神经支配及相互关系。

方法

进行了40例新鲜尸体解剖和组织学分析。根据肩袖肌腱状态区分出三组标本:(1)肩袖完整;(2)冈上肌腱撕裂但ISP肌腱完整;(3)冈上肌和ISP肌腱均撕裂。记录肌肉纤维组织以及肌肉和肌腱长度。研究ISP和TM的神经支配及纤维结构。

结果

ISP肌肉由在两个平面上组织的三组纤维组成:两组表浅纤维,相对于下方组中央肌腱轴的平均羽状角分别为27°±4°和23°±3°。TM是厚的梭形肌肉,呈平行排列;26例标本(67%)有腱膜将TM隔开,平均长度为5.2±2.7厘米。肩袖损伤与ISP肌腱相对肌肉长度增加有关。ISP肌肉的神经支配包括肩胛上神经的2 - 4个主要分支,TM的神经支配为腋神经的1个分支。

结论

ISP肌肉主体形态源自两个平面上的三组纤维。TM呈平行排列。多条神经分支支配ISP肌肉,而TM仅由一条神经分支支配。在三分之二的病例中,两块肌肉主体之间的界限由腱膜筋膜构成。

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