背景:结缔组织的作用不仅仅是空间填充。此外,越来越多的证据表明,结缔组织在腕管综合征(CTS)等疾病的发病机理中起着重要作用。根据我们的假设,正中神经(MN)被一个结缔组织系统包围,该系统位于旋前圆柱的远端,并一直延伸到,包括,腕管.
方法:为了观察正中神经周围的结缔组织,我们解剖了15个身体捐献者的前臂,用高碘酸希夫(PAS)染色创建的塑化切片,并将墨水注入到所看到的空间中。我们通过对10名健康个体的放射学数据进行分段分析来验证我们的发现。
结果:我们从宏观上描述了在旋前杆远端的结缔组织(MC)的正中神经系统,直至并包括腕管。这个系统创建,连接,并分隔空间。至少从旋前圆柱到腕管,它还会从近端到远端创建子空间。对于MC来说,我们确定腕管的平均横截面面积为153.1mm2(SD=37.15)。正中神经始终位于这个MC的中心,进一步连接到前臂的屈肌,和桡骨。在腕管里,MC在内部创建子空间。在那里,它还充当包裹屈肌肌腱的最外层内层,MN。
结论:术语MC并不否定,而是命令其他“连接词”的存在,像滑膜下结缔组织,内皮-,上尿症或会阴尿症,表皮,骨膜,或Peritendinea,与正中神经相关的层次结构。MN的疾病很常见。了解MC的解剖结构及其与MN功能的关系可以帮助临床医生识别和理解诸如CTS的状况。
BACKGROUND: Connective tissue serves a role beyond mere spatial filling. Furthermore, there is increasing evidence that connective tissue plays an important role in the pathogenesis of conditions such as carpal tunnel syndrome (CTS). According to our hypothesis, the median nerve (MN) is surrounded by a system of connective tissue distal to the pronator teres and extending up to, and including, the carpal tunnel.
METHODS: To visualize the connective tissue surrounding the median nerve, we dissected the forearms of 15 body donors from pronator teres to the carpal tunnel, created plastination slices stained with Periodic Acid-Schiff (PAS), and injected ink into the seen spaces. We verified our findings with a segmentational analysis of radiological data of 10 healthy individuals.
RESULTS: We macroscopically describe the median nerve´s system of connective tissue (MC) distal to the pronator teres and up to and including the carpal tunnel. This system creates, connects, and separates spaces. At least from the pronator teres to the carpal tunnel it also creates subspaces from proximal to distal. For the MC, we established a mean cross-sectional area of 153.1 mm2 (SD=37.15) in the carpal tunnel. The median nerve consistently resides at the center of this MC, which further connects to flexor muscles of the forearm, and to the radius bone. In the carpal tunnel, the MC creates subspaces inside. There, it also acts as the outermost internal layer enveloping flexor tendons, and the MN.
CONCLUSIONS: The term MC does not negate but orders the existence of other \"connectives\", like subsynovial connective tissue, endo-, epi- or perineuria, epimysia, periostea, or peritendinea, to a hierarchy related to the median nerve. Diseases of the MN are common. Knowing the anatomy of the MC and how it relates to MN function may help clinicians recognize and understand conditions like CTS.