肱三头肌解剖(Anatomy of the Triceps Muscle)

原创马明医生  2019-10-17

来自专辑

上肢解剖

The triceps muscle is a powerful extensor of the elbow joint.

肱三头肌是肘关节强有力的伸肌。

The triceps muscle has three heads, including the long head, the lateral head, and the medial head. All three of these heads insert into the olecranon. 

肱三头肌有三个头，包括长头，外侧头和内侧头。这三个头都止于鹰嘴。

Additionally, the superficial part of the triceps is formed by the long and lateral heads, while the deep part is formed by the medial head alone.

肱三头肌的浅层由长头和外侧头组成，而深层由内侧头组成。

The long head arises from the scapula and stretched across the shoulder and elbow joints. It originates from the infraglenoid tubercle of the scapula and inserts into the proximal end of the olecranon process of the ulna.

长头起于肩胛骨的盂下结节，横跨肩关节和肘关节，止于尺骨鹰嘴的近端。

The lateral head of the triceps muscle originates from the posterior aspect of the humerus, superior to the spiral groove, and stretches across the elbow joint. It then inserts into the proximal end of the olecranon process of the ulna.

肱三头肌的外侧头起于肱部的后部，桡神经沟上方，横跨肘关节，然后止于尺骨鹰嘴的近端。

The medial head of the triceps originates from the posterior aspect of the humerus, inferior to the spiral groove, and stretches across the elbow joint. It then inserts into the proximal end of the olecranon process of the ulna.

肱三头肌的内侧头也起于肱部的后部，桡神经沟下方，横跨肘关节，然后止于尺骨鹰嘴的近端。

The arterial supply of the triceps muscle comes from the branches of the deep brachial artery.

肱三头肌的血液供给来自肱深动脉的分支。

The radial nerve supplies the triceps muscle, and it comes from the posterior cord of the brachial plexus. The radial nerve runs through the spiral groove between the lateral head and the medial head of the triceps, 13 cm above the trochlea. It then pierces the lateral intermuscular septum approximately 7.5 cm above the trochlea. It is important to know the relationship between the radial nerve and the triceps.

桡神经支配肱三头肌，它来自臂丛的后束。桡神经穿过三头肌外侧头和内侧头之间的桡神经沟，位于滑车上方13厘米处，然后穿过距滑车约7.5厘米的外侧肌间隔。了解桡神经和肱三头肌之间的关系是很重要的。

There are three important anatomical spaces bordered by the triceps muscle. These are the quadrangular space, the triangular interval, and the triangular space.

肱三头肌周围有三个重要的解剖空间：一个四边形空间，两个三角形区间。

The boundaries of the quadrangular space are the teres minor (superior), the teres major (inferior), the long head of the triceps (medial), and the surgical neck of the humerus (lateral). This area contains the axillary nerve and the posterior circumflex humeral artery. Next, the boundaries of the triangular interval are the teres major, the long head of the triceps, and the humeral shaft. This area contains the deep branch of the brachial artery and the radial nerve. Finally, the triangular space’s boundaries are the teres major, the teres minor, and the long head of the triceps. The triangular space contains the circumflex scapular artery.

四边形空间的边界是小圆肌(上)、大圆肌(下)、肱三头肌的长头(内)和肱骨外科颈(外侧)。这个区域包括腋神经和肱后动脉。一个三角形的边界是大圆肌、肱三头肌的长头和肱骨干。这个区域包括肱动脉深支和桡神经。最后一个三角空间的边界是大圆肌、小圆肌和三头肌的长头，这个三角形空间包含了回旋的肩胛动脉。

All three heads of the triceps are inserted into the olecranon process, which are prone to rupture of the distal triceps. Rupture of the distal triceps tendon usually results from sports such as weightlifting and/or bodybuilding, and therefore is often seen in middle aged men. The rupture usually occurs at the insertions site, and may be partial or complete.

肱三头肌的三个头都止于鹰嘴突，此处易发生远端肱三头肌腱断裂。远端肱三头肌腱断裂通常是由于举重或健身等运动所致，常见于中年男性，断裂通常发生在止点部位，可能是部分断裂，也可能是完全断裂。

Some risk factors associated with triceps tendon rupture include local injections of steroids or use of anabolic steroids, taking antibiotics like ciprofloxacin, or general systemic diseases like rheumatoid arthritis, hyperparathyroidism, diabetes, or renal disease.

与肱三头肌腱断裂相关的一些危险因素包括局部注射类固醇或使用合成代谢类固醇，服用环丙沙星等抗生素，或一些全身性疾病，如类风湿关节炎、甲状旁腺功能亢进、糖尿病或肾疾病。

To diagnose a triceps tendon rupture, the patient will be unable to extend the elbow, or extension of the elbow will be weaker on the injured side compared to the healthy elbow. The patient may hear a painful “pop” with rupture of the tendon.

肱三头肌腱断裂，患者将无法伸展肘部，或受伤一侧肘部的伸展与健侧肘部相比较弱，病人可能会听到肌腱断裂的声音。

To obtain imaging of a triceps rupture, MRI is probably the best study to conduct. However, there will be a flake sign, which is an avulsion of a small piece of bone from the elbow, which is sometimes seen on a lateral x-ray.

确诊肱三头肌腱断裂，MRI是首选检查方法。有时，会有片状征象，这是肘部的撕脱骨折，有时在侧位x光片中可见。

To treat a triceps tendon rupture that is an acute complete tear or a partial tear more than 50%, primary surgical repair of the tendon should be performed. Reconstruction of the tendon by a tendon graft is the best choice for chronic, neglected cases, especially if the patient has a major disability in elbow extension. However, the result of this case is not as good as that of an acute repair.

对于急性完全撕裂或部分撕裂超过50%的肱三头肌腱断裂，应进行手术修复。慢性的、漏诊的、特别是当病人有肘部伸展严重残疾的病例应选择肌腱移植重建肌腱，但慢性病历修复效果往往较差。

Additionally, in elderly patients with a comminuted olecranon fracture, excision of the comminuted olecranon fragments with reattachment of the triceps tendon may be done with reasonable results if the fragment size is less than 50%.

此外，对于鹰嘴粉碎性骨折的老年患者，如果碎片小于50％，则可以切除粉碎的鹰嘴碎片，并重建肱三头肌腱，可获得满意的效果。

肱三头肌解剖视频讲解见公号