手掌分区与指掌侧总神经和指掌侧总动脉

Division of Palm Regarding Total Palmar Digital Nerve and Total Palmar Digital Artery

目的:为研究手掌血管、神经损伤修复重建提供解剖学基础。方法:手掌借5条横平行线和4条纵平行线分为20区,解剖并观察指掌侧总神经和指掌侧总动脉在手掌的分布及其伴行关系。结果:第一、二指掌侧神经起始处位于7区外上象限,第三指掌侧总神经、小指尺掌侧神经起始处位于4区内下象限。第一、二、三指掌侧总动脉起始处位于7、8区近C线处,小指尺掌侧动脉起始处位于8区内下象限。第一、二指掌侧总神经在7区被掌浅弓骑跨,分弓上、下两段。弓上、下段,分别在13、14区D线处发出指掌侧固有神经。小指尺掌侧神经、第三指掌侧总神经起始处位于同名动脉的近侧,其行程在9、15、20区位于同名动脉的尺侧。第一、二指掌侧总动脉分别在18、19区距E线0．8-1．0cm处发出相应的指掌侧固有动脉。第一、二、三指掌侧总神经及其发出的指掌侧固有神经与同名的指掌侧总动脉的伴行关系有四型:H1、H2、O、V型。结论:指掌侧总神经与指掌侧总动脉在手掌的一定区域内有按规律分布的特点,有助于手掌损伤离断手术修复过程中指掌侧总神经与指掌侧总动脉的寻找和吻合,以及手掌神经阻滞麻醉的精确定位。

Objective： To provide anatomical base for the reseach of repairation reestablish of palm vassular and nervous injury. Methods： 30 palms Were dissected. Each palm was respectively divided into 20 regions by the 5 transverse lines and the 4 longitudinal lines of the palm. And then the distribution of total palmar digital nerves（TPDN） and total palmar digital artery （TP- DA） were observed. Results： The 1st and the 2nd TPDN started from lower inner quadrant of the 4th region. The 1st and the 2nd and the 3rd TPDA started from the 7th and the 8th region nearby C line, the 5th TPDA started from lower inner quadrant of the 8th region. The 1th and the 2 nd TPDN were riddenby the superficial palmar arch at the 7th region and divided into superior segment of arch and inferior segment of arch. The inferior segment of arch erupted digital nerves of median nerve respectively at thel3th and the 14th region nearby D line. The 1st and the 2nd TPDA erupted propotional digital palmar arteries from a region of approximately 0.8,1.0cm to E line at thel8th and the 19th region. The company path relationship of the 1st, the 2nd and the 3rd TPDN and digital nerve of median nerve and homonymous TPDA has 4 types： H1,H2,O and V. Conclusions： TPDN and TPDA have a characteristic distributing according to its region, which is useful for seeking and anastomosing the disconnected nerves of palm and for locating the block anaesthesia of palm nerve accurately.