（參考課件）臂叢神經(jīng)解剖圖譜.ppt

1、-1-,臂 叢 Nerves of the upper limb:Brachial plexus,-2-,-3-,-4-,-5-,根(root)：C5T1. 分支（branches） 1.Nerve to serratus anterior (long thoracic N.)胸長(zhǎng)神經(jīng)C5,6,7 2. Nerve to rhomboideus (dorsal scapular N.)肩胛背神經(jīng)C5,-6-,翼狀肩winging of the scapular,胸長(zhǎng)神經(jīng),受損原因： Sudden pressure on the shoulder from above; carrying hea

2、vy loads on the shoulder,前鋸肌,-7-,肩胛背神經(jīng),-8-,分支（branches）:僅從上干發(fā)出分支 Suprascapular nerve肩胛上神經(jīng)C5,6 Nerve to subclavius至鎖骨下肌的神經(jīng)C5,6,干： Upper trunk 上干 middle trunk 中干 lower trunk 下干,-9-,肩胛上神經(jīng),-10-,股：anterior and posterior divisions前股和后股（此處無(wú)分支）,索：lateral, posterior and medial cords 前索、后索、外側(cè)索,-11-,外側(cè)索的分支C5,6

3、 1.Lateral pectoral N. 胸外側(cè)神經(jīng)C5,6 2. Musculocutaneous肌皮神經(jīng)C5,6 3. Lateral root of median正中神經(jīng)的外側(cè)根,-12-,肌皮神經(jīng),-13-,內(nèi)側(cè)索的分支C8,T1 1.Medial pectoral N. 胸內(nèi)側(cè)神經(jīng) 2. Medial cutaneous N. of arm臂內(nèi)側(cè)皮神經(jīng) 3. Medial cutaneous N. of forearm 前臂內(nèi)側(cè)皮神經(jīng) 4. Ulnar N. 尺神經(jīng) 5. Medial root of median正中神經(jīng)的外側(cè)根,-14-,正中神經(jīng),尺神經(jīng),-15-,后索的分支

4、C5-T1 subscapular N.肩胛下神經(jīng)C5,6 2. Thoracodorsal N.胸背神經(jīng)C7,8 3. Axillary N. 腋神經(jīng)C5,6 4. Radial N. 橈神經(jīng)C5-T1,-16-,subscapular N. 肩胛下神經(jīng) Axillary N. 腋神經(jīng) Radial N. 橈神經(jīng),-17-,胸背神經(jīng) 背闊肌,-18-,正中神經(jīng),-19-,皮支,-20-,猿手,肌支,除肱橈?。锷窠?jīng)）、尺側(cè)腕屈肌、指深屈肌尺側(cè)半（尺神經(jīng)） 以外所有前臂前群肌 魚(yú)際肌（拇收肌尺神經(jīng)） 1、2蚓狀肌,-21-,-22-,-23-,尺神經(jīng),-24-,皮支,-25-,肌支,尺側(cè)腕屈肌

5、 指深屈肌尺側(cè)半 拇收肌 小魚(yú)際 骨間肌 3.4蚓狀肌,爪形手,-26-,橈神經(jīng),肌支,肱三頭肌 肱橈肌 前臂后群肌,垂腕,-27-,-28-,皮支,-29-,Undue separation of the head from the shoulder： 產(chǎn)傷；肩部受傷；麻醉期 2. 癱瘓的肌肉：三角肌、肱二頭肌、肱肌、肱橈?。?部分的岡上肌、岡下肌、旋后肌,Erbs 點(diǎn),臂叢的損傷Lesions of the Brachial Plexus Erbs paralysis 麻痹(upper trunk),policemans tip hand or porters tip hand,-30-,

6、Undue abduction of the arm 2. 癱瘓的肌肉：intrinsic M. of the hand(手內(nèi)肌T1)；ulnar flexors of the wrist and fingers(尺側(cè)屈腕和屈指肌C8) 3. Claw hand(爪形手)：hyperextension at the metacarpophalangeal jt and flexion at the interphalangeal jt,Klumpkes paralysis麻痹(lower trunk),-31-,1.Dislocation of humerus肩關(guān)節(jié)脫位 2. 涉及到的神經(jīng)：musculocutaneous N.肌皮神經(jīng)；lateral root of median正中神經(jīng)的外側(cè)根 3.癱瘓的肌肉：肱二頭肌、喙肱??；除了手肌之外由正中神經(jīng)支配的肌肉。 4.不能屈腕、屈肘，前臂橈側(cè)感覺(jué)缺失。,Injury to lateral cord 外側(cè)束的損傷,-32-,1. Subcoracoid dislocation of humerus肩關(guān)節(jié)喙突下脫位 2. 涉及到的神經(jīng)：ulner N.尺神經(jīng)；me