下肢周围神经综合征概述
- Author
- Seward B Rutkove, MD
Seward B Rutkove, MD
- Professor of Neurology
- Harvard Medical School
- Section Editor
- Jeremy M Shefner, MD, PhD
Jeremy M Shefner, MD, PhD
- Section Editor — Neuromuscular Disease
- Professor and Chair of Neurology, Barrow Neurological Institute
- Professor of Neurology, University of Arizona, Phoenix
- Clinical Professor of Neurology, Creighton University
- Deputy Editor
- John F Dashe, MD, PhD
John F Dashe, MD, PhD
- Deputy Editor — Neurology
- Translators
- 张文华, 主任医师，教授
张文华, 主任医师，教授
- 山东大学齐鲁医院神经外科
引言
本专题对下肢周围神经综合征进行了概述。累及上肢的周围神经综合征将单独讨论。(参见“上肢周围神经综合征概述”)
解剖学
神经根自腰2-骶4水平的神经孔发出，且汇合形成一个名叫腰骶神经丛的复合体(图 1)。不像臂丛的解剖结构被描述成干、股和束，腰骶神经丛只有两个主要部分：腰丛(由腰2-腰5的神经根纤维组成)和骶丛(骶1-骶4神经根纤维组成)。
从腰丛发出的最大的一支神经是股神经，它在分成一些支配大腿前部肌肉组织和皮肤的较小分支之前，自腹股沟韧带下方下行(图 2)。隐神经作为一支纯感觉神经分支，继续沿腿内侧下行至足弓。髂腰肌由股神经或其穿行在股部的细小分支所支配，尽管这一观点尚有分歧。闭孔神经也发自腰丛，较股神经更靠内侧下行，自闭孔出盆腔，支配大腿内收肌和大腿内侧小范围皮肤。
一支较小的神经，即股外侧皮神经，也直接发自腰丛。它在腹股沟韧带下沿股神经外侧走行，支配大腿外侧皮肤。
腰丛下部和骶丛上部共同形成坐骨神经。该神经通过坐骨孔并下行至腿后侧面，直至在腘窝分为胫后神经和腓总神经。
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