锥状肌及耻骨前韧带的解剖学观测

Anatomical observation of pyramidalis muscle and anterior pubic ligament

目的探究锥状肌及耻骨前韧带的毗邻关系,为进一步了解维持耻骨联合稳定的机制提供解剖学依据。方法选用24具标本(男19具,女5具),观测锥状肌的长、宽、厚及其与邻近的腹直肌、长收肌和耻骨前韧带之间的毗邻关系。结果95.8%大体标本双侧存在锥状肌(23/24,男性19例,女性4例),4.2%右侧缺如(1/24,女性1例)。测得锥状肌长度,右侧:男(70.64±13.48)mm,女(71.81±11.27)mm,左侧:男(69.60±12.01)mm,女(64.25±19.79)mm;宽度,右侧:男(20.68±4.12)mm,女(20.65±2.04)mm,左侧:男(20.02±2.99)mm,女(18.23±4.77)mm;厚度,右侧:男(2.50±1.61)mm,女(1.49±0.40)mm,左侧:男(2.19±1.06)mm,女(1.50±0.56)mm,左、右侧锥状肌的长、宽和厚未见统计学差异(P>0.05)。测得耻骨前韧带宽度,右侧:男(5.96±1.55)mm,女(6.60±1.10)mm,左侧:男(6.35±1.58)mm,女(6.16±0.69)mm。锥状肌以腱性纤维起于耻骨前面及耻骨联合前的纤维性韧带;腹直肌肌腱、长收肌肌腱、腹股沟韧带以及锥状肌起点在耻骨嵴处交织毗邻,形成层次鲜明的耻骨前韧带。结论锥状肌起于耻骨前韧带,与腹股沟韧带和长收肌肌腱一同构成耻骨前韧带;同时以耻骨前韧带为中心,毗邻结构共同构成一个复合体,为耻骨联合的稳定提供重要的支撑。

Objective To explore the adjacent relationship between pyramidalis muscle and anterior pubic ligament,so as to provide anatomical basis for further understanding the mechanism of maintaining the stability of the pubic symphysis.Methods Twenty-four specimens(19 males and 5 females) were selected to observe the length,width,thickness of the pyramidalis muscle and the adjacent relationship between the adjacent rectus abdominis,adductor longus and anterior pubic ligaments.Results In the 24 gross specimens,23 cases of pyramidalis muscle existed bilaterally(accounting for 95.8%,19 cases in males,4 cases in females).One case lacked the right muscle(accounting for 4.2%,1 case in female).The length of pyramidalis muscle was(70.64±13.48) mm in males and(71.81±11.27) mm in females on the right side,(69.60±12.01)mm in males,(64.25±19.79) mm in females on the left side.Width,on the right side:male(20.68±4.12) mm,female(20.65±2.04) mm,on the left side:male(20.02±2.99) mm,female(18.23±4.77) mm.Thickness,right:male(2.50±1.61) mm,female(1.49±0.40) mm,left:male(2.19±1.06) mm,female(1.50±0.56) mm.There was no statistical difference in the length,width and thickness of the pyramidalis muscle(P>0.05).The width of anterior pubic ligament was(5.96±1.55)mm in males and(6.60±1.10) mm in the females on the right side,(6.35±1.58) mm in males and(6.16±0.69) mm in females on the left side.The pyramidalis muscle originated from the fibrous ligament anterior to the pubic bone and pubic symphysis with tendinous fibers.The origin of rectus abdominis tendon,adductor longus tendon,inguinal ligament and the starting point of the pyramidal muscle were intertwined with adjacent to the pubic crest,forming a distinct anterior pubic ligament.Conclusions The pyramidalis muscle originates from the anterior pubic ligament and forms the anterior pubic ligament together with the inguinal ligament and the adductor longus tendon.At the same time,with the anterior pubic ligament as the center,adjacent structures together form a complex,which provides important support for the stability of the pubic symphysis.