胸骨肌与双侧胸锁乳突肌相连变异1例

笔者在局解教学过程中,发现一例双侧胸骨肌没有退化,而且与双侧胸锁乳突肌连为一体变异。现报道如下：     

单侧副胸锁乳突肌与胸骨肌相连1例

在解剖一成年男性尸体标本时 ,发现其右侧副胸锁乳突肌与胸骨肌相连的变异 ,较为罕见 ,报道如下 :(1)副胸锁乳突肌上端连于胸锁关节处 ,向左下方连于左侧胸骨角下缘 ,位于体壁肌肉浅层 ,长 2 .0ｃｍ ,宽 1.0ｃｍ。(2 )胸骨肌上端在胸锁关节处 ,分别与胸锁乳突肌和副胸锁乳突肌相连 ,下端与右侧腹直肌鞘前层相续 ,位于肌肉浅层 (即浅筋膜下方 )最宽处 4 .0ｃｍ ,长 9.0ｃｍ ,与副胸锁乳突肌呈 4 5°夹角。(3)左侧未见异常 ,分析变异原因 :副胸锁乳突肌的发生可能于腮弓间充质演化异常有关 ;而胸骨肌变【收稿日期】2 0 0 1 - 0 4 - 2 3异则可…     

双侧副胸锁乳突肌与胸骨肌相连1例

在局解教学过程中 ,发现一例双侧副胸锁乳突肌与胸骨柄相连的变异 ,较为罕见 ,故报道如下。女性 ,70岁左右。变异肌肉位于深筋膜深面、胸锁乳突肌及胸大肌的浅表 ,呈“Ｘ”形 (附图 )。两侧副胸锁乳突肌于胸骨柄水平处以中间腱相连后止于胸骨柄前面 ,肌腹 (宽约 1.5ｃｍ ,厚约 1.0ｃｍ)向两侧外上方斜行约 18ｃｍ后止位于两侧颞骨乳突外侧面、胸锁乳突肌止点浅表。胸大肌浅表尚有两变异肌肉起于胸大肌下缘 (第 5～ 6肋间 ) ,向内上方斜行约 16ｃｍ后连于中间腱。右侧肌腹较大 ,下缘宽约 8ｃｍ ;左侧肌腹较小 ,宽约 4ｃｍ。中间腱又借胸大肌…     

胸锁乳突肌与胸骨肌变异1例

笔者在解剖实验课上解剖一具男尸标本,发现其双侧胸骨肌未完全退化,并与双侧胸锁乳突肌相连变异,现报道如下：     

胸锁乳突肌变异一例报告

在尸体解剖中,发现一例左胸锁乳突肌变异.本例为女性尸体70岁左右,左侧胸锁乳突肌起始部有三个头,一个起自胸骨柄即胸骨头;一个起自锁骨胸骨端即锁骨头;第三个头起自锁骨中、内1/3交界处,根据其位置、起止认定为“锁骨乳突肌”.为人类体质变异积累资料,现报告如下:胸骨头和锁骨头发起后即在锁骨上方汇合为一个肌腹(胸骨头纤维居锁骨头的浅面),两头与锁骨间形成锁骨上小窝.“锁骨乳突肌”第三头呈长带状,被颈阔肌覆盖,深面紧贴肩胛舌骨肌,颈横动、静脉,外测缘与颈外静脉相邻.以肌纤维起自锁骨,起始部肌宽2.0 cm,其前缘距锁骨     

胸锁乳突肌锁骨头的血供及应用解剖

目的:为临床应用胸锁乳突肌锁骨头复合瓣提供应用解剖学基础。方法:在40侧成人尸体标本上,解剖观察胸锁乳突肌的形态,血供来源及其动脉在胸锁乳突肌内的分布、构筑特点。结果:胸锁乳突肌血供丰富。其锁骨头主要血供为甲状腺上动脉胸锁乳突肌肌支。该支出现率占82.5%,距甲状腺上动脉起点(1.72±0.76)cm处发出,起始外径(1.52±0.10)mm,肌外长度为(22.07±0.4)mm;胸锁乳突肌由副神经支配,其体表投影位于乳突尖下方(4.01±0.39)cm,距肌前缘的距离为(2.14±0.46)cm处。结论:胸锁乳突肌锁骨头血供丰富为多源性,血管粗、蒂长,可以制成胸锁乳突肌锁骨头带半片锁骨瓣修复骨组织缺损。     

胸锁乳突肌延长术治疗斜颈的应用解剖与临床疗效

目的:为提高先天性斜颈的临床疗效进行相关的解剖学研究以及临床上三种手术方式的效果评价;方法:对28具成人尸体的49例(侧)胸锁乳突肌及其周边结构进行应用解剖研究。临床治疗先天性肌性斜颈278例,其中行胸锁乳突肌切断术92例,胸锁乳突肌延长术154例,胸锁乳突肌单头延长术32例;结果:胸锁乳突肌两头可分离的长度为:109.0±29.9mm,占胸锁乳突肌前缘长189.4±14.6mm的56.8％,对于轻、中度或较重度的斜颈患者,其两头可分离的长度都可足够进行胸锁乳突肌延长术,与其他两种术式相比,胸锁乳突肌延长术治疗肌性斜颈可行且疗效好;结论:胸锁乳突肌延长术可以作为治疗肌性斜颈的一种良好术式。     

胸锁乳突肌血供的研究

本文用１７具成人尸体，采用三种不同的方法研究了胸锁乳突肌的微血管构筑，具体论述了支配胸锁乳突肌的各动脉来源、走行、分支、分布及血管吻合等情况，并测量了胸乳突肌内的血管网网眼密度、网眼面积，测理结果进行统计学处理。     

双侧胸骨肌与胸锁乳突肌相连变异一例

笔者在解剖1具成年男性尸体时发现双侧胸骨肌,且与同侧胸锁乳突肌在胸骨柄处通过腱性结构相连.胸骨肌位于胸骨两侧,呈\"八\"字形走行,分布于胸大肌的前面.两侧胸骨肌起于肋弓,部分肌纤维止于胸骨柄的前面,肌腱上行,部分被致密结缔组织和部分胸锁乳突肌肌纤维包裹,并与胸锁乳突肌的腱性结构相续(图1).     

Bilateral sternalis with unusual left-sided presentation: a clinical perspective

An unusual variation creates interest among anatomists, but is a cause of concern among clinicians when it mimics a pathology. The sternalis muscle is one such variant of the anterior chest wall located subcutaneously over the pectoralis major, ranging from a few short fibers to a well-formed muscle. We observed a bilateral case, which was accompanied by an atypical presentation on the left side where a huge, bulky sternalis muscle was associated with the absence of the sternal fibers of the pectoralis major. The fibers arose as a lateral strip from the upper two-thirds of the body of the sternum and costal cartilages 2 through 6 with the intervening fascia and aponeurosis of the external oblique. The right sternalis was strap-like and was placed vertically over the sternal fibers of the pectoralis major, arising from the underlying fascia and aponeurosis of the external oblique. The sternalis muscles, on each side, converged into an aponeurosis over the manubrium that was continuous with the sternal heads of the right and left sternocleidomastoid muscle, respectively. This rare anomaly has puzzled radiologists and surgeons in confirming diagnosis, missing it all together or mistaking it for a tumor on mammography or CT scan. These findings prompted us to review its topography, development, and application in relation to the anterior chest wall.     

应用多层螺旋CT观察胸骨肌的发生率和解剖特点

目的:采用多层螺旋CT(MDCT)研究普通人群中胸骨肌的出现率及解剖特点.方法:回顾性分析5000例无前胸壁疾患成人胸部MDCT轴位图像,统计胸骨肌出现率,单、双侧出现率及性别差异,并进一步分析其位置,形态,起、止及大小等解剖特点.结果:5000例成人中胸骨肌出现率为5.8%,男性(6.7%)高于女性(4.3%).单、双侧分别为195、95例.单侧195例中左、右侧分别为71例、124例,单、双侧出现率男女性别差异无统计学意义.在CT轴位上胸骨肌位于胸骨两侧,胸大肌浅面,其断面呈扁平状或结节状,重建图上呈上下纵向走行扁梭形或条带状,部分可呈内上向外下走行.胸骨肌上缘起自第5肋软骨水平以上,附着于肋软骨、胸大肌、胸骨柄及体部、胸锁乳突肌肌腱,下缘止于第3～7肋软骨水平,附着于腹外斜肌腱、胸肌筋膜、肋软骨、胸骨体及剑突.胸骨肌形态变异大,平均长度(7.01±2.69)cm,平均厚度(0 50±0.20)cm,平均宽度(2.10±1.21)cm.结论:胸骨肌在正常人群中有较高出现率,MDCT轴位与三维重建结合能很好地显示其解剖特点.     

Primary echinococcosis of the sternocleidomastoid muscle

Muscular echinococcosis accounts for 0.5% to 5.4% of all hydatid disease cases, with very little data on the incidence of muscular echinococcosis of the head and neck. We report a unique case of primary echinococcosis of the right sternocleidomastoid muscle in a 56-year-old man. Preoperative assessment by ultrasound and fine needle aspiration did not point to echinococcosis. We suspected the right diagnosis intraoperatively and confirmed it postoperatively by pathohistology and serologic tests. Echinococcosis of the liver and the lungs was also excluded postoperatively. Combination of operative treatment and postoperative albendazole herapy in two 28-day cycles one month apart resulted in complete regression of the disease. Echinococcosis should be considered as differential diagnosis of a multicystic mass in neck, particularly if it is of longstanding duration. Serologic tests for echinococcosis should be included in differential diagnostic procedures for each multicystic formation on the neck, especially in endemic areas.     

The sternalis muscle: an uncommon anatomical variant among Taiwanese

The sternalis muscle is an uncommon anatomical variant. It is located on the human anterior pectoral wall, superficial to pectoralis major. This muscle has been reported both in males and females, and in whites, blacks and Asians (Barlow, 1934; Kida & Kudoh, 1991; Shen et al. 1992; Bradley et al. 1996).
Although the importance of this muscle is still a mystery, various different interpretations have been made. Clemente (1985) considered sternalis to be a misplaced pectoralis major, although some embryologists have viewed it as part of a ventral longitudinal column muscle layer arising at the ventral tip of the hypomeres (Sadler, 1995). Sadler claimed that this muscle is represented by rectus abdominis in the abdominal region and by the infrahyoid musculature in the cervical region; in the thorax, this layer usually disappears but occasionally remains as a sternalis muscle. Kitamura et al. (1985) reported a case of congenital partial deficiency of pectoralis major accompanied by an enormous sternalis. Barlow (1934), on the other hand, claimed that sternalis represents the remains of a panniculus carnosus.     

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.