Solomonow M, Guanche C, Wink C, Knatt T, Baratta R V, Lu Y
Department of Orthopaedic Surgery, Louisiana State University Medical Center, New Orleans 70112, USA.
J Shoulder Elbow Surg. 1996 Mar-Apr;5(2 Pt 1):139-46. doi: 10.1016/s1058-2746(96)80009-7.
A reflex arc from the glenohumeral capsule to the biceps, infraspinatus, supraspinatus, and subscapular muscles was shown in a feline preparation. Branches of the suprascapular and subscapular nerves terminating in the capsule were identified and then stimulated with a 100 microseconds supramaximal pulse at 10 pulses per second. Stimulation of the suprascapular articular nerve elicited electromyographic discharge in the biceps and infraspinatus muscles, whereas stimulation of the subscapular articular nerve elicited electromyographic discharge in the biceps, subscapularis, infraspinatus, and supraspinatus muscles. When the articular nerves were transected between their emergence from the main nerve trunk and the stimulation electrodes, the electromyographic discharge was abolished confirming the afferent nature of the nerves. The mean time delay ( +/- SD) from application of the stimulus to the peak of the recorded electromyographic activity was 3.2 +/- 0.27 msec. Anatomic dissection and staining of the capsule segments where the articular nerves terminated revealed mechanoreceptors consisting primarily of free nerve endings and Golgi tendon organs, Ruffini's endings, and pacinian corpuscles. The existence of a ligamento-muscular reflex arc in the glenohumeral joint extends the concept of passive and active restraints of a joint by virtue of the synergy between ligaments and muscles. That such a reflex exists may advocate modification of surgical repairs of the capsule, leading to preservation of as many neurologic structures as possible; it may also form the foundation for new postsurgical therapeutic modalities.
在猫的实验标本中显示了从盂肱关节囊到肱二头肌、冈下肌、冈上肌和肩胛下肌的反射弧。识别出肩胛上神经和肩胛下神经终止于关节囊的分支，然后以100微秒的超强脉冲、每秒10次脉冲进行刺激。刺激肩胛上关节神经可引起肱二头肌和冈下肌的肌电图放电，而刺激肩胛下关节神经可引起肱二头肌、肩胛下肌、冈下肌和冈上肌的肌电图放电。当关节神经在从主神经干发出处和刺激电极之间被横断时，肌电图放电消失，证实了这些神经的传入性质。从施加刺激到记录的肌电图活动峰值的平均时间延迟（±标准差）为3.2±0.27毫秒。对关节神经终止处的关节囊节段进行解剖和染色，发现主要由游离神经末梢、高尔基腱器官、鲁菲尼小体和环层小体组成的机械感受器。盂肱关节中韧带 - 肌肉反射弧的存在，通过韧带和肌肉之间的协同作用扩展了关节被动和主动约束的概念。这种反射的存在可能主张对关节囊手术修复进行改进，以尽可能保留更多的神经结构；它也可能为新的术后治疗方式奠定基础。
