论文部分内容阅读
背景:跟下神经损伤和受累可致足跟疼痛综合征。熟悉跟内侧神经和跟下神经的走行和分布,可避免足部手术时损伤跟内侧神经及跟下神经。目的:了解人体下肢跟内侧神经和跟下神经的走行和分布。设计:单一样本实验。单位:沈阳医学院解剖实验室。对象:实验于2002-08/2004-10在沈阳医学院解剖实验室进行。观察对象为自愿捐献及有关部门支援的成人尸体下肢标本36条,常规防腐固定。方法:自小腿中段1/3段开始解剖胫神经,至其分成足底内侧神经和足底外侧神经。观察并测量跟内侧神经和跟下神经的来源、走行、分支及其分布。以内踝中心与足中心连线作参照点,神经经过连线处为“0”点,以上为正值,以下为负值。主要观察指标:成人下肢跟内侧神经及跟下神经的来源、行程、分支及其分布。结果:36条标本中均存在跟内侧神经和跟下神经。①跟内侧神经来源:来自胫神经27条(75%);来自足底外侧神经7条(19%);来自胫神经和足底外侧神经2条(6%)。②跟内侧神经的分支情况:有2个主要分支的29条(81%)。多数分支位于木展肌浅层脂肪垫内及皮下。③跟下神经来源:来自足底外侧神经的31条(86%);来自胫神经3条(8%);来自足底内侧神经的2条(6%)。④跟下神经发出部位:在0点下方(1.7±4.5)cm 。⑤跟下神经分支及分布:有2个主要分支的24条(67%),跟下神经大部分分布于足底方肌内侧缘的浅层。结论:跟内神经和跟下神经的来源、走行及分布较恒定,跟下部手术时应在外侧进路,当需下方进路时,应尽量靠后,避免损伤两神经。
Background: Heel and pain syndrome can be caused by injury and involvement of the nerves. Familiar with the medial nerve and the nerve following the line and distribution, to avoid foot surgery injuries with the medial nerve and the lower nerve. Purpose: To understand the movement and distribution of the lower extremity, the medial nerve, and the inferior nerve. Design: Single sample experiment. Unit: Shenyang Medical College Anatomy Laboratory. PARTICIPANTS: Experiments were performed at the Department of Anatomy, Shenyang Medical College from August 2002 to October 2004. Observations were made on voluntary donations and 36 specimens of adult lower extremities supported by relevant departments, and were routinely preserved in antisepsis. Methods: The tibial nerve was dissected from the 1/3 segment of the middle leg and divided into the medial plantar nerve and the lateral plantar nerve. Observe and measure the origin, movement, branch, and distribution of the medial and inferior nerves. The medial malleolus and foot center connection as a reference point, nerves through the connection at the “0” point, the above is positive, the following is a negative value. MAIN OUTCOME MEASURES: The origin, travel, branch and distribution of the adult lower extremity and medial and inferior nerves. Results: Thirty-six specimens were found with medial nerve and inferior nerve. ① with the medial nerve Source: 27 from the tibial nerve (75%); 7 from the lateral basal nerve (19%); 2 from the tibial nerve and basolateral nerve (6%). ② with the medial branch of the situation: There are 2 main branches of the 29 (81%). Most branches are located in the superficial fat pad and subcutaneous mucosal muscle. ③ inferior nerve source: 31 from the plantar lateral nerve (86%); 3 from the tibial nerve (8%); 2 from the medial plantar nerve (6%). ④ with the lower part of the nerve issued: 0 points below (1.7 ± 4.5) cm. ⑤ followed by nerve branches and distribution: there are 2 main branches of the 24 (67%), with the lower part of the nerve distribution in the medial floor of the plantar muscle shallow. CONCLUSION: The sources of internal nerve and inferior nerve are relatively constant in motion and distribution. They should approach the lateral side with the operation of the lower part. When the lower part needs to be advanced, they should be placed backwards to avoid damaging the two nerves.