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双侧胸骨肌伴单侧胸大肌胸肋部缺如及胸小肌变异

Bilateral Sternalis Muscle With the Absence of Unilateral Sternocostal Part of the Pectoralis Major and Variation of Pectoralis Minor Muscles.

作者信息

Shekhawat Devendra, Kumar Dinesh, Tubbs R Shane

机构信息

Anatomy, Maulana Azad Medical College, New Delhi, IND.

Anatomical Sciences, St. George's University, St. George's, GRD.

出版信息

Cureus. 2023 Jul 10;15(7):e41653. doi: 10.7759/cureus.41653. eCollection 2023 Jul.

DOI:10.7759/cureus.41653
PMID:37565121
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10411918/
Abstract

This study aims to report a 57-year-old male cadaver with a rare muscular variation of the sterno-pectoral region. An unusual sternalis muscle was observed on both sides, arising from the external oblique muscle aponeurosis. The fibers converged upwards and medially in a curved course, producing a bundle 99.50 mm long on the right side and 74.60 mm on the left. The muscles on both sides were supplied by the second, third, and fourth intercostal nerves. In the right pectoralis major (PM) muscle, the sternocostal head was completely absent, and the clavicular head arose from the medial two-thirds of the clavicle, whereas abdominal fibers arose from the aponeurosis of the external abdominal oblique muscle and ran upward and laterally and joined the clavicular fibers with a wide triangular gap. On the left side, there was an anatomically normal PM muscle. The origin of the pectoralis minor was unusually high on both sides. The morphological variations of sterno-pectoral musculature have significant implications for clinical practice, which allows more precise surgical or radiological outcomes. Clinicoradiological evaluation of these variations is important to achieve appropriate dissection planes during chest wall surgery.

摘要

本研究旨在报告一例57岁男性尸体,其胸锁区存在罕见的肌肉变异。两侧均观察到一块异常的胸骨肌,起自腹外斜肌腱膜。肌纤维呈弯曲走向向上和内侧汇聚,右侧形成一条长99.50毫米的肌束,左侧为74.60毫米。两侧肌肉均由第二、第三和第四肋间神经支配。右侧胸大肌中,胸肋头完全缺如,锁骨头起自锁骨内侧三分之二,而腹部纤维起自腹外斜肌腱膜,向上外侧走行,与锁骨纤维以较宽的三角形间隙相连。左侧胸大肌解剖结构正常。两侧胸小肌起点均异常高。胸锁区肌肉组织的形态变异对临床实践具有重要意义,有助于实现更精确的手术或放射学结果。对这些变异进行临床放射学评估,对于在胸壁手术中获得合适的解剖层面很重要。

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本文引用的文献

1
The prevalence and distribution of sternalis muscle: a meta-analysis of published literature of the last two hundred years.胸肋肌的流行率和分布:对过去两百年文献的荟萃分析。
Anat Sci Int. 2022 Jan;97(1):110-123. doi: 10.1007/s12565-021-00632-9. Epub 2021 Sep 30.
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The Split Pectoralis Flap: Combining the Benefits of Pectoralis Major Advancement and Turnover Techniques in One Flap.胸大肌劈开皮瓣:在一个皮瓣中结合胸大肌推进和翻转技术的优点。
Plast Reconstr Surg. 2017 Jun;139(6):1474-1477. doi: 10.1097/PRS.0000000000003328.
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A unilateral rectus sternalis muscle: rare but normal anatomical variant of anterior chest wall musculature.
单侧胸直肌:一种罕见但正常的前胸壁肌肉解剖变异。
J Clin Diagn Res. 2013 Dec;7(12):2665-7. doi: 10.7860/JCDR/2013/7379.3726. Epub 2013 Dec 15.
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Sternalis muscle, what every anatomist and clinician should know.胸骨肌,每位解剖学家和临床医生都应了解的知识。
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