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腓肠肌的双侧第三头,在形态上类似于比目鱼肌。

A bilateral third head of the gastrocnemius which is morphologically similar to the plantaris.

机构信息

Department of Basic Medical Science, Graduate School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, 286-8686, Japan.

Department of Anatomy, Faculty of Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba, 286-8686, Japan.

出版信息

Surg Radiol Anat. 2021 Jul;43(7):1095-1098. doi: 10.1007/s00276-020-02670-w. Epub 2021 Jan 10.

Abstract

PURPOSE

An extra muscle was observed on both sides of the popliteal fossa in the cadaver of a 78-year-old Japanese male during dissection. The aim of this case report was to identify whether this variant is a double plantaris or a third head of the gastrocnemius according to its morphological characteristics and innervation.

METHODS

The muscles were displayed by careful dissection and delineation of surrounding structures. The size of each of the muscle bellies and tendons of those extra muscles were measured manually by the vernier caliper.

RESULTS

The origin of each extra muscle was lateral to the tibial nerve and superior to the plantaris, and each extra muscle which transitioned to a descending tendon parallel to the plantaris had a cone-shaped belly. However, the tendon of the extra muscles was fused into the investing fascia of the gastrocnemius with a tendon length of 4.5 cm on the left and 4.6 cm on the right. The extra muscles were innervated by the branch of the tibial nerve to the medial head of the gastrocnemius on both sides.

CONCLUSION

Although they had an origin and shape similar to that of the plantaris, we identified the extra muscles in this case as a third head of the gastrocnemius, because of innervation to the plantaris arises directly from the tibial nerve. This case highlighted that the innervation is essential to understanding the myogenesis of extra muscles, especially in cases which are difficult to categorize based on the morphological features of the muscle.

摘要

目的

在一名 78 岁日本男性尸体的腘窝两侧观察到一块额外的肌肉。本病例报告的目的是根据其形态特征和神经支配来确定该变异是双比目鱼肌还是腓肠肌的第三个头。

方法

通过仔细解剖和周围结构的描绘来展示肌肉。用游标卡尺手动测量每个额外肌肉的肌腹和肌腱的大小。

结果

每个额外肌肉的起点均位于胫神经外侧和比目鱼肌上方,每个额外肌肉的降肌腱与比目鱼肌平行,呈锥形肌腹。然而,这些额外肌肉的肌腱在左侧融合入腓肠肌的筋膜,长度为 4.5 厘米,在右侧融合入腓肠肌的筋膜,长度为 4.6 厘米。这些额外肌肉由胫神经到腓肠肌内侧头的分支支配。

结论

尽管这些额外肌肉的起点和形状与比目鱼肌相似,但由于比目鱼肌的神经支配直接来自胫神经,我们将这种情况下的额外肌肉确定为腓肠肌的第三个头。这个病例强调了神经支配对于理解额外肌肉的肌发生的重要性,特别是在基于肌肉形态特征难以分类的情况下。

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