Anatomical localization of nerve entry points and intramuscular nerve distribution patterns in the human obliquus externus abdominis

ZHU Guang-qiong, LI Shou-tian,HE Bing,YANG Fang-jiu

Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (3) : 241-244.

Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (3) : 241-244. DOI: 10.13418/j.issn.1001-165x.2018.03.001

Anatomical localization of nerve entry points and intramuscular nerve distribution patterns in the human obliquus externus abdominis

  • ZHU Guang-qiong1, LI Shou-tian1,HE Bing2,YANG Fang-jiu1
Author information +
History +

Abstract

Objective To locate the nerve entry points to human obliquus externus abdominis and to observe the intramuscular nerve staining to provide morphological data for clinical application. Methods The nerve entry points to the muscles were located in 11 adult cadavers and Sihler’s staining technique was applied in  5 adult cadavers.    Results    The obliquus externus abdominis was innervated by the lateral muscular branches of the inferior 8 pairs of intercostal nerves. The nerve entry point to each extended muscle fiber was (1.54 ± 0.33) cm from the midpoint at where the corresponding fiber arose, and was located at the connecting line from the junction between the midclavicular line and the lower margin of the 5th rib to the junction between the posterior axillary line and the lower margin of the 11th rib cage. Sihler’s staining showed that the lateral muscular branches of the intercostal nerves innervating obliquus externus abdominis gave off small branches to the 1/3 beginning of each extended muscular fiber, and then divided into an upper branch and a lower branch, innervating the middle  third of  the serrated origin of each muscle. These 2 nerve branches branched out in the middle third of each fiber, with the upper and lower branches of two adjacent fibers anastomosed, forming a “U” shape at each mid-distal fiber, where small branches were distributed to the 1/3 of the end of each fiber. In the upper half of the external oblique muscle, the nerve branches supplied the corresponding fiber, whereas in the lower half, the distal part of upper fiber was supplied by the nerve branch (upper branch) of next fiber at the lower portion.    Conclusion   ①This study can provide clinical guidance for local anesthesia over the upper abdomen and nerve block for postoperative incisional pain; ②A “wavy” dense area with nerve branches is formed at mid-distal part of the obliquus externus abdominis from the top down; ③It is recommended that the abdominal surgical incision should not cross more than four extended muscular fibers.

Key words

Obliquus externus abdominis /  Nerve entry point /  Intramuscular nerve

Cite this article

Download Citations
ZHU Guang-qiong, LI Shou-tian,HE Bing,YANG Fang-jiu. Anatomical localization of nerve entry points and intramuscular nerve distribution patterns in the human obliquus externus abdominis[J]. Chinese Journal of Clinical Anatomy. 2018, 36(3): 241-244 https://doi.org/10.13418/j.issn.1001-165x.2018.03.001

References

[1]  蔡悦桂, 季中成, 朱宝国. 腹直肌、腹外斜肌联合替代股四头肌41例疗效观察[J]. 苏州医学院学报,2000,20(3): 279, 284.
[2]  张如明, 张琥, 顾新丰, 等. 全腹外斜肌筋膜皮瓣下移修复肿瘤性腹股沟和下腹壁缺损[J]. 中国肿瘤临床, 2008, 35(18): 1038-1040.
[3]  顾岩, 杨建军, 宋志成. 内镜组织结构分离技术在巨大腹壁切口疝治疗中应用价值[J]. 中国实用外科杂志, 2015, 35(11): 1165-1169.
[4]  Alonso F, Graham R, Rustagi T, et al. The subcostal nerve during lateral approaches to the lumbar spine: an anatomical study with relevance for injury avoidance and postoperative complications such as abdominal wall hernia[J]. World Neurosurg, 2017,104: 669-673.
[5]  Lawrence H, Bannister Martin M, Berry Patricia Collins Mary Dyson Julian E, et al. 格氏解剖学[M].第38版,辽宁教育出版社,1996,840.
[6]  朱光琼, 刘建, 李寿田. 胸骨舌骨肌的构筑学和肌内神经的研究[J]. 中国临床解剖学杂志, 2014, 32(6): 659-661.
[7] Liem RSB, Van Willigen JD. In toto staining and preservation of peripheral nervous tissue[J]. Stain Technol, 1988, 63(2): 113-120.
[8]  朱常花, 王琛, 谢红. 超声引导下腹横肌平面阻滞镇痛有效性的初步观察[J]. 苏州大学学报, 2011,31(3): 488-490.
[9]  南洋, 李军, 马千, 等. 超声引导下髂腹股沟及髂腹下神经阻滞在小儿麻醉的应用[J]. 中华医学杂志, 2012,92(13): 873-877.
[10]Yang F, Zhang X, Xie X, et al. Intramuscular nerve distribution patterns of anterior forearm muscles in children: a guide for botulinum toxin injection[J]. Am J Transl Res, 2016,8(12): 5485-5493.
[11]Rodriguez-Acevedo O, Elstner KE, Jacombs ASW,et al. Preoperative botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia[J].Surg Endosc, 2017, 32(2): 1-9.

Accesses

Citation

Detail

Sections
Recommended

/