Đặc điểm hình thái các nhánh sơ cấp của thần kinh phụ vào cơ thang trên xác người Việt Nam trưởng thành

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Tác giả: Nguyễn Anh Tuấn Hồ, Quang Tuyền Lê, Thanh Tú Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2024

Mô tả vật lý: tr.158

Bộ sưu tập: Metadata

ID: 286488

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Đặt vấn đề: Cơ thang là một trong những cơ bị ảnh hưởng nhiều nhất bởi hội chứng đau cơ mạc. Việc hiểu biết đường đi và đặc điểm hình thái các nhánh của thần kinh phụ vào cơ thang cung cấp nhiều dữ liệu quan trọng trong việc chẩn đoán và điều trị hội chứng đau cơ mạc. Mục tiêu: Mô tả đặc điểm hình thái các nhánh sơ cấp của thần kinh phụ vào cơ thang trên xác người Việt trưởng thành. Phương pháp: Nghiên cứu cắt ngang mô tả
thực hiện trên 18 mẫu cơ thang từ 9 xác người Việt trưởng thành bảo quản đông lạnh tại bộ môn giải phẫu trường Đại học Y khoa Phạm Ngọc Thạch từ tháng 4/2024 đến 07/2024. Phẫu tích khảo sát đường đi thần kinh phụ (TKP) đoạn từ tam giác cổ sau đến mặt bụng cơ thang (CTh), ghi nhận đặc điểm hình thái các nhánh sơ cấp (SC) tách ra từ thân chính TKP. Kết quả: Nghiên cứu ghi nhận 100% trường hợp có sự hiện diện nhánh sơ cấp của thần kinh phụ đi vào cơ thang. Số nhánh sơ cấp trung bình là 7,9 ± 2,5. Các nhánh sơ cấp đều chi phối cho cả ba phần cơ thang, nhưng phần giữa chiếm tỷ lệ cao nhất (54,9%). Hình thái các nhánh sơ cấp được ghi nhận có 2 dạng, trong đó đa số là dạng 1 chiếm 81,7%. Ngoài ra, nghiên cứu còn ghi nhận các đặc điểm trên đường đi của TKP bao gồm tất cả các trường hợp TKP đều thoát ra tại vị trí 1/3 trên bờ sau cơ ức đòn chũm, thân chính tách ra nhánh đi vào bờ trước cơ thang chiếm 11,2%
thân chính TKP có nhánh nối với đám rối cổ chiếm 44,5%. Kết luận: Phân bố các nhánh thần kinh phụ trên cơ thang có sự đa dạng và phức tạp. Vì vậy cần thêm những nghiên cứu tương tự trên với số liệu lớn trên người Việt. Để ứng dụng dễ trên lâm sàng, nên tiến hành nghiên cứu định vị điểm thần kinh vào cơ bằng hệ trục tọa độ trên bề mặt da. Abstract Background: The trapezius muscle is one of the most affected by the myofascial pain syndrome. Understanding the course and morphological characteristics of the branches of the AN innervating the TM provides valuable data for the diagnosis and treatment of myofascial pain syndrome. Objectives: Report the morphological characteristics of the primary branches of the accessory nerve innervating the trapezius muscle in adult Vietnamese cadavers. Methods: A descriptive cross-sectional study was conducted on 18 trapezius muscle specimens obtained from 9 adult Vietnamese cadavers preserved by freezing at the Department of Anatomy, Pham Ngoc Thach University of Medicine, from April 2024 to July 2024. Dissection was performed to examine the course of the accessory nerve (AN) from the posterior cervical triangle to the ventral surface of the trapezius muscle (TM), and the morphological characteristics of the primary branches (PB) arising from the main trunk of the AN were recorded. Results: The study observed in 100% of cases that the primary branches of the AN entered the trapezius muscle. The average number of primary branches of the AN entering the TM is 7.9 ± 2.5. The primary branches innervate all three parts of the trapezius muscle, but the middle part has the highest proportion (54,9%). Two morphological patterns of the primary branches are observed, with type 1 being the most prevalent, accounting for 81.7%. Along the course of the AN, it is observed in 100% of cases that the AN emerged at the junction of the upper and middle thirds of the posterior border of the sternocleidomastoid muscle. The main trunk gives off a branch to the anterior border of the TM in 11.2% of cases. In addition, the study found that in 44.5% of cases, the main trunk of the AN had a communicating branch with the cervical plexus. Conclusions: The distribution of the accessory nerve branches on the trapezius muscle exhibits considerable variability and complexity, necessitating further studies with larger sample sizes in the Vietnamese population. For easy clinical application, it is recommended to conduct research on locating nerve points into muscles using a coordinate system on the skin surface. DOI: 10.59715/pntjmp.3.4.19

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