三角肌神经入肌点定位及肌内神经分布的研究

The nerve entering point and the distribution of imtramusclar nerves in human deltoid muscle

目的 揭示三角肌神经入肌点和肌内神经分支分布 ,为其临床应用提供较为详尽的形态学资料。方法 ①用经甲醛固定 2年以上的成人尸体 (2 0～ 5 0岁 ) 12具 (男 9,女 3)共 2 4侧。以肩峰后角为骨性标志 ,测量三角肌各亚部神经支入肌点的位置。②用经甲醛固定 1年以内的童尸 3具 (3～ 10岁 )及成人尸体 2具 (2 0、4 0岁 )完整取下三角肌 ,采用Sihler′s肌内神经染色法观察肌内神经分支分布。结果 ①三角肌各亚部神经入肌点的体表投影 :三角肌前亚部、中亚部、后亚部的神经入肌点分别在距肩峰后角下方 (5 7± 0 7)cm、(5 9± 0 8)cm、(4 8± 0 5 )cm处的水平线上 ,距三角肌前缘外后方 (3 6± 0 4 )cm处及距三角肌后缘外前方 (3 5± 0 6 )cm、(2 3± 0 3)cm处 ,上述三点均在肌的中 1/3部。②肌内神经分布 :三角肌前、后亚部的肌内神经支在肌内为直接横过肌纤维中部 ,沿途再发出分支与肌纤维并行走行 ;而中亚部肌内神经支在各个羽内 ,与肌纤维相交 ,行向短肌纤维的起止端。结论 ①三角肌的神经入肌部位及入肌形式与该肌的形态和功能有关联 ;②三角肌的肌内神经分支分布可能与该肌的肌纤维长度及肌纤维型有关 ;③三角肌中亚部的肌内神经吻合网较宽而致密 ,推测有着更精细的神经调节。

Objectives To provide anatomidcal basis for clinical application by studying the nerve entering point and the distribution of imtramusclar nerves in human deltoid muscle.Methods 1.Morphology,vessels and nerves supply were observed on 24 sides adult arm specimens(20～50 years).2.Sihler′s neural staining technique was used to obeerve the intramusclar never branch patterns of 6 sides children arm specimens(3～10 years)and 4 sides adult arm specimens(25 years,40 years).Results ①The point of nerve entering to the anterior,middle,posterior compartments of the deltoid muscle lay (3 6±0 4)cm postlateral of anterior border of the muscle and (3 5±0 6)cm,(2 3±0 3)cm antelateral of posterior border of the muscle respectively and cross the horizontal line of (5 7±0 7)cm,(5 9±0 8)cm,(4 8±0 5)cm,respectively below the posterior corner of the acromion namely,the nerve branches to the deltoid muscle penetrated the muscle belly at its middle one thirds.②The intramusclar nerve branches to the anterior and posterior compartments of the deltoid muscle passed directly through the middle of the belly and distributed parallel small terminal branches along its course in the muscle.The intramusclar nerve branches to the middle compartment extended to both ends of the muscle and went verically in the muscle.The intramsclar nerve branches to the middle compartment extended to both ends of the muscle and went verically in the muscle.There were plenty of intramuscular nerve branches which formed a dense anastomotic network in three compartments of the deltoid muscle.The intramusclar nerve branches and anasomotic network in the middle compartments were much denser than those in the anterior and posterior compartments.Conclusion ①The place and pattern of the nerve entrance to the deltoid muscle has relation to the configuration and function of the muscle.②It was possible that the distribution of the intramuscular nerve branches to the deltoid muscle had relation to the fiber length and the fiber type.③The middle compartment had a much denser anastomotic network that was no doubt related to delicate adujustments.