人背阔肌肌内神经分布和肌构筑特征及其临床意义

The distribution of intramuscular nerve,muscle architectural features and their clinical significance of human latissimus dorsi

目的:为背阔肌亚部肌移植的临床应用提供形态学基础。方法:改良Sihler’s肌内神经染色法和肌构筑法。结果:(1)支配背阔肌的胸背神经发出2～3支一级神经支入肌,入肌后发出呈树枝状分支分布到该肌,在肌中部构成网格状的神经分支密集区。(2)背阔肌内上部肌重(58.91±10.29)g、肌长(18.76±1.67)cm、生理横切面积(3.39±0.65)cm2,外下部肌重(119.60±20.89)g、肌长(29.33±1.70)cm、生理横切面积(4.69±0.92)cm2。结论:(1)背阔肌有恒定的肌内神经分支分布,可分为两个亚部:内上部和外下部。(2)背阔肌内上部在肢体运动中更多的维持肩关节的稳定;而背阔肌外下部则更多参与肢体的速度运动。

Objective： To provide the morphological data for clinical aplication of the compartments of latissimus dorsi in muscle transplant. Methods： Modified Sihler＇s neural staining and muscle architecture methods were performed. Results： （1） The thoracodorsal nerve had two or three first class branchs entering into latissimus dorsi and then gave off tree-like branchs.There was a latticed dense region of neural branchs in the middle of latissimus dorsi. （2） The muscle weight （MW）, muscle length （ML） and physiologic cross sectional area （CSA） of the medial superior part of latissimus dorsi were 58.91±10.29g, 18.76± 1.67cm and 3.39±0.65cm^2 separately. These indexes of the lateral inferior part of latissimus dorsi were 119.60 ±20.89g, 29.33 ±1.70cm and 4.69±0.92cm^2 respectively. Conclusions： （ 1 ） Latissimus dorsi has fixed distribution of intramuscular nerve branchs, so it can be divided into the medial superior and lateral inferior compartments. （2） The medial superior part of latissimus dorsi mainly maintain the stability of shoulder articulation in limb movement and the lateral inferior part of latissimus dorsi mainly take part in the speedy motion of limb.