人鱼际肌的肌内神经分支分布和肌梭密度研究

Study on Distribution Features of Intramuscular Nerve and Muscle Spindles Density in Human Thenar

目的探索鱼际肌肌肌内神经分支和肌梭密度的分布。方法采用改良Sihler’s肌内神经染色法和HE染色法进行解剖学研究。结果鱼际肌的神经常从肌起端深面入肌,神经入肌后在拇短展肌、拇对掌肌、拇收肌横头内与肌长轴垂直走向,拇收肌斜头和拇短屈肌内沿肌长轴平行走形。80%～82.5%的拇短屈肌和拇指对掌肌接受正中神经和尺神经的双重支配。拇短屈肌浅头和深头、拇收肌横头和斜头有独立的神经支配,可分出神经肌肉亚部。4块肌内神经分支分布密集区多在肌的中部与近端,可见"Y"、"O"、"H"或"U"型等不同的神经吻合形式。鱼际肌肌梭密度高达16.19～27.14个/g,高低顺序为拇指对掌肌>拇短屈肌>拇短展肌>拇收肌。结论鱼际肌肌内神经吻合丰富,肌梭密度高,除拇对掌肌外,其余肌块可作整肌或半肌移植的供体。

Objective To investigate the distribution features of intramuscular nerve branches and muscle spindle density of human thenar.Methods Modified Sihler＇ staining,and Hematoxylin-Eosin staining were used in this experiment.Results The extramuscular nerve used to start from the origination of the thenar to its deep surface,then run along the vertical direction of the long axis of the abductor pollicis brevis,the opponens pollicis and the transverse head of adductor pollicis respectively,.The flexor pollicis brevis and opponens pollicis were innervated both by the median nerve and the ulnar nerve,all of which was 80%-82.5%.The superficial and deep head of flexor pollicis brevis,the transverse and oblique head of adductor pollicis had independent innervation that could be divided into neuromuscular compartments.Dense area of branches of intramuscular nerve were located in middle and proximal of four muscles mostly.＂Y-like＂,＂O-like＂,＂H-like＂and＂U-like＂ nerve anastomose patterns were observed in the thenar.Muscle spindle density of thenar ranged between 16.19~27.14/g,the order of rank was opponens pollicis flexor pollicis brevis abductor pollicis brevis adductor pollicis.Conclusions There were abundant nerve anastomoses and high density muscle spindles in the thenar so that thenar muscles,besides opponens pollicis,could be served as donors for whole muscles or half-muscles transplantion.