解剖学报 ›› 2019, Vol. 50 ›› Issue (1): 77-81.doi: 10.16098/j.issn.0529-1356.2019.01.013

• 解剖学 • 上一篇    下一篇

腹前外侧群肌的肌内神经分布模式

杨宪1 赵宏明1 杨胜波2*   

  1. 1.遵义医学院2013级临床医学系; 2.遵义医学院人体解剖学教研室,贵州 遵义 563099
  • 收稿日期:2018-02-05 修回日期:2018-03-29 出版日期:2019-02-06 发布日期:2019-04-18
  • 通讯作者: 杨胜波 E-mail:yangshengbo8205486@163.com
  • 基金资助:
    国家自然科学基金;国家自然科学基金;贵州省科技厅联合基金

 Intramuscular nerve distribution pattern of anterolateral abdominal wall muscles

YANG Xian1 ZHAO Hong-ming1 YANG Sheng-bo 2*   

  1. 1.Department of Clinical Medicine, Grade 2013, Zunyi Medical College; 2.Department of Anatomy, Zunyi Medical College, Guizhou Zunyi 563099, China
  • Received:2018-02-05 Revised:2018-03-29 Online:2019-02-06 Published:2019-04-18
  • Contact: YANG Sheng-bo E-mail:yangshengbo8205486@163.com

摘要:

目的 揭示腹前外侧群肌的肌内神经分布模式,探讨其临床意义。 方法 取经甲醛固定的12具24侧中国成年尸体的腹前外侧群肌,行改良的Sihler染色。 结果 腹前外侧群肌的神经绝大多数源于节段性分布的胸神经。腹外斜肌各肌齿有独立的神经支配,在髂前上棘和髂结节之间的髂嵴上方有一纵向神经密集带。腹内斜肌腹股沟韧带中点上方有一纵向神经密集带,髂嵴上方有一横向神经密集带。腹横肌髂前上棘与第8、9肋软骨连结处之间有一弧形的神经密集带。腹直肌各肌腹中部有一横向神经密集带,上3个肌腹有独立神经支配。 结论 腹外斜肌和腹直肌可分出神经肌肉亚部;各肌内的神经密集带应被考虑为肉毒毒素A注射和局部麻醉的最佳靶点部位,不宜设为腹壁手术的切口部位。

关键词: 腹前外侧群肌, 肌内神经, 分布模式, Sihler’s染色, 应用解剖,

Abstract:

Objective To investigate the intramuscular nerve distribution pattern of anterolateral abdominal wall muscles and to explore its clinical significance. Methods Twenty-four anterolateral abdominal wall muscles from twelve Chinese adult cadavers that were fixed with formaldehyde were removed for modified Sihler’s staining. Results Most of the innervation of the anterolateral abdominal wall muscles originated from the segmental distribution of the intercostal nerve. Each muscular serration of the obliquus externus abdominis muscle had an independent innervation and there was a single longitudinal nerve dense band above the iliac crest between the anterior superior iliac spine and iliac tubercle. In the obliquus internus abdominis muscle, there was a longitudinal nerve dense band above the midpoint of the inguinal ligament and a transverse nerve dense band above the iliac crest. In the transversus abdominis muscle, there was an arched nerve dense band between the anterior superior iliac spine and the junction of the ninth and eighth costal cartilage. The rectus abdominis muscle had one transverse nerve dense band in the middle of each muscle belly and the upper 3 muscle bellies had independent innervation. Conclusion The obliquus externus abdominis and rectus abdominis muscle can be divided into neuromuscular subdivisions. The nerve dense zone in each muscle should be considered as the optimal target site for botulinum toxin A injections and local anesthesia, and it should not be designed as the incision site for abdominal wall surgery.

Key words: Anterolateral abdominal wall muscle, Intramuscular nerve, Distribution pattern, Sihler’s staining, Applied anatomy, Human