寰枢关节错位与胸锁乳突肌和斜方肌疼痛的解剖关系的初步研究

doi:10.13418/j.issn.1001-165x.2015.06.003

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (6): 627-630.doi: 10.13418/j.issn.1001-165x.2015.06.003

寰枢关节错位与胸锁乳突肌和斜方肌疼痛的解剖关系的初步研究

谭海智^1，2，　张鸣生²，　高卫邦²，　叶金群²

1. 南方医科大学, 广州 510515；　2.广东省人民医院广东省医学科学院，广州 510080

收稿日期:2015-09-18 出版日期:2015-11-25 发布日期:2015-12-18
通讯作者: 张鸣生，教授，主任医师，博士生导师，E-mail：mszrch@163.com
作者简介:谭海智（1989-），男，广东韶关人，在读硕士研究生，主要研究方向：脊柱错位与推拿手法治疗方面的研究，E-mail：15013312549@163.com

The pilot study of anatomy relationship between atlanto-axial joint misalignment with sternocleidomastoid and trapezius muscles pain

TAN Hai-zhi ^1,2, ZHANG Ming-sheng ², GAO Wei-bang², YE Jin-qun ²

1. Southern Medical University, Guangzhou 510515, China; 2. Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080,China

Received:2015-09-18 Online:2015-11-25 Published:2015-12-18

摘要/Abstract

摘要：

目的　观察寰枢椎与副神经及第2颈神经的解剖关系，以及观察胸锁乳突肌和斜方肌的神经支配特点，为寰枢关节错位致胸锁乳突肌和斜方肌疼痛提供解剖学依据。方法　对3具共6侧成年人颈部尸体标本进行解剖，观察寰椎横突与副神经、寰枢外侧关节与第2颈神经前支、寰枢椎椎间孔外韧带的解剖结构，以及观察胸锁乳突肌和斜方肌的神经支配特点,测量副神经与寰椎横突尖的最短距离。结果 (1)胸锁乳突肌和斜方肌均受副神经和颈丛（第2~4）神经支配，并且副神经与颈丛神经存在交通支联系。(2)副神经走行在寰椎横突前方，二者关系密切，副神经与寰椎横突尖的距离为4.84~7.60 mm(左侧)和3.22~6.80 mm（右侧）。(3)寰枢椎存在椎间孔外韧带，该韧带与第2神经相连，并附着在寰椎横突。(4)第2颈神经前支贴着寰枢外侧小关节向前走行。结论寰枢关节错位可能会刺激副神经及第2颈神经或其前支，从而引起胸锁乳突和斜方肌紧张、疼痛。

关键词: , 寰枢关节, 副神经, 颈神经, 胸锁乳突肌, 斜方肌

Abstract:

Objective　To observe the anatomic relationship of atlanto-axial joint with the accessory nerve and the second cervical nerve, and to observe the innervation of sternocleidomastoid and trapezius muscle, providing the anatomy basis of sternocleidomastoid and trapezius muscles’pain caused by atlanto-axial joint misalignment. 　Methods　Three adult cadaveric neck specimens(6 sides) underwent dissection. The anatomic relationship of atlas transverse process with accessory nerve and lateral atlantoaxial joint with second cervical nerve’anterior branch, the anatomy of atlanto-axial joint’extraforaminal ligament, and the innervation of sternocleidomastoid and trapezius muscle were observed. The minimum distance between atlas transverse process tip and accessory nerve was measured. Results (1)Sternocleidomastoid and trapezius muscles were innerved by both accessory nerve and cervical nerve (2th~4th), and accessory nerve had communicating branch with cervical nerve. (2)Accessory nerve was situated anteriorly to the transvers process of the atlas, and a close anatomic relationship between them could be observed. The minimum distance between the tip of atlas transverse process and accessory nerve was 4.84~7.60 mm (left side) and 3.22~6.80 mm(right side). (3) Extraforaminal ligament existed in the atlanto-axial joint intervertebral foramen, which was in contact with the second cervical nerve and adhered to atlas transverse process. (4)The anterior branch of second cervical nerve travelled forward in contact with lateral atlantoaxial joint. Conclusion Atlanto-axial joint misalignment may stimulate the accessory nerve and thesecondcervicalnerveor its anterior branch,which may cause sternocleidomastoid,trapezius muscle tension and pain.

Key words: Atlanto-axial , joint, Accessory nerve, Cervical nerve, Sternocleidomastoid, Trapezius

谭海智,张鸣生,高卫邦,叶金群. 寰枢关节错位与胸锁乳突肌和斜方肌疼痛的解剖关系的初步研究[J]. 中国临床解剖学杂志, 2015, 33(6): 627-630.

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寰枢关节错位与胸锁乳突肌和斜方肌疼痛的解剖关系的初步研究

The pilot study of anatomy relationship between atlanto-axial joint misalignment with sternocleidomastoid and trapezius muscles pain

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