【作者】 王政；

【导师】 高振平；

【作者基本信息】 吉林大学 ， 人体解剖与组织胚胎学， 2007， 硕士

【摘要】 正中神经(median nerve)以两根分别起自臂丛的内侧束和外侧束。在前臂,正中神经自肘窝向下穿旋前圆肌至前臂正中,继而行于指浅、深屈肌之间,在腕部稍上方,正中神经行于桡侧腕屈肌和掌长肌之间的深方,再向下穿腕管至手掌。正中神经在前臂近侧部发出许多肌支支配除肱桡肌、尺侧腕屈肌和指深屈肌尺侧半以外的前臂肌前群。由于正中神经在前臂发出的肌支较多,且分布的类型和相关解剖学数据变异较大,从而使临床上治疗正中神经损伤以及骨间前神经卡压综合征面临一定的困难。另外至目前为止,虽然有些学者结合临床肌瓣的应用和创伤修复,对上肢前臂部正中神经肌支进行了一些观察,然而对成人的正中神经肌支进行区段定位的应用研究甚少。为此,本研究利用30侧成人上肢标本,在测量正中神经前臂段肌支基本解剖学数据的同时,对正中神经的区段定位进行了全面细致的研究,以期为临床治疗修复提供重要的解剖学依据。更多还原

【Abstract】 Objective: To measure the anatomical data of the muscular branches of the median nerve in the forearm. To provide the morphological evidence for the repair of the median nerve in the forearm and the median nerve compression syndrome.Methods: By the method of the anatomical dissection, the muscular branches of the median nerves from 30 upper extremities of adult cadavers were measured and observed anatomically, the obtained data were analyzed by the statistics software SPSS 11.5.Result: In the upper portion of the forearm, the median nerve gives off a lot of large muscular branches to supply the muscles in front of the forearm except the brachioradialis, the flexor carpi ulnaris and the medial half of the flexor digitorum profundus, including the branches to the pronator teres, the flexor carpi radialis, the palmaris longus, the flexor digitorum superficialis, the flexor pollicis longus, the flexor digitorum profundus and the pronator quadrates. Of all, the branches to the pronator teres, the flexor carpi radialis, the palmaris longus and the flexor digitorum superficialis are gived off directly from the median nerve, but the branches to the flexor pollicis longus, the flexor digitorum profundus and the pronator quadrates are the terminal branches of the anterior interosseous nrve from the median nerve.There are four types of the muscular branches of the median nerve in the forearm, including 1 branch, 2 branches, 3 branches and 4 branches. Of all, the number of the branches to the pronator teres(87%) is 3, the number of the branches to the flexor digitorum superficialis(90%) and flexor digitorum profundus (86.7%) is 4, the number of the branches to the flexor carpi radialis(96.7%), the palmaris longus(96.7%) and the flexor pollicis longus(93.3%) is 1. The muscular branches of the median nerve concentrate on 10～65% of the forearm.Conclusion: To confirm the danger location and position of the median nerve in the forearm; to discuss the type of the muscular branches which could be transferred with the blood vessel and muscle; to provide the anatomical basis for the pronator quadrates muscle branch of anterior interosseous nerve transfered to repair the median nerve and ulnar nerve, the diagnosis and treatment of the anterior interosseous nerve syndrome and the pronator teres syndrome.更多还原