腹外斜肌移位代股四头肌的应用解剖学

在50侧成人尸体上测量观察了邻外斜肌的面积、厚度、纤维长度 肌门数目、位置及穿过肌门的血管神经束长和动脉管径。讨论了小儿麻痹后遗症以腹外斜肌腱移位代替股四头肌手术中关于肌力、肌力与肌纤维方向的关系,并指出分离腹外斜肌时如何注意出血。     

腹外斜肌移位术治疗小儿连枷膝(附17例报告)

<正> 本文作者采用腹外斜肌移位术重建股四头肌功能治疗17例小儿连枷膝,随诊及肌电图检查证实疗效满意,手术方式是将腹外斜肌腱膜于近耻骨联合处切断,将断端移位于大腿前外侧通过皮下隧道与阔筋膜缝合。由于支配腹外斜肌的脊髓前角细胞很少被小儿     

腹前外侧肌群“米”字教学法

腹前外侧肌群“米”字教学法陈惠宇（山东省菏泽师范专科学校体育系菏泽２７４０１５）腹前外侧肌群包括腹外斜肌、腹内斜肌、腹横肌和腹直肌等。腹外斜肌大部分肌束由外上斜向前下方，两侧呈外八字“＼／”形；腹内斜肌大部分肌束由外下斜向前上方，两侧呈内八字“八”形...     

腹外斜肌的神经入肌点定位与肌内神经分布研究

目的　对人腹外斜肌的神经入肌点定位和肌内神经染色观察，为其临床应用提供形态学资料。 方法　成尸11具定位神经入肌点和5具行Sihler’s 肌内神经染色。 结果　腹外斜肌受下8对肋间神经外侧肌支支配，各个肌齿的神经入肌点距离相应肌齿起端中点(1.54±0.33)cm，位于锁骨中线与第5肋下缘的交界处至腋后线与第11肋下缘交界处的连线上。Sihler’s染色显示支配腹外斜肌的肋间神经外侧肌支入肌后分出小分支分布到各肌齿的起端1/3，然后约在各肌齿的近、中1/3交界处分出2支二级神经分支，即上支与下支，它们分出小分支分布到各肌齿的中间1/3，相邻两个肌齿的上支与下支在各肌齿中远部形成“U”形吻合，从“U”形吻合弓上分出小分支分布到各肌齿的止端1/3。在腹外斜肌上半部，各肌齿的神经分支分布到相应的肌齿，但在腹外斜肌下半部，上一肌齿的远侧下份是由下一肌齿的神经分支(上支)分布。 结论　①为临床上腹壁局部麻醉和术后切口疼痛的神经阻滞提供指导意义；②腹外斜肌中远部从上至下形成“波浪形”的神经分支密集区；③腹部手术切口建议不要超过四个肌齿。     

腹股沟区的解剖学观察

1 材料与方法1.1 80具尸体(成尸50具、童尸30具皆为男性)经福尔马林防腐固定,上述尸体均系局解手术学教学用尸体.1.2在解剖160侧腹股沟区时,将腹外斜肌腱膜从髂前上棘水平切至腹直肌外缘,然后沿外缘切至耻骨结节,将腹外斜肌腱膜翻向外下方;观察腹股沟     

大鼠腹外斜肌肌纤维型组成及分布研究

目的探讨大鼠腹外斜肌的肌纤维型组成和分布,借以了解该肌功能,并为运动训练模型的建立提供理论依据和研究平台。方法采用Guth-Samaha肌球蛋白ATP酶组织化学染色法并稍做改良,对成年SD大鼠腹外斜肌冰冻切片进行肌纤维分型研究。结果SD大鼠腹外斜肌经肌球蛋白ATP酶组织化学染色后可明确分出2型肌纤维,即明亮色白的Ⅰ型纤维(慢缩纤维)和幽暗深褐的Ⅱ型纤维(快缩纤维),并且,2种纤维在肌内呈棋盘样均匀分布;图像分析仪下计数Ⅱ型纤维达到(84.8±5.3)%,而Ⅰ纤维仅占(15.2±2.1)%,前者占绝对优势(P<0.01)。结论SD大鼠腹外斜肌以Ⅱ型纤维为主,除了起保护腹腔脏器作用外,还参与力量和速度运动。     

胎儿腹前壁的解剖观察

对44例妊娠3个月至足月胎儿尸体腹前壁标本,在解剖显微镜下进行了解剖观察。胎儿腹前壁的腱膜都是双层结构,每一个腹直肌鞘的前、后壁由3层腱膜组成。6层腱膜全部是斜行的,在正中线附近,两侧腱膜相互交叉编织,形成下列延续关系,即两侧腹外斜肌的2层腱膜,两侧腹横肌的2层腱膜,一侧内斜肌的腱膜与对侧外斜肌腱膜(深层)和腹横肌腱膜(前层)。此外,脐以下的部分腹横肌腱膜纤维穿过同侧腹内斜肌腱膜,与外斜肌腱膜纤维融合。脐环处还有少量纤维束附于脐索的深筋膜上。本文观察表明,腹前壁扁肌腱膜的再分层及其规则排列,在胎儿时期即已形成,这对增加腹壁的弹性和韧性,并利于腹直肌在鞘内的收缩活动具有重要功能意义。     

髂腹下神经的应用解剖及临床意义

目的为临床上阑尾切除术、腹股沟疝修补术、剖宫产术、肾切除术等手术作腹壁切口时,注意髂腹下神经和切口的关系提供应用解剖学资料。方法在33具(66侧)教学用的成人尸体上对髂腹下神经的行程进行了研究。用游标卡尺测量分析了该神经在穿腹横肌、腹内斜肌、腹外斜肌时距一些骨性点的距离。结果髂腹下神经在腰大肌外侧1/3处穿出,经髂嵴最高点与第12肋尖端的中份,穿过腹横肌腱膜,距髂前上棘内侧4cm处,在腹横肌与腹内斜肌之间穿腹内斜肌,最后在腹股沟韧带上方2.5cm处与腹股沟韧带平行走行,并被腹外斜肌腱膜覆盖,在距耻骨联合上缘5cm处,它的终末皮支穿过腹外斜肌腱膜。结论在阑尾切除术时为了避免切断髂腹下神经,切口应选择在距髂前上棘至少4cm处;在作低位的旁正中切口时切口应在距腹股沟韧带3.5cm处进行;在作肾切除术时,在腰大肌外侧缘上1/3处易找到髂腹下神经。     

腹前外侧群肌的肌内神经分布模式

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。     

解剖学比喻教学法

解剖学是医学启蒙学科,它涉及的医学名词多,大多数内容需要记忆,只要正常理解,不难掌握.如教者能把它们恰当地联系比喻用于教学,讲起课来就形象得多,学生也乐于接受,容易牢记,效果甚佳,现介绍如下:1.腹前外侧壁肌及其腱膜与腹直肌的关系讲授这部分内容时,学生往往不易弄懂腹外斜肌、腹内斜肌、腹横肌三层扁肌腱膜构成的腹直肌鞘与腹直肌的关系.如果教者用一支红色粉笔,夹于中指与无名指之间,并将除拇指以外的四指伸直,就"构成了"弓状线以上的腹直肌及腹直肌鞘.红色粉笔表示腹直肌,食指表示腹外斜肌腱膜,中指表示腹内     

Distribution of slow muscle fiber of muscle spindle in postnatal rat masseter muscle

We investigated the properties of the muscle spindle in the masseter muscle at an immunohistochemical level in rats fed for 6 weeks. Slow myosin heavy chain (MyHC) isoforms were measured and intrafusal fibers in the muscle spindle were studied to determine the relationship between the superficial and deep regions of rat masseter muscle after alternated feeding pattern. However, muscle spindles were found in both regions, mainly in the deep region of the posterior superficial region of masseter muscle. The total number of the slow fiber in the intrafusal fiber and number of muscle spindle in the deep region were high from 5 to 8 weeks old in spite of various dimensions of data such as diameter and the compositions of the intrafusal fiber. The relationship of the protein expression of slow MyHC in the two regions at 5 weeks old reversed five weeks later (10 weeks old). This period is an important stage because the mastication system in masseter muscle with muscle spindle may be changed during the alternated feeding pattern of suckling to mastication. The changes may be a marker of the feeding system and of the control by the tension receptor of muscle spindle in this stage of masseter muscle after postnatal development.     

Elevator muscle of the tendon of latissimus dorsi muscle

Muscular dispositions in the axilla acquire importance under certain surgical procedures that involve the axillary artery ligature. These supernumerary muscles make the approach to the axillary fossa and their content difficult. We dissected 108 formalized corpses from adult male individuals. The specimens belong to the topographic Anatomy Unit of the Faculty of Medicine, Universidad de La Frontera, Chile. In all dissections, a rare and infrequent muscular variation attributed to the presence of a elevator muscle at the dorsal part of the latissimus muscle on the right upper limb from an adult individual was found. This muscle was fusiform and originated at the coracoid process by a short tendon of cylindrical form inserted in the dorsal superior part of the tendon of the latissimus dorsi muscle. Muscular belly and tendons of origin and insertion were closely related to the brachial plexus and the axillar vessels that they crossed.     

Thermosensitivity of muscle: high-intensity thermal stimulation of muscle tissue induces muscle pain in humans

Small-calibre afferent units responding to thermal stimuli have previously been reported to exist in muscle. The question as to whether these receptors in humans mediate subjective thermal sensations from muscle remains unresolved. The aims of the present study were to determine in humans whether intramuscular injection of warm and cold isotonic saline elicits temperature sensations, muscle pain or any other sensations. In 15 subjects, no thermal sensations assessed on a temperature visual analogue scale (VAS) could be detected with intramuscular injections of isotonic saline (1.5 ml) into the anterior tibial muscle at temperatures ranging from 8 to 48 °C. The same subjects recorded strongly increasing scores on a temperature VAS when thermal stimuli in the same intensity range were applied to the skin overlying the muscle by a contact thermode. However, i.m. isotonic saline of 48 °C induced muscle pain with peak scores of 3.2 ± 0.8 cm on a VAS scale ranging from 0 to 10 cm. Using the the McGill pain questionnaire a subgroup, of subjects qualitatively described the pain using the 'thermal hot' and 'dullness' word groups. Temperature measurements within the muscle during the stimulating injections showed that the time course of the pain sensation elicited by saline at 48 °C paralleled that of the intramuscular temperature and far outlasted the injection time. The present data show that high-intensity thermal stimulation of muscle is associated with muscle pain. High-threshold warm-sensitive receptors may mediate the pain following activation by temperatures of 48 °C or more. Taken together, the data indicate that thermosensation from a given volume of muscle is less potent than nociception.     

Axillopectoral muscle (Langer's muscle)

In a routine dissection of the axillary fossa, a muscle originating from the coracoid process of the scapula and extending to the long head of triceps brachii muscle was observed. The mentioned muscle was adhering to both the triceps brachii muscle and the tendinous part of the latissimus dorsi muscle. This anatomical variation is referred to as axillary arch (Langer's muscle or axillopectoral muscle). The muscle mass was measured 9.6 cm in length and 1.4 cm in width. The accessory muscle can be a reason of an axillary mass and can exert pressure on the neighboring neurovascular bundle or lymph routes; thus, exposing a wide range of symptoms. Therefore, variations of this area should be kept in mind in surgical interventions.     

Electrogenesis of muscle fibers of the rat masseter muscle

It was shown by intracellular recording of resting membrane potentials (RMP) and action potentials that the superficial layers of the rat masseter muscle contain chiefly fibers with a high MPP and small overshoot, whereas the deep layers contain mainly fibers with a low MPP but a high overshoot. The excitability of the cytoplasmic membrane of muscle fibers with different MPP levels was found to be similar with respect to its electrical parameters. It is suggested that the rat masseter muscle contains a high proportion of fast phasic fibers in its superficial layers and slow phasic fibers in its deep layers.Department of Pathological Physiology, N. A. Semashko Moscow Medical Stomatologic Institute. (Presented by A. D. Ado.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 88, No. 9, pp. 265–267, September, 1979.     

c-Met在骨骼肌损伤组织肌卫星细胞中的表达

目的 探讨肝细胞生长因子受体(c-Met)在正常和注射心脏毒素后,致肌损伤的肌肉组织中具有再生能力的肌卫星细胞的表达情况;为进一步研究某些肌肉变性疾病,如进行性肌营养不良(DMD)在发病中的分子机制和治疗肌肉退行性变提供参考依据. 方法 C57雄性小鼠12只,饲养于独立送排风笼具(IVC Cage)实验室.随机分为6组,1～6组左侧股四头肌局部注射心脏毒素(5μg/只),右侧股四头肌为对照,1～6组分别在注射后1d、4d、1周、2周、4周、6周颈椎脱臼处死小鼠,完整分离出股四头肌.浸入4%甲醛溶液中固定,常规包埋切片染色,与对照C57小鼠股四头肌进行组织学和免疫组织化反转录聚合酶链式反应(RT-PCR)比较分析(样本量为10),了解c-Met的原位表达情况. 结果 免疫组织化学和反转录聚合酶链式反应结果显示,正常小鼠股四头肌中c-Met在肌卫星细胞上仅有少量的表达;与对照比较,注射心脏毒素24h后,表达即明显增加并持续到观察终点的第6周,且其表达量在第1周达到高峰且直到观察期间末(第6周),仍高于正常肌肉组织,其差异有统计学意义(P<0.05).结论 c-Met可能是肌肉损伤修复过程的关键蛋白.     

Role of nitric oxide in muscle regeneration following eccentric muscle contractions in rat skeletal muscle

We examined the role of nitric oxide (NO) in muscle repair and regeneration following repetitive eccentric contractions (ECC). A standardized exercise protocol was used to create eccentric contraction-induced injury to the left tibialis anterior muscle of 48 male Wistar rats (body wt 250–350 g), using a customized isokinetic test device and a bout of 40 ECCs under electrical stimulation. A nitric oxide synthase inhibitor, N(G)-nitro-l-arginine-methyl ester (l-NAME; 35 mg kg^?1 day^?1), was included in the diet for half the animals (n = 24) beginning 3 days prior to the ECC and continuing throughout the experiment, whereas the other half (n = 24) received a control diet. ECC/+l-NAME and ECC/?l-NAME were killed after the ECC protocol at 0, 1, 3 and 7 days (n = 6 on each day). An unexercised contralateral limb with and without l-NAME infusion served as a respective control muscle at each time point. Muscle NO content, skeletal muscle damage, leukocyte infiltration, calpain activity, and MyoD and myogenin expression were assessed. NO has both pro-inflammatory and anti-inflammatory properties, and several possible roles for NO in skeletal muscle damage have been postulated. NO content was greater in the ECC/?l-NAME group at all time points (p < 0.05) compared to ECC/+l-NAME. Additionally, significant differences in NO content were observed on day 0 (p < 0.05), and day 3 (p < 0.05), ECC/+l-NAME versus ECC/?l-NAME. One day following the bout of ECC, and NO levels were increased in the ECC/?l-NAME group. Three days following ECC, there was greater myofiber damage (measured by β-glucuronidase activity) and leukocyte invasion in the ECC/?l-NAME group as compared to the ECC/+l-NAME group. One day after ECC, calpain activity was significantly increased in ECC/?l-NAME compared with control muscles (p < 0.05). On days 3 and 7, Myo-D and myogenin gene expression was increased in both groups; however, the degree of regeneration was less in the ECC/+l-NAME-treated animals. These data suggest that NO dynamics have important implications in the regulation of various factors during skeletal muscle regeneration following damaging eccentric muscle contractions.     

Stimulated muscle force assessment of the sternocleidomastoid muscle in humans

The aim of this study was to configure a force assessment device and determine potential testing protocols for quantitative evaluation of human neck muscles. The study design consisted of non-randomized control trials, with repeated measures; data from 12 normal subjects were obtained. Several apparatuses were designed, constructed and tested, i.e. single or short trains of supramaximal stimuli were used to activate sternocleidomastoid muscles in a seated position with strain gauges (6.2% variability with double-pulse stimulations) or in supine positions with load cells (5.2% variability with similar activation). Using a final configuration, maximum elicited peak forces were 1742 +/- 323 g for single-pulse and 3976 +/- 484 g for double-pulse stimulations (n = 12). There were no significant differences in maximum recorded peak torques between sessions per individual. Yet, detectable muscle activities were simultaneously recorded in the contralateral sternocleidomastoid muscles. This non-invasive, quantitative assessment approach has novel value for determining treatment efficacy, disease progression, and/or approach has novel value for determining determining treatment efficacy, disease progression, and/or relative distribution of muscle strength in patients with abnormal neck muscle function.