成人胸大肌和胸小肌神经入口点和肌内神经密集区的定位及其阻断肌肉痉挛的意义,Journal of Anatomy

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成人胸大肌和胸小肌神经入口点和肌内神经密集区的定位及其阻断肌肉痉挛的意义
Journal of Anatomy ( IF 1.8 ) Pub Date : 2021-06-27 , DOI: 10.1111/joa.13493
Yanrong Li ₁ , Meng Wang ₂ , Shaohua Tang ₃ , Xiankun Zhu ₄ , Shengbo Yang ₂

Affiliation

本研究的目的是定位体表位置和神经进入点的深度，以及胸大肌和胸小肌肌肉内神经密集区的中心，为阻断肌肉痉挛提供指导。使用福尔马林固定的成年尸体（66.3 ± 5.2 岁）。皮肤上从肩峰到颈静脉切迹最下点的曲线定义为水平参考线（H）。从颈静脉切迹的最下点到剑骨关节的线被定义为纵向参考线 (L)。神经入口点在解剖学上暴露。采用 Sihler 染色、硫酸钡标记和计算机断层扫描来确定体表上的投影点 (P)。_H和 P _L，分别。神经入口点或肌内神经密集区中心的投影在横切面上呈相反方向，记为P'。使用 Syngo 系统确定 H 和 L 线上P _H和 P _L的百分比位置，以及神经入口点和肌内神经密集区深度的中心。胸大肌有两个神经入口点，而胸小肌只有一个。此外，在胸大肌中发现了两个肌内神经密集区，而在胸小肌中仅发现了一个区域。神经入口点的 P _H分别为 47.83%、32.31% 和 34.31%，而 P_ħ肌内神经密集区域的中心的分别在41.95％，55.88％，和线H的32.58％。神经入口点的 P _L分别为 -9.84%、36.16% 和 2.44%，而 P _L肌内神经密集区的三个中心分别位于线 L 的 -3.87%、25.29% 和 -7.13%。各神经入口点深度分别为PP''线的17.76%、17.53%和25.51%，肌内神经密集区中心深度分别为5.23%、6.75%和25.51%。分别为线 PP' 的 13.73%。这些百分比值都是平均值。明确这些神经入口点的表面位置和深度以及肌内神经密集区的中心，可以提高靶区阻滞对胸大肌和小肌痉挛的定位效率和疗效。

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Localization of nerve entry points and the center of intramuscular nerve-dense regions in the adult pectoralis major and pectoralis minor and its significance in blocking muscle spasticity

The aims of this study were to localize the body surface position and depth of nerve entry points, and the center of the intramuscular nerve-dense regions of the pectoralis major and pectoralis minor in order to provide guidance for blocking muscle spasticity. Formalin-fixed adult cadavers (66.3 ± 5.2 years) were used. The curved line on the skin from the acromion to the most inferior point of the jugular notch was defined as the horizontal reference line (H). The line from the most inferior point of the jugular notch to the xiphisternal joint was defined as the longitudinal reference line (L). The nerve entry points was anatomically exposed. Sihler's staining, barium sulfate labeling, and computed tomography were employed to determine the projection points (P) on the body surface. The intersection of the longitudinal line through the P point and the H line and the horizontal line through the P point and the L line were recorded as P_H and P_L, respectively. The projection of the nerve entry points or the center of the intramuscular nerve-dense regions were in the opposite direction across the transverse plane and were recorded as P'. The percentage positions of P_H and P_L on the H and L lines, as well as the nerve entry points and the center of the intramuscular nerve-dense regions depths, were determined using the Syngo system. The pectoralis major had two nerve entry points, while the pectoralis minor had only one. In addition, two intramuscular nerve-dense regions were found in the pectoralis major, while only one region was found in the pectoralis minor. The P_H of the nerve entry points were located at 47.83%, 32.31%, and 34.31%, while the P_H of the center of the intramuscular nerve-dense regions were at 41.95%, 55.88%, and 32.58% of line H, respectively. The P_L of the nerve entry points were at −9.84%, 36.16%, and 2.44%, while the P_L for each of three center of the intramuscular nerve-dense regions was at −3.87%, 25.29%, and −7.13% of line L, respectively. The depth for each of the nerve entry points was at 17.76%, 17.53%, and 25.51% of line P-P′’, respectively, and the depth of the center of the intramuscular nerve-dense regions was at 5.23%, 6.75%, and 13.73% of line P-P′, respectively. These percentage values are all means. The definition of the surface position and depth of these nerve entry points and center of the intramuscular nerve-dense regions can improve the localization efficiency and efficacy of target blocking for pectoralis major and minor spasticity.

更新日期：2021-06-27

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