각 관절의 신경지배에 대해서 탐구 중
탐구는 끝이 없구나..
nerve block을 할때 매주 중요한 지식.
어깨 침도를 시행할때도 매우 중요한 지식!
panic bird..
1996 Innervation of the Human Shoulder Joint and Its Implications for Surgery.pdf
The distribution and variability of the nerves innervating the shoulder joint were determined in 25 fresh human adult cadavers using 3.5x magnification for dissection.
The results showed that 100% of the specimens had dual innervation of the coracoclavicular ligaments, the subacromial bursa, and the acromioclavicular joint. This dual innervation was from the articular branches of the supra scapular nerve and of the lateral pectoral nerve.
Constant relationship of these 2 nerves to bony landmarks will permit anesthetic blocks for diagnosis and possible therapeutic intervention. A consistent pattern of innervation of the posterior and inferior shoulder joints also is described.
Fig 1. Anterior view of the shoulder joint; the articular branches of the subscapular nerves indicated by little circles as these enter into the subscapularis muscle; AX = the anterior branch of the axillary nerve, which innervates the inferior aspect of the anterior capsule and the axillary recess.
어깨 전면부 신경(심부)
- subscapular nerve의 관절가지가 견갑하근(subscapular muscle)으로 작은 원을 만들며 지배함.
Fig 2. Anterior view of the shoulder joint; the clavicular head of the pectoralis major muscle has been reflected; the articular branch of the lateral pectoral (LP) nerve, which advances laterally to innervate the anterior superior shoulder joint structures.
어깨 전면부 신경(천부)
- 대흉근의 쇄골지를 반영함.
- 외측 흉신경의 관절지는 어깨관절의 앞, 위쪽을 지배함.
Fig 3. Posterior view of the shoulder joint; SA = the superior articular branch of the suprascapular nerve, which constantly separates from the main nerve approximately 4.5 cm before its passage underneath the transverse scapular ligament; IA = the inferior articular branch of the suprascapular nerve; the axillary joint recess, which receives contributions from the AX.
어깨의 후면부 신경
- 상견갑신경의 위쪽 관절지는 몇개의 가지로 나뉨
- 그림 참조
Fig 4. Superior view of the shoulder joint; the coracoclavicular ligaments, the acromioclavicular joint, the subacromial bursa, and the superior shoulder joint capsule receive contributions from the articular branch of the LP nerve and the SA branch of the suprascapular nerve.
