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尺神经损伤感染
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卡压综合征尺腋桡神经

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许多周围神经受卡压都会出现典型下位运动神经元症状:

无力或是迟缓性瘫痪(Weaknessorflaccidparalysis)

自发性收缩(Fasciculation)

肌萎缩症(Muscleatrophyovertime)

反射减退/无反射(Hyporeflexia/areflexia)

在诊断上的例外如“肌萎缩性侧索硬化症AmyotrophicLateralSclerosis(ALS)”临床表现可能会出现上下肢的上下位运动神经元的矛盾现象。也请务必排除其他可能的鉴别诊断:例如神经肌肉性疾病—重肌无力症(MG),虽然典型(MG)现象会从头部肌肉开始,但临床上还是出现过例外的案例。若肌肉力量越用越无力,这有可能是一个警讯。尺神经解剖学

尺神经是臂神经丛内侧束的主要延伸。通常源自于C8与T1神经根。

在腋窝处,神经在腋动脉和静脉之间运行。

在手臂处,神经位于肱动脉和静脉之间,与正中神经共享神经及血管束。他在肱三头肌内侧头的内侧面下行。尺神经只支持前臂与手的肌肉,不支持上臂。

运动支持

所有的(手部小型内跗肌smallhandintrinsicmuscles)包含(ABP-正中神经)、尺侧腕屈肌(Flexorcarpiulnaris)、小指及无名指的长屈肌、深指屈肌IIIIV(FlexordigitorumprofundusIIIIV)。

感觉支持

手掌内侧、第五指及第四指的内半侧。(下图蓝色区域)

Andy医生小贴士“尺神经常见的卡压综合症有4个,而其中肘管综合症与尺侧腕屈肌卡压造成原因类似。而其中的肘管综合症也是最常见的周围神经卡压之一。尤其发生在"用手腕工作的人群中",它与正中神经的旋前圆肌综合症有时会伴随着一起出现,要注意多灶性神经病变的可能性”24综合症之5:尺神经沟神经卡压

在尺神经沟的尺神经损伤。

在肘部也称为神经损伤。

通常由尺神经沟压迫原因一般如下:

重复性创伤,如习惯性倚在肘部;

创伤性关节畸形;

肱骨远端骨折;

肘错位;

神经复发性半脱位;

退化性关节疾病;

外翻畸形;

手术固定;

尺神经损伤通常认定属于缓慢性尺神经麻痹(TardyUlnarPalsies)。

尺神经沟损伤应当与肘管综合征损伤区别开来,其临床特征如下:

尺神经包括手背的感觉分布:疼痛、麻木或感觉异常;

肘部敏感;

顶部背侧和尺侧神经支配的手部肌肉的无力和损耗,包括內跗肌(intrinsicmuscles) 尤其是第一指;

尺侧腕屈肌和指屈肌无力在这种情况下可能發生。

Andy医生小贴士“疼痛位置与检测尺侧屈肌肌力是个诊断上快速简单的好方法,但也要注意例外的案例”24综合症之6:肘管综合症

损伤形成在连接肱骨和尺侧腕屈肌尺骨头的腱弓。位于内上髁(medialepicondyle)远程1-2厘米;

肘部弯曲肘管管会缩窄;

双侧压迫是常见的;

在此部位做手术是为了降压(de







































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