İnsan fetuslarında nervus medianus, nervus ulnaris ve nervus radialisin motor dallarının seyri ve varyasyonlarının tespiti
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Dosyalar
Tarih
2007
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Nervus medianus, n. ulnaris ve n. radialis üst ekstremitenin innervasyonunu saglayan plexus brachialis'in en önemli terminal dallarındandır. Bu sinirlerin seyrini, varyasyonlarını ve özellikle musküler dallarının innervasyon paternlerini belirlemek amacıyla, 2. trimestr ve 3. trimestrdeki toplam 100 fetusun (50 disi ve 50 erkek) 200 ekstremitesinde kol, önkol ve elin palmar yüzünde diseksiyonlar gerçeklestirildi. ncelemeler mikroskop altında yapıldı ve fotografları çekildi. Uzunluk, kalınlık ve uzaklık ölçümleri 0,01 mm hassas dijital kumpas kullanılarak aynı kisi tarafından alındı. Verilerin istatistigi SPSS for Windows 13.0 programında yapıldı. Ortalamaların karsılastırılmasında varyansların homojen olmadıgı belirlendigi için Mann-Whitney U testi ve Spearman korelasyon testi kullanıldı. Çalısmada yapılan ölçümler sonucunda, n. radialis'in en fazla kalınlıga sahip oldugu ve n. medianus'un baslangıç yerinin boyun köküne en uzak mesafede oldugu bulundu. Sinirlerin kalınlık ve uzaklık ölçümlerinde 2. ve 3. trimestr arasında anlamlı farklılık (P<0,01) tespit edilirken sagsol ve erkek-disi arasında farklılık izlenmedi. Diseksiyonlar sırasında 15 (%7,5) kolda n. medianus ve n. ulnaris arasında Martin Gruber Anastomozu'na rastlanıldı. 59 (%29,5) kolda elin palmar yüzünde bu iki sinir arasında baglantı dalı tespit edildi. 52 (%26) kolda n. radialis'ten m. brachialis'in inferolateral segmentine giden bir musküler dal belirlendi. N. medianus, n. ulnaris, n. radialis'in seyri, musküler dalları, birbirleriyle iliskileri ve varyasyonlarının özellikle bu bölgenin cerrahisiyle ugrasan uzmanlar tarafından iyi bilinmelidir.
Median, ulnar and the radial nerves are the most important terminal branches of brachial plexus providing upper extremity?s innervation. For the purpose of determining the courses, the variations, and especially the muscular branches? innervation patterns of these nerves, dissections were made on the arms, forearms, and the palmar surfaces of 100 second and third trimester fetuses? (50 female, and 50 male) 200 upper extremities. The studies were made by means of microscope and their photos were taken. Length, thickness, and distance measurements were taken by the same person using 0,01 mm sensitive digital compas. The statistical analyses of the data were made with SPSS for Windows 13.0 program. As it was found that the variances were not homogeneous, Mann-Whitney U test and Spearman correlation tests were used in the comparison of the mean values. It was found that radial nerve was the thickest, and the distance between the starting point of median nerve and root of the neck was the highest. A considerable difference was found between second and third trimesters, on the thickness and distance measurements of the nerves, but there was no difference between right and left upper extremities, and between male and female fetuses. During the dissections, Martin Gruber Anastomosis was encountered between median and ulnar nerves on 15 (%7,5) forearms. On 59 (%29,5) arms, a connecting segment between these two nerves was determined on the palmar surface of the hands. A muscular branch going from radial nerve to inferolateral segment of brachial muscle was determined on 52 (%26) arms. The courses, muscular branches, relationships with each other, and variations of median, ulnar and radial nerves should be well known by the specialists especially working on the local surgery of this region.
Median, ulnar and the radial nerves are the most important terminal branches of brachial plexus providing upper extremity?s innervation. For the purpose of determining the courses, the variations, and especially the muscular branches? innervation patterns of these nerves, dissections were made on the arms, forearms, and the palmar surfaces of 100 second and third trimester fetuses? (50 female, and 50 male) 200 upper extremities. The studies were made by means of microscope and their photos were taken. Length, thickness, and distance measurements were taken by the same person using 0,01 mm sensitive digital compas. The statistical analyses of the data were made with SPSS for Windows 13.0 program. As it was found that the variances were not homogeneous, Mann-Whitney U test and Spearman correlation tests were used in the comparison of the mean values. It was found that radial nerve was the thickest, and the distance between the starting point of median nerve and root of the neck was the highest. A considerable difference was found between second and third trimesters, on the thickness and distance measurements of the nerves, but there was no difference between right and left upper extremities, and between male and female fetuses. During the dissections, Martin Gruber Anastomosis was encountered between median and ulnar nerves on 15 (%7,5) forearms. On 59 (%29,5) arms, a connecting segment between these two nerves was determined on the palmar surface of the hands. A muscular branch going from radial nerve to inferolateral segment of brachial muscle was determined on 52 (%26) arms. The courses, muscular branches, relationships with each other, and variations of median, ulnar and radial nerves should be well known by the specialists especially working on the local surgery of this region.
Açıklama
Anahtar Kelimeler
Fetus, Median sinir, Median nerve, Radyal sinir, Radial nerve, Ulnar sinir, Ulnar nerve
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Doğan, N. Ü. (2007). İnsan fetuslarında nervus medianus, nervus ulnaris ve nervus radialisin motor dallarının seyri ve varyasyonlarının tespiti. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
