临床肘关节MRI详细解剖

Medial

epicondyleTrochleaHead

of

radiusUlnaRadiusCoronoid

process

Semilunai

trorcnHumerus·

Bones·

Ligaments·

Tendons·

Nerves·

Muscles·

Other

softtissuesCommonextensorLCL/LUCLAnnular

ligBicepstendonUCLBrachialisflexorUCLCFTCHumerus-肱骨Fibrous

membraneof

jointcapsule

·关节囊纤维膜Olecranon-鹰嘴Jointcapsule关节囊Anularligament

环状韧带UIna-尺骨Radial

collateral-ligament桡侧副韧带Anularligament环状韧带Ulnar

collateralligament尺侧副韧带Humerus.

肱骨Fibrous

membrane-

of

jointcapsule关节囊纤维膜Lateralepicondyle一外上髁肘关节关节囊纤维膜和韧带(前面观)Radialcollateralligament桡侧副韧带Medialepicondyle内上髁Radius

桡骨Radius

桡骨Ulna

尺骨Fibrousmembraneof

jointcapsule关节囊纤维膜Olecranon鹰嘴关节囊纤维膜Fibrousmembraneof

jointcapsule环状韧带AnularligamentUlnarcollateralligament,尺侧副韧带前部

posterior

partUlnarcollateralligament,oblique

part尺侧副韧带斜部环状韧带AnularligamentFibrousmembrane

ofjoint

capsule关节囊纤维膜肘关节关节囊纤维膜和韧带(外侧面观)桡侧副韧带RadialcollateralligamentArticular

cartilage

关节软骨Anularligament—

环状韧带Fibrousmembraneof

jointcapsule

关节囊纤维膜Coronoidfossa

冠突窝Fat

pad

脂肪垫Synovialmembrane.

滑膜Olecranonfossa鹰嘴窝Fat

pad

脂肪垫肘关节矢状切面(内侧面观)Ulnarcollateralligament,anterior

part尺侧副韧带后部关

节

囊Joint

capsule桡

侧

副

韧

带

Radial

collateral

ligament桡

骨

环

状

韧

带Anular

ligament

of

radius肱二头肌腱Bicepsbrachiitendon桡骨Radius尺骨Ulna鹰嘴皮下囊Subcutaneous

olecranon

bursa肱骨Humerus内

上

髁Medialepicondyle尺

侧

副

韧

带Ulnar

collateral

ligament肱

肌

止

点Insertion

of

branchialis

muscle斜

束Obliquecord尺骨Ulna关节囊

Joint

capsule外上

髁

Lateral

epicondyle桡

侧

副

韧

带Radial

collateral

ligament桡

骨

环

状

韧

带

Anular

ligament

of

radius肱

二

头

肌

腱

Biceps

brachii

tendon桡

骨Radius骨间

膜Interosseous

membrane关

节

囊Jointcapsule桡骨环状韧带Anular

ligament

of

radius斜束

肱肌止点

鹰嘴皮下囊肱骨Humerus肱三头肌腱Tricepsbrachii

tendon尺侧副韧带

Ulnarcollateral

ligament肱骨Humerus肱三头肌

腱TricepsbrachiitendonB.外侧观

LateralviewC.内侧观

MedialviewA.前面观

Anterior

view桡侧(外侧)尺侧副韧带

Radial(lateral)ulnarcollaterallig.(UCL)尺侧副韧带前束Anteriorband,UCL桡侧副韧带Radialcollaterallig.环状韧带Annularlig.尺侧副韧带后束Posteriorband,UCL尺侧副韧带横束Transverseband,UCL肱二头肌

Bicepsm.桡侧腕长伸肌Extensor

carpi

radialis

longus

m.指伸肌和小指伸肌Extensor

digitorum

andminimim.桡侧腕短伸肌Extensorcarpi

radialis

brevis尺侧腕伸肌Extensorcarpi

ulnaris

m.旋前圆肌(前)和桡侧腕屈肌Pronator

teres(anterior)&flexor

carpi

radialis

m.掌长肌Palmaris

longus

m.指浅屈肌Flexor

digitorum

superficialis

m.尺侧腕屈肌

Flexor

carpi

ulnaris

m.尺侧副韧带后束Posterior

band

of

ulnar

collateral

lig.尺侧副韧带横束Transverse

band

of

ulnar

collateral

lig.肱二头肌腱膜Biceps

aponeurosisBrachialis

m.

肱肌伸肌总腱Common

extensort.Anconeus

m.肘肌Brachialis

t.

肱肌腱—Bicepst.肱二头肌肌腱伸肌总腱和屈肌总腱示意图肱肌

Brachialis

muscle旋前圆肌(肱头)Pronator

teres

muscle(humeral

head)由旋前圆肌、桡侧腕屈肌、掌长肌、尺侧腕屈肌、指浅屈肌的肌腱(肱尺头)共起形成的屈肌总腱Common

flexortendon

sharedbypronatorteres,flexorcarpi

radialis,palmaris

longus,flexor

carpi

ulnaris,flexor

digitorum

superficialis(humeroulnar

head)muscle指浅屈肌(肱尺头)Flexor

digitorum

superficialismuscle(humeroulnar

head)旋前圆肌(尺头)Pronator

teres

muscle(ulnar

head)指深屈肌Flexordigitorumprofundus

muscle旋

前

方

肌Pronator

quadratus

muscle尺

骨Ulna尺

侧

腕

屈

肌Flexor

carpi

ulnaris

muscle尺侧腕伸肌Extensor

carpiulnaris

muscle指浅屈肌Flexor

digitorum

superficialismuscle肱

桡

肌Brachioradialis

muscle桡侧腕长伸肌Extensor

carpiradialis

longusmuscle由桡侧腕短伸肌、指伸肌、尺侧腕伸肌共起形成的伸肌总腱Commonextensortendon

sharedbyextensor

carpi

radialis

brevis.extensordigitorum,extensor

carpi

ulnaris

muscle肱肌

Brachialis

muscle肱

二

头

肌Biceps

brachii

muscle旋

后

肌

Supinator

muscle指浅屈肌(桡头)Flexor

digitorum

superficialis

muscle(radial

head)旋

前圆

肌Pronator

teres

muscle拇

长

屈

肌Flexor

pollicis

longus

muscle桡

骨Radius旋前方肌Pronator

quadratus

muscle肱桡肌Brachioradialis

muscle拇长展肌Abductorpollicis

longusmuscle桡侧腕屈肌Flexorcarpi

radialis

muscle拇长屈肌Flexorpollicislongus

muscle指深屈肌Flexor

digitorumprofundus

muscle肌肉附着点Muscle

attachments起

点

Origins止

点Insertions桡

侧

腕

长

伸

肌Extensorcarpi

radialis

longus

muscle由桡侧腕短伸

肌

、

指

伸

肌

、

小

指

伸肌、

尺

侧

腕

伸

肌

共

起

形

成的

伸

肌

总

腱Commonextensortendon

sharedby

extensorcarpi

radialis

brevis,extensor

digitorum,extensordigiti

minimi,extensor

carpi

ulnaris

muscle肘

肌Anconeus

muscle肱二头肌Biceps

brachii

muscle旋后肌Supinator

muscle拇长展肌Abductor

pollicis

longus

muscle旋前圆肌

Pronator

teres

muscle拇短伸肌Extensor

pollicis

brevis

muscle桡

骨Radius肱桡肌Brachioradialis

muscle拇长展肌Abductor

pollicis

longus

muscle拇短

伸

肌

Extensor

pollicis

brevis

muscle肱

三

头

肌(

内

侧

头

)Triceps

brachii

muscle(medial

head)肱三

头

肌

腱Triceps

brachii

tendon屈

肌

总

腱Commonflexortendon尺

侧

腕

屈

肌(

尺

侧

起

点

头

)Flexor

carpi

ulnaris

muscle(ulnar

origin)指深屈

肌Flexor

digitorum

profundus

muscle尺

侧

腕

伸

肌(

尺

侧

起

点

)Extensor

carpi

ulnaris

muscle

(ulnar

origin)拇长伸

肌Extensorpollicis

longusmuscle示指伸肌Extensor

indicis

muscle尺

骨

Ulna桡

侧

腕长

伸

肌Extensorcarpi

radialis

longus

muscle桡

侧

腕

短

伸

肌Extensorcarpi

radialis

brevis

muscle尺

侧

腕

伸

肌Extensorcarpi

ulnaris

muscle拇长伸

肌Extensor

pollicis

longus

muscle指

伸

肌(

中

央

束

)Extensor

digitorum

muscle(central

bands)小指伸

肌Extensordigitiminimimuscle指

伸

肌(

侧

束

)Extensordigitorummuscle(lateral

bands)肌

肉

附

着

点Muscle

attachments起点

Origins止

点

Insertions示指伸肌Extensorindicismuscle肱桡肌

Brachioradialis

muscle肘窝、桡神经和正中神经的关系肱动脉

Brachiala.正中神经Mediann.屈肌总腱Common

flexort.总屈肌群Commonflexor

m.masS旋前圆肌(切断)Pronatorteres(cut)肱二头肌腱膜Biceps

aponeurosis骨间前神经Anteriorinterosseousn.正中神经Mediann.Brachialism.

肱肌肌皮神经Musculocutaneousn.肱二头肌及肌腱(近端切断)

Bicepsm.(cutproximally)&t.Radial

n.桡神经肱桡肌(切断)

Brachioradialism.(cut)桡神经深支

Deepbranch,radialn.桡神经浅支Superficialbranch,radialn.Radiala.

桡动脉Ulnara.

尺动脉伸肌(切断)Extensorm.(cut)旋前圆肌(切断)

Pronatorteresm.(cut)屈肌总腱Commonflexort.鹰嘴OlecranonUlnarn.尺神经Cubitalretinaculum肘管支持带尺侧后返动脉Posteriorulnarrecurrent

a.肱三头肌和肌腱Tricepsm.&t.屈肌总腱(切断)

Common

flexor

t.(cut)尺侧腕屈肌(切断)

Flexorcarpiulnaris

m.(cut)尺神经Ulnar

n.滑车上肘肌Anconeusepitrochlearis肘管支持带(Osborne韧带)

Cubitalretinaculum(lig.of

Osborne)尺神经Ulnarn.上图：肘管横轴位示意图。尺神经在肘管内可能被肿块、创伤后骨畸形或尺返动脉的动脉瘤压迫(肘管综合征)。尺神经也可以被邻近的肱三头肌内侧头压迫致使半脱位出肘管。下图：肘管内侧图。滑车上肘肌是不稳定的副肌头静脉肱肌及肌腱肱桡肌肱骨内上髁桡侧腕长伸肌肱骨外上髁肱三头肌及肌腱肱动脉贵要静脉肱肌及肌腱桡神经肱桡肌桡侧腕长伸肌肱骨外上髁鹰嘴尖肱三头肌及肌腱肱二头肌及肌腱头静脉肱肌及肌腱桡神经肱桡肌旋前圆肌肱骨外上髁鹰嘴尖

肱三头肌及肌腱肱骨内上髁尺神经肱三头肌及肌腱图9-1-2

经肱骨内外上髁上部横断A.T₁WI;B.PDWI

FS图9-1-1

经肱骨髁上横断面A.T₁WI;B.PDWI

FS头静脉肱肌及肌腱肱桡肌贵要静脉浅静脉桡侧腕长伸肌肱骨外上髁肱动脉贵要静脉肱动脉

肱二头肌及肌腱肱二头肌及肌腱贵要静脉肱动脉肱二头肌腱及腱膜头静脉肱肌及肌腱桡神经肱桡肌伸肌总腱

肱骨外上髁尺神经肱骨滑车鹰嘴肱二头肌腱及腱膜头静脉肱肌及肌腱肱桡肌桡侧腕长伸肌

伸肌总腱肱骨外上髁肱骨滑车

鹰嘴肱二头肌腱及腱膜肱肌及肌腱桡神经肱桡肌桡侧腕长伸肌伸肌总腱肱骨外上髁肱骨滑车鹰嘴肱肌及肌腱桡神经肱桡肌屈肌总腱伸肌总腱肱骨外上髁肱骨滑车图9-1-3

经肱骨内外上髁中部横断面A.T₁WI;B.PDWI

FS图9-1-4

经肱骨内上髁下缘横断面A.T₁WI;B.PDWI

FS屈肌总腱肱骨内上髁正中神经旋前圆肌肱动脉

贵要静脉桡侧腕

长伸肌正中神经长伸肌肱动脉肱二头肌腱及腱膜肱肌及肌腱桡神经肱桡肌桡侧腕长伸肌指浅屈肌桡侧副韧带伸肌总腱外侧尺侧副韧带指深屈肌肘肌肱动脉

肱二头肌腱及腱膜正中神经肱肌及肌腱桡神经旋前圆肌肱骨小头指浅屈肌桡侧副韧带尺侧副韧带鹰嘴指深屈肌肱二头肌腱及腱膜肱肌及肌腱桡神经肱桡肌桡侧腕长伸肌

桡侧副韧带伸肌总腱外侧尺侧副韧带尺侧副韧带鹰嘴指深屈肌肱动脉与肱二头肌肌腱及腱膜肱肌及肌腱桡神经肱桡肌旋前圆肌桡侧腕屈肌长伸肌

桡侧副韧带伸肌总腱外侧尺侧副韧带鹰嘴肘肌图9-1-5

经肱骨滑车中部横断面A.T,WI;B.PDWI

FS图9-1-6

经肱尺关节横断面A.T₁WI;B.PDWI

FS肱动脉与正中神经肱骨滑车正中神经肱骨滑车指深屈肌

尺侧腕屈肌伸肌总腱

外侧尺侧韧带肱动脉

正中神经尺侧副韧带

后束和横束、桡侧腕长伸肌后束和横束尺侧腕屈肌肱桡肌肘肌鹰嘴肱动脉与肱二头肌腱及腱膜正中神经

肱肌及肌腱肱桡肌旋前圆肌桡神经桡侧腕长

短伸肌指伸肌桡侧副韧带桡骨小头环状韧带前后附着处鹰嘴

肘肌肱动脉与肱二头肌腱及腱膜正中神经

肱肌及肌腱

肱桡肌桡神经

桡侧腕长

短伸肌指伸肌伸肌总腱桡骨头

环状韧带肘肌肱二头肌腱及腱膜肱肌及肌腱

肱桡肌桡神经

桡侧腕长

短伸肌指浅屈肌尺侧腕屈肌指深屈肌鹰嘴肱二头肌腱及腱膜肱肌及肌腱

肱桡肌桡神经

桡侧腕长短伸肌指伸肌肘肌肱动脉与正中神经旋前圆肌桡侧腕屈肌指浅屈肌尺神经尺侧腕屈肌指深屈肌图9-1-8

经桡尺近侧关节横断面A.T₁WI;B.PDWI

FS图9-1-7

经桡尺近侧关节横断面A.T₁WI;B.PDWI

FS环状韧带前后附着处肱动脉与

正中神经尺侧腕屈肌桡侧腕屈肌尺侧腕屈肌旋前圆肌指深屈肌指深屈肌尺骨肱二头肌腱及腱膜桡动脉尺动脉

肱桡肌正中神经

桡侧腕长短伸肌旋前圆肌桡侧腕屈肌指

浅

屈

肌指深屈肌正中神经

肱桡肌短伸肌指伸肌旋后肌指深屈肌

尺骨

肘肌正中神经肱动脉

肱肌及肌腱

肱桡肌桡侧腕长

短伸肌指伸肌指浅屈肌旋后肌桡骨颈肘肌尺骨正中神经

肱动脉旋前圆肌桡侧腕屈肌指伸肌旋后肌

桡骨颈肘肌肱二头肌腱及腱膜

肱二头肌腱及腱膜图9-1-10

经桡骨颈下部横断面A.T₁WI;B.PDWI

FS图9-1-9

经桡骨颈横断面A.T₁WI;B.PDWI

FS桡侧腕长

短伸肌肱肌及肌腱肱肌及肌腱尺侧腕屈肌桡侧腕长指浅屈肌指深屈肌肱桡肌肱动脉与、正中神经肱二头肌腱肱动脉与正中神经旋前圆肌-图9-1-12

经肘窝深部冠状面A.T,WI;B.PDWI

FS图9-1-11

经肘窝冠状面A.T₁WI;B.PDWI

FS·肱桡肌头静脉肱动脉神经旋前圆肌神经肱肌及

肌腱桡侧腕

长伸肌-旋后肌肱肌肱骨滑车肱骨小头桡骨头桡侧腕长腕短伸肌-旋后肌图9-1-13

经肱骨小头前缘冠状面A.T₁WI;B.PDWI

FS图9-1-14

经尺骨冠突尖部冠状面A.T,WI;B.PDWI

FS肱桡肌桡侧副韧带桡侧腕长腕短伸肌---旋后肌图9-1-16

经肱骨内外上髁前部冠状A.T₁WI;B.PDWI

FS图9-1-15

经尺骨冠突冠状面A.T₁WI;B.PDWI

FS----------肱肌--肱桡肌副韧带腕短伸肌-肱肌桡侧副韧带

与环状韧带桡侧腕长

腕短伸肌-旋后肌图9-1-17

经肱骨内外上髁中部冠状面A.T₁WI;B.PDWI

FS图9-1-18

经肱骨内外上髁后部冠状A.T₁WI;B.PDWI