Fetal kadavralarda derin ense kaslarının morfolojisi ve komşu yapılarla ilişkileri
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Dosyalar
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Regio suboccipitalis, kafa iskeleti ile columna vertebralis'in üst kısmı arasındaki eklemin çevresini içeren bölgedir. Yüzeyelinde m. trapezius ile m. semispinalis capitisbulunur. Derininde derin ense kasları olarak sınıflandırılan m. rectus capitis posterior major, m. rectus capitis posterior minor, m. obliquus capitis inferior ve m. obliquus capitis superior yer alır. Regio suboccipitalis, içerisinde önemli anatomik oluşumları barındırması nedeniyle bölgede gerçekleştirilecek invaziv girişimler açısından önem arz etmektedir. Bu çalışmanın amacı derin ense kaslarının morfolojik olarak değerlendirilmesi, n. occipitalis major ve n. occipitalis tertius'un regio occipitalis'teki seyirleri ve kaslar ile ilişkisi hakkında detaylı anatomik bilgiye sahip olmaktır. Çalışma, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Anatomi Anabilim Dalı'nda bulunan fetal kadavra koleksiyonu'nda yer alan 15 adet fetal kadavra (7 erkek, 8 dişi) üzerinde gerçekleştirildi. Diseksiyonlar mikrodiseksiyon mikroskobu altında yapıldı. Morfometrik ölçümler için (n. occipitalis tertius'un ve n. occipitalis major'un m. trapezius'un aponörozunu deldiği yerin linea nuchalis superior'a uzaklığı, n. occipitalis major'un m. semispinalis capitisi deldiği yer ile dalları arası mesafe, derin ense kaslarının origo, insersiyo genişliği ve kasların uzunlukları) elektronik kumpas kullanıldı. N. occipitalis major'un, m. semispinalis capitis ve m. obliquus capitis inferior'a göre konumu belirlendi. Ayrıca derin ense kaslarının ve m. semispinalis capitis'in innervasyonları belirlenerek çalışma sırasında tespit edilen varyasyonlar not edildi. Kaslar ile ilgili ölçümler değerlendirildiğinde sadece m. obliquus capitis inferior'un origo genişliği ile m. obliquus capitis superior'un uzunluğunun cinsiyetlere göre istatistiksel olarak anlamlı farklılık (p<0.05) gösterdiği tespit edildi. N. occipitalis major'un fetal kadavraların 27 (% 90)'sinde tek parça halinde, 3 (%10)'ünde birden fazla parça halinde m. semispinalis capitis'in medial kısmını delerek çıktığı gözlendi. Kadavraların 29 (%96.7)' unda n. occipitalis major'un kasın içerisinden, 1 (%3.3)'inde ise medialinden geçtiği belirlendi. Bölgede yer alan n. occipitalis major'un seyri sırasında komşu kasları delmesi nedeni ile tuzak nöropatileri görülebilir. Özellikle bu tuzak nöropatilerin neden olduğu baş ağrısının tedavisinde n. occipitalis major'un blokajı oldukça önemlidir. Bölgede yapılacak cerrahi girişimler ve/veya sinir blokajlarında bölgedeki sinirlerin seyri ve kaslar ile ilişkisi hakkında detaylı anatomik bilgiye sahip olmanın faydalı olacağı kanaatindeyiz.
Objective: Regio suboccipital is the region containing the joint between the head skeleton and the upper part of the columna vertebralis. Trapezius and semispinalis capitis muscle is located at superficial. Rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior and obliquus capitis inferior classified as a back of the neck muscles are located at deep. Regio suboccipital is important in terms of invasive interventions in the region due to the presence of important anatomical structures within it. The aim of this study is to evaluate back of the neck muscles morphologically, the course of greater occipital nerve and third occipital nerve in occipital region and have detailed anatomical knowledge about the relationship between muscles and nerves. Method: This study was conducted on 15 fetal cadavers (7 males, 8 females) in the fetal cadaver collection at Department of Anatomy, Faculty of Meram Medicine, University of Necmettin Erbakan. The dissections were made under microdissection microscope. Electronic caliper was used for morphometric measurements (the distance between superior nuchal line and the point where the greater occipital nerve and third occipital nerve emerged the aponeurosis of trapezius muscle, the distance between greater occipital nerve where it emerged the semispinalis capitis muscle and the point where it gives first branch, width of origo and insertion of back of the neck muscles and length of back of the muscles). Also, the position of the greater occipital nerve was determined according to semispinalis capitis and obliquus capitis inferior. In addition, innervation of the back of the muscles was detected and the variations were noted during the study. Results: When the measurements related to the muscles were evaluated, it was found that only the origo width of obliquus capitis inferior muscle and the length of obliquus capitis superior muscle was statistically significant (p <0.05) between genders. It was observed that greater occipital nerve pierced the semispinalis capitis in one piece in 27 (90%) of the fetal cadavers. In 3 (10%) fetal cadavers, more than one branch of greater occipital nerve pierced the semispinalis capitis. It was determined that the greater occipital nerve passed through the semispinalis capitis muscle in 29 (96.7) of fetal cadavers and passed from the medial edge of muscle in 1(3.3%). Conclusion: Entrapment neuropathies can be seen by reason of greater occipital nerve pierced the neighboring muscles in the occipital region. Especially in the treatment of a headache caused by these entrapment neuropathies, blockage of a greater occipital nerve is very important. We believe that it would be beneficial to have detailed anatomical knowledge about the nerves in this region and the relationship between this nerve and the muscles during the surgical procedures and/or nerve blockages to be performed in the region.
Objective: Regio suboccipital is the region containing the joint between the head skeleton and the upper part of the columna vertebralis. Trapezius and semispinalis capitis muscle is located at superficial. Rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior and obliquus capitis inferior classified as a back of the neck muscles are located at deep. Regio suboccipital is important in terms of invasive interventions in the region due to the presence of important anatomical structures within it. The aim of this study is to evaluate back of the neck muscles morphologically, the course of greater occipital nerve and third occipital nerve in occipital region and have detailed anatomical knowledge about the relationship between muscles and nerves. Method: This study was conducted on 15 fetal cadavers (7 males, 8 females) in the fetal cadaver collection at Department of Anatomy, Faculty of Meram Medicine, University of Necmettin Erbakan. The dissections were made under microdissection microscope. Electronic caliper was used for morphometric measurements (the distance between superior nuchal line and the point where the greater occipital nerve and third occipital nerve emerged the aponeurosis of trapezius muscle, the distance between greater occipital nerve where it emerged the semispinalis capitis muscle and the point where it gives first branch, width of origo and insertion of back of the neck muscles and length of back of the muscles). Also, the position of the greater occipital nerve was determined according to semispinalis capitis and obliquus capitis inferior. In addition, innervation of the back of the muscles was detected and the variations were noted during the study. Results: When the measurements related to the muscles were evaluated, it was found that only the origo width of obliquus capitis inferior muscle and the length of obliquus capitis superior muscle was statistically significant (p <0.05) between genders. It was observed that greater occipital nerve pierced the semispinalis capitis in one piece in 27 (90%) of the fetal cadavers. In 3 (10%) fetal cadavers, more than one branch of greater occipital nerve pierced the semispinalis capitis. It was determined that the greater occipital nerve passed through the semispinalis capitis muscle in 29 (96.7) of fetal cadavers and passed from the medial edge of muscle in 1(3.3%). Conclusion: Entrapment neuropathies can be seen by reason of greater occipital nerve pierced the neighboring muscles in the occipital region. Especially in the treatment of a headache caused by these entrapment neuropathies, blockage of a greater occipital nerve is very important. We believe that it would be beneficial to have detailed anatomical knowledge about the nerves in this region and the relationship between this nerve and the muscles during the surgical procedures and/or nerve blockages to be performed in the region.
Açıklama
Yüksek Lisans Tezi
Anahtar Kelimeler
Derine ense kasları, morfoloji, n.occipitalis major, n. occipitalis tertius, Back of the muscles, morphlogy, greater occipital nerve, third occipital nerve
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Yağmurkaya, Ü. (2018). Fetal kadavralarda derin ense kaslarının morfolojisi ve komşu yapılarla ilişkileri. (Yayınlanmamış Yüksek Lisans Tezi). Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü Anatomi Anabilim Dalı, Konya.
