人胸锁乳突肌的应用解剖学

Applied anatomy of the human sternocleidomastoid muscles

目的 探讨人胸锁乳突肌各亚部的构筑特征 ,并对该肌的神经入肌点进行定位 ,为胸锁乳突肌移植的取材提供形态学资料。方法 ①用 14侧胸锁乳突肌进行肌构筑学研究。②用 5 0侧胸锁乳突肌进行大体解剖测量并对其中 4 0侧的神经入肌点进行定位研究。结果 ①胸骨头亚部肌重 2 0 .5± 6 .6 7g、肌长 19.6 3± 2 .6 2cm、生理横切面积 1.81± 0 .73cm2 ,锁骨头浅亚部肌重 7.0 9± 2 .6 6 g、肌长 16 .4 8± 2 .33cm、生理横切面积 0 .5 9± 0 .2 5cm2 ,锁骨头深亚部肌重 7.6 2± 2 .71g、肌长 14 .4 3± 1.82cm、生理横切面积 0 .77± 0 .38cm2 。②神经入胸锁乳突肌有两种形式 ,一是穿锁骨头深亚部入肌 ,占 35 % ,入肌点距乳突尖 4 .0 3± 0 .38cm ;一是在锁骨头深亚部后缘入肌 ,占6 5 % ,入肌点距乳突尖 4 .4 2± 0 .31cm。结论 ①胸骨头亚部的肌重与生理横切面积分别是锁骨头两亚部之和的1.4 0倍与 1.33倍 ,是胸锁乳突肌肌力的主要提供者。②胸锁乳突肌的神经入肌点约在锁骨头深亚部深面中、上1/3交界处。

Objective To study the architectural feature of three compartments of the human sternocleidomastoid muscle(SCM) and to locate the point of entrance of the accessory nerve into SCM, so as to provide a morphological data for the transplate of human SCM. Methods ① The architectural features of the muscle were studied in 14 sides SCM. ② The 50 sides SCM were measured and the point of entrance of the accessory nerve into SCM was located in 40 sides.Results ① The muscle weight(MW), muscle length(ML) and physiologic cross sectional area (CSA) of the sternal-head compartment of SCM were 20.5±6.67g、19.63±2.62cm and 1.81±0.73cm 2 respectively. These indices of the superficial clavicular-head compartment of SCM were 7.09±2.66g、16.48±2.33cm and 0.59±0.25cm 2 respectively. These indices of the deep clavicular-head compartment of SCM were 7.62±2.71g、14.43±1.82cm and 0.77±0.38cm 2 respectively. ② The nerve have two forms to enter SCM: one is insert the deep clavicular-head compartment of SCM (35%), and the distance between the point of entrance of the accessory nerve into SCM and the tip of mastoid process was 4.03±0.38cm. the other is crosses the posterior edge of the deep clavicular-head compartment of SCM (65%), and the distance between the point of entrance of the accessory nerve into SCM and the tip of mastoid process was 4.42±0.31cm. Conclusions ① MW and CSA of the sternal-head compartment was separately 1.40 and 1.33 times the size of the two compartment of clavicular-head. The force of SCM was mainly produced by the sternal-head compartment. ② The point of entrance of the nerve into SCM was approximately at the common boundary of superior 1/3 joint with inferior 2/3 in the deep clavicular-head compartment of SCM. [