Canoso Juan J, Alvarez Nemegyei José, Naredo Esperanza, Murillo González Jorge, Mérida Velasco José Ramón, Hernández Díaz Cristina, Olivas Vergara Otto, Alvarez Acosta José Guillermo, Navarro Zarza José Eduardo, Kalish Robert A
Department of Medicine, ABC Medical Center, Mexico City 05348, Mexico.
Division of Rheumatology, Tufts University School of Medicine, Boston, MA 02111, USA.
Diagnostics (Basel). 2023 Sep 20;13(18):3004. doi: 10.3390/diagnostics13183004.
Palpation, a traditional haptic ability, is used daily by practitioners of all medical and surgical specialties to assess patients. In the current study, one of the authors, in a routine clinical setting, was able to deduce the dynamic features of the putative inferior belly of omohyoid. This led to a proof-of-concept study that yielded results consistent with the clinical findings.
The first part of the study involved a survey of 300 rheumatic disease patients in whom the greater supraclavicular fossa was explored by palpation. While the patient kept the head straight, the clinician placed his middle three fingers 2.5-3 cm dorsal to the clavicle in the window between the sternocleidomastoid and trapezius clavicular insertions, explored the supraclavicular fossa, and palpated the paired contractile inferior belly of the assumed omohyoid during flexion in the three orthogonal planes. In the second part of the study, five normal subjects were examined in a similar manner by the same clinician and had independent ultrasonography performed on the dominant side. Descriptive statistics were used, and Yates' corrected chi-squared test was applied to certain nominal variables. Additionally, a comparative anterolateral bilateral neck dissection was performed in a cadaveric specimen.
Both studies showed that the contractile structure was the inferior belly of omohyoid and that its contraction occurred during anterior neck flexion and was opposite to the side of neck rotation, resembling the sternocleidomastoid.
Palpation uncovered a previously unknown function of the inferior belly of omohyoid, suggesting that physical examination of the musculoskeletal system based on palpation may lead to hypotheses worthy of exploration.
触诊作为一种传统的触觉能力，被所有医学和外科专业的从业者日常用于评估患者。在本研究中，一位作者在常规临床环境中能够推断出假定的肩胛舌骨肌下腹的动态特征。这促成了一项概念验证研究，其结果与临床发现一致。
研究的第一部分涉及对300名风湿性疾病患者进行调查，通过触诊探查其锁骨上大窝。当患者头部保持正直时，临床医生将其食指、中指和无名指放在锁骨后方2.5 - 3厘米处，位于胸锁乳突肌和斜方肌锁骨附着点之间的区域，探查锁骨上窝，并在三个相互垂直平面的颈部屈曲过程中触诊假定的肩胛舌骨肌的成对收缩性下腹。在研究的第二部分，同一位临床医生以类似方式检查了5名正常受试者，并对其优势侧进行了独立的超声检查。使用描述性统计方法，并对某些名义变量应用了耶茨校正卡方检验。此外，在一具尸体标本上进行了双侧颈前外侧对比解剖。
两项研究均表明，收缩结构为肩胛舌骨肌下腹，其收缩发生在前颈部屈曲时，且与颈部旋转方向相反，类似于胸锁乳突肌。
触诊揭示了肩胛舌骨肌下腹一项此前未知的功能，表明基于触诊的肌肉骨骼系统体格检查可能会得出值得探索的假设。
