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1.
面神经颊支的应用解剖   总被引:6,自引:0,他引:6  
目的:观测分析面神经颊支的分支类型及其与腮腺管之间的解剖关系,为腮腺区手术提供解剖学基础。方法:60例成人头部标本,观测面神经颊支的分支类型、行程、神经与腮腺管的位置关系。结果:面神经颊支以双干型多见(58.3%),三干型次之(28.3%)。神经多行于腮腺管浅面(73.3%)。腮腺管走行在颊支之问的占61.7%,导管距上颊支垂直距离约4.86mm;腮腺管走行在神经下方者占11.7%,距下颊支的垂直距离约1.71mm;腮腺管走行在神经上方者占26.7%,距上颊支的垂直距离约2.56mm。结论:面神经颊支多行于腮腺管浅层,与腮腺管关系十分密切,腮腺区手术时循颊支向后追踪面神经是比较安全、有效的方法,容易掌握。  相似文献   

2.
面神经下颌缘支的应用解剖   总被引:5,自引:2,他引:3  
目的了解面神经下颌缘支的正常层次解剖位置,为涉及面侧区和颌下区的美容外科手术提供临床应用解剖学资料。方法解剖33具(共66例)成人尸体标本的头颈部标本,观察了面神经下颌缘支的分支类型、走行、与面动脉的位置关系以及穿出腮腺处和与面动脉的交叉处的体表位置。结果面神经下颌缘支为1-2支,以单干型居多,约占58%,大多行于下颌骨下缘上方约占44%,行于骨下缘下方者占5%。未发现面神经下颌缘支不与面动脉交叉,位置在均下颌角下缘上、下方约0.5-1 cm范围内。面神经下颌缘支经过面动脉的浅面和深面者分别占89%和6%;面神经下颌缘支穿出腮腺处的体表位置分别在下颌角上方和下颌支后缘前方1 cm交点附近,面神经下颌缘支与面动脉交处距下颌支后缘约4 cm,距下颌骨下缘约1 cm。结论面神经下颌缘支的毗邻和行程关系较为复杂,了解其与周围结构的重要位置关系,可以减少美容外科手术因神经损伤造成下唇及口角功能障碍的发生。  相似文献   

3.
目的:研究颏下逆行岛状皮瓣血管蒂与面神经分支的解剖关系,为该皮瓣在临床的推广应用、提高手术成功率、减少面神经损伤提供解剖学依据.方法:利用福尔马林灌注固定的头颈部标本,解剖观测面动、静脉与面神经分支的交叉关系、交叉点至神经人肌点的距离、面神经各分支出腮腺处至入肌处的距离;模拟逆行蒂颏下瓣修复眼部缺损的手术过程.结果:面神经颈支从下颌角后方出腮腺向前下走行于颈阔肌深面而分布于该肌,该神经出腮腺处至面动、静脉与下颌缘交点处的距离为29.4 mm±4.0 mm;面神经下颌缘沿下颌骨下缘走行,与下颌骨之间常有淋巴结分隔,该神经均于面动、静脉浅面与其交叉,交叉点至下颌缘支入肌处的距离为16.9 mm±3.7 mm,下颌缘支出腮腺处至入肌处的距离为44.3 mm±5.1 mm;面神经颊支多以2干出腮腺,行程中各颊支之间及与下颌缘支、颧支之间互相吻合形成多个神经弓,在颊脂体表面常交织成丛,继而发出分支进入颧大肌、颊肌和笑肌,与面静脉形成2~4个交叉点,口角平面通常有一个交叉点,其余交叉点均在口角平面以上.结论:为了提高颏下逆行带蒂岛状皮瓣的转瓣点,须从面神经下颌缘支与下颌骨之间向上牵拉皮瓣,因此需充分分离神经与骨之间的间隙,以免牵拉皮瓣经过该间隙时损伤面神经下颌缘支;血管蒂旋转点不宜高于口角水平,以免损伤面神经颊支、口角诸肌和影响皮瓣的血供.  相似文献   

4.
目的:总结面神经颈支和下颌缘支的应用解剖研究成果,了解其走行及变异情况,以利于手术中对其保护,避免手术损伤.方法:查阅近年来国内外有关面神经颈支和下颌缘支的应用解剖及其临床意义方面的文献资料,并进行汇总分析.结果:面神经颈支位置恒定,行程短,可作为逆行分离面神经干的解剖标志.面神经下颌缘支变异较多,行程长,在手术中易受损伤.结论:通过对面神经颈支和下颌缘支的临床解剖学研究,为头颈部手术路径的设计提供了新的解剖标志,为手术中避免上述神经的损伤提供帮助.  相似文献   

5.
目的分析沿下颌缘支逆向解剖面神经方法切除腮腺肿瘤的手术效果。方法回顾性分折2002~2010年我科施行腮腺肿瘤切除术43例。腮腺浅叶切除31例,腮腺全切除12例。全部病例均采用下颌缘支逆行法解剖面神经。结果全组术后随访10~60个月,无肿瘤复发病例。2例术后腮腺瘘,14~23 d痊愈。无永久性面瘫、术后出血、感染等并发症。结论沿下颌缘支逆向解剖面神经的腮腺肿瘤手术方法解剖标志清楚,容易寻找,可有效降低面瘫的发生,有一定的临床应用价值。  相似文献   

6.
大体解剖学     
面神经下颌缘支的应用解剖学目的:为颌面部手术切口定位提供解剖学依据。材料和方法:观测了33具(66例)成人尸体标本面神经下颌缘支的分支类型、行程、神经与面动脉的位置关系以及神经穿出腮腺处和与面动脉交叉处的体表位置。结果:①面神经下颌缘支单干型居多,占57.6%;双干型占2巳7%;合干型占16.7%;②面神经下颌缘支走行于下颌骨下缘的上方者占76.6%,走行于骨下缘的下方者占23.4%;分别走行于骨下缘的上、下方1.5cm范围内;③面神经下颌缘支经过面动脉的浅面和深面者分别占92.6%和7.4%;④面神经下颌缘支穿出腮腺处…  相似文献   

7.
面神经的应用解剖学研究进展   总被引:1,自引:0,他引:1  
王爱平  李严斌 《解剖与临床》2007,12(3):216-216,F0003
面神经颅外段由面神经核发出的躯体运动纤维构成,从茎乳孔穿出颅外,分支分布于面部的表情肌.按其与腮腺的毗邻关系,可将面神经颅外段分为腮腺前段、腮腺内段和腮腺后段.本文主要介绍面神经的腮腺后段.腮腺后段指由腮腺丛发出的5组分支,出腮腺以后至表情肌的一段.颞支、颧支和上颊支主要来自颞面干,下颊支、下颌缘支和颈支主要来自颈面干.熟悉面神经的走行方向、分支分布及其与周围组织的毗邻关系,对于保护面神经及其分支免受损伤非常重要.现就面神经各分支的解剖学研究进展综述如下.  相似文献   

8.
腮腺区面神经的解剖及临床意义   总被引:12,自引:3,他引:9  
目的:为腮腺区手术提供解剖学基础。方法:在25具50侧经防腐处理的完整头部标本上观测面神经干的长度、横径以及各个分支再分支前长度和各个分支的解剖特点。结果:颞支横径为(1.1±0.2)mm,分支有(1.7±0.8)支;颧支横径为(1.8±0.3)mm,分支有(1.6±0.6)支,位置恒定;颊支有上下颊支型、融为一支型和一支再分型3种类型,上下颊支多位于距腮腺导管上下0.5cm以内的浅层;下颌缘支横径为(1.2±0.4)mm;颈支横径为(0.9±0.2)mm,走行长度为(2.3±0.3)cm,分支有(1.1±0.4)支。结论:面神经与腮腺区关系密切,腮腺区手术时循颊支向后追踪面神经是比较安全有效的方法。  相似文献   

9.
面神经下颌缘支的走行层次及分段定位   总被引:1,自引:0,他引:1  
目的 了解面神经下颌缘支的走行层次及分段定位,为防止面侧区颌面部下部手术中造成面神经下颌缘支损伤提供解剖学依据.方法 参照设定的坐标系,观测28具成人尸体(即56侧)面神经下颌缘支的走行层次和位置.结果 面神经下颌缘支主要穿行于腮腺和咬肌筋膜内,全长可分为降段、弓段和升段3段,与下颌后静脉及面动脉交叉处的坐标值分别是(-6.4±1.5)mm和(9.8 ±1.3)mm、(28.8±4.1)mm 和(11.6±1.6)mm.结论 采用分段定位的方法能更准确显示面神经下颌缘支的位置,以满足颌面部外科手术的需要.  相似文献   

10.
目的 探讨家兔面神经颅外段的主干及分支特点。 方法 健康家兔15只,在显微镜下解剖家兔面神经,并对其形态特点进行观测。 结果 家兔面神经出茎乳孔后分出耳后支、二腹肌支、茎突舌骨肌支及面神经主干。兔面神经主干在面部的分支有颞支、颧支、颊支、下颌缘支和颈支,其中颧支与颊支关系密切,走行过程中合成一干,然后在口角后缘分离。 结论 家兔面神经颧支与颊支在耳廓下缘前部位到口角后缘之间,分支少,神经干较粗,便于进行面神经缺损修复动物模型的建立。  相似文献   

11.

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

  • Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
  • The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
  • To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.
Quadriceps weakness is a common consequence of traumatic knee joint injury1,2 and chronic degenerative knee joint conditions.3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.5 The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,6 biomechanical deficits,7 and possibly reinjury.5 Furthermore, researchers8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,1012 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators15 have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,7 produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,1618 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.5 The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.19 Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.1618 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.20 Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.  相似文献   

12.
13.
即早基因c-fos与脑血管病及学习记忆   总被引:6,自引:1,他引:5  
即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.  相似文献   

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OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.  相似文献   

20.
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