Skip to main content
Erschienen in: Surgical and Radiologic Anatomy 6/2010

01.07.2010 | Original Article

Anatomic localization of motor entry points and intramuscular nerve endings in the hamstring muscles

verfasst von: X. C. An, J. H. Lee, S. Im, M. S. Lee, K. Hwang, H. W. Kim, Seung-Ho Han

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 6/2010

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To elucidate the location of motor entry points (MEPs) and intramuscular nerve endings of the hamstring muscles.

Methods

We dissected 50 cadaveric lower extremities to identify the MEPs, where the nerve branch first pierced the muscle belly, and the proximal and distal limit points (PLPs and DLPs, respectively) of the terminal intramuscular nerve endings. These points were measured in relation to a reference line, expressed in x-coordinate, which connected the superior medial aspect of ischial tuberosity to the proximal aspect of the medial femoral epicondyle. We also expressed the MEP in y-coordinate, which is perpendicular to the x-coordinate connecting the superior medial aspect of ischial tuberosity to the lateral aspect of the greater trochanter. Finally, these distances were translated into percentage distances in relation to the total length of the reference lines and their mean values were calculated.

Results

For the long head of biceps femoris muscles, the MEPs were located at 41.5 and 36.3% distance of the x and y coordinates, while the PLP and DLP were located at 39.7 and 72.9% distance of the x-coordinate. For the short head, the corresponding data were 56.2, 59.7, 58.9 and 80.2%. The semitendinosus showed two innervations zones; the data for the upper and lower zones were 20.3, 18.9, 18.6, 36.8% and 59.9, 21.4, 56.6, 79.1%, respectively. For the semimembranosus, the data were 62.2, 18.8, 55.9 and 89.1%.

Conclusions

The parameters provided from this study should help increase the efficacy and precision of motor point injections to the hamstring muscles.
Literatur
1.
Zurück zum Zitat Aquilonius SM, Askmark H, Gillberg PG, Nandedkar S, Olsson Y, Stålberg E (1984) Topographical localization of motor endplates in cryosections of whole human muscles. Muscle Nerve 7:287–293CrossRefPubMed Aquilonius SM, Askmark H, Gillberg PG, Nandedkar S, Olsson Y, Stålberg E (1984) Topographical localization of motor endplates in cryosections of whole human muscles. Muscle Nerve 7:287–293CrossRefPubMed
2.
Zurück zum Zitat Bandholm T, Sonne-Holm S, Thomsen C, Bencke J, Pedersen SA, Jensen BR (2007) Calf muscle volume estimates: implications for botulinum toxin treatment? Pediatr Neurol 37:263–269CrossRefPubMed Bandholm T, Sonne-Holm S, Thomsen C, Bencke J, Pedersen SA, Jensen BR (2007) Calf muscle volume estimates: implications for botulinum toxin treatment? Pediatr Neurol 37:263–269CrossRefPubMed
3.
Zurück zum Zitat Basmajian J (1971) Grant’s method of anatomy. Williams & Wilkins, Baltimore Basmajian J (1971) Grant’s method of anatomy. Williams & Wilkins, Baltimore
4.
Zurück zum Zitat Chua KS, Kong KH (2000) Alcohol neurolysis of the sciatic nerve in the treatment of hemiplegic knee flexor spasticity: clinical outcomes. Arch Phys Med Rehabil 81:1432–1435CrossRefPubMed Chua KS, Kong KH (2000) Alcohol neurolysis of the sciatic nerve in the treatment of hemiplegic knee flexor spasticity: clinical outcomes. Arch Phys Med Rehabil 81:1432–1435CrossRefPubMed
5.
Zurück zum Zitat Coers C (1959) Structual organization of the motor nerve endings in mammalian muscle spindles and other striated muscle fibers. Am J Phys Med 38:166–175PubMed Coers C (1959) Structual organization of the motor nerve endings in mammalian muscle spindles and other striated muscle fibers. Am J Phys Med 38:166–175PubMed
6.
Zurück zum Zitat Corry IS, Cosgrove AP, Duffy CM, Taylor TC, Graham HK (1999) Botulinum toxin A in hamstring spasticity. Gait Posture 10:206–210CrossRefPubMed Corry IS, Cosgrove AP, Duffy CM, Taylor TC, Graham HK (1999) Botulinum toxin A in hamstring spasticity. Gait Posture 10:206–210CrossRefPubMed
7.
Zurück zum Zitat Decq P, Filipetti P, Feve A, Saraoui A (1996) Selective peripheral neurotomy of the hamstring branches of the sciatic nerve in the treatment of spastic flexion of the knee. Apropos of a series of 11 patients. Neurochirurgie 42:275–280PubMed Decq P, Filipetti P, Feve A, Saraoui A (1996) Selective peripheral neurotomy of the hamstring branches of the sciatic nerve in the treatment of spastic flexion of the knee. Apropos of a series of 11 patients. Neurochirurgie 42:275–280PubMed
8.
Zurück zum Zitat Dunne JW, Heye N, Dunne SL (1995) Treatment of chronic limb spasticity with botulinum toxin A. J Neurol Neurosurg Psychiatry 58:232–235CrossRefPubMed Dunne JW, Heye N, Dunne SL (1995) Treatment of chronic limb spasticity with botulinum toxin A. J Neurol Neurosurg Psychiatry 58:232–235CrossRefPubMed
9.
Zurück zum Zitat Eames NW, Baker R, Hill N, Graham K, Taylor T, Cosgrove A (1999) The effect of botulinum toxin A on gastrocnemius length: magnitude and duration of response. Dev Med Child Neurol 41:226–232CrossRefPubMed Eames NW, Baker R, Hill N, Graham K, Taylor T, Cosgrove A (1999) The effect of botulinum toxin A on gastrocnemius length: magnitude and duration of response. Dev Med Child Neurol 41:226–232CrossRefPubMed
10.
Zurück zum Zitat Graham HK (2001) Botulinum toxin type A management of spasticity in the context of orthopaedic surgery for children with spastic cerebral palsy. Eur J Neurol 8(Suppl 5):30–39CrossRefPubMed Graham HK (2001) Botulinum toxin type A management of spasticity in the context of orthopaedic surgery for children with spastic cerebral palsy. Eur J Neurol 8(Suppl 5):30–39CrossRefPubMed
11.
Zurück zum Zitat Grey H, Clemente C (1985) Anatomy of the human body. Lea & Febiger, Philadelphia Grey H, Clemente C (1985) Anatomy of the human body. Lea & Febiger, Philadelphia
12.
Zurück zum Zitat Hwang K, Jin S, Hwang SH, Lee KM, Han SH (2007) Location of nerve entry points of flexor digitorum profundus. Surg Radiol Anat 29:617–621CrossRefPubMed Hwang K, Jin S, Hwang SH, Lee KM, Han SH (2007) Location of nerve entry points of flexor digitorum profundus. Surg Radiol Anat 29:617–621CrossRefPubMed
13.
Zurück zum Zitat Koman LA, Mooney JF 3rd, Smith BP, Walker F, Leon JM (2000) Botulinum toxin type A neuromuscular blockade in the treatment of lower extremity spasticity in cerebral palsy: a randomized, double-blind, placebo-controlled trial. BOTOX Study Group. J Pediatr Orthop 20:108–115CrossRefPubMed Koman LA, Mooney JF 3rd, Smith BP, Walker F, Leon JM (2000) Botulinum toxin type A neuromuscular blockade in the treatment of lower extremity spasticity in cerebral palsy: a randomized, double-blind, placebo-controlled trial. BOTOX Study Group. J Pediatr Orthop 20:108–115CrossRefPubMed
14.
Zurück zum Zitat Lepage D, Parratte B, Tatu L, Vuiller F, Monnier G (2005) Extra- and intramuscular nerve supply of the muscles of the anterior antebrachial compartment: applications for selective neurotomy and for botulinum toxin injection. Surg Radiol Anat 27:420–430CrossRefPubMed Lepage D, Parratte B, Tatu L, Vuiller F, Monnier G (2005) Extra- and intramuscular nerve supply of the muscles of the anterior antebrachial compartment: applications for selective neurotomy and for botulinum toxin injection. Surg Radiol Anat 27:420–430CrossRefPubMed
15.
Zurück zum Zitat O’Brien CF (1997) Injection techniques for botulinum toxin using electromyography and electrical stimulation. Muscle Nerve Suppl 6:S176–S180PubMed O’Brien CF (1997) Injection techniques for botulinum toxin using electromyography and electrical stimulation. Muscle Nerve Suppl 6:S176–S180PubMed
16.
Zurück zum Zitat Parratte B, Tatu L, Vuillier F, Diop M, Monnier G (2002) Intramuscular distribution of nerves in the human triceps surae muscle: anatomical bases for treatment of spastic drop foot with botulinum toxin. Surg Radiol Anat 24:91–96CrossRefPubMed Parratte B, Tatu L, Vuillier F, Diop M, Monnier G (2002) Intramuscular distribution of nerves in the human triceps surae muscle: anatomical bases for treatment of spastic drop foot with botulinum toxin. Surg Radiol Anat 24:91–96CrossRefPubMed
17.
Zurück zum Zitat Peker T, Gulekon N, Turgut BH, Anil A, Karakose M, Mungan T, Danisman N (2006) Observation of the relationship between the shape of skeletal muscles and their nerve distribution patterns: a transparent and microanatomic study. Plast Reconstr Surg 117:165–176CrossRefPubMed Peker T, Gulekon N, Turgut BH, Anil A, Karakose M, Mungan T, Danisman N (2006) Observation of the relationship between the shape of skeletal muscles and their nerve distribution patterns: a transparent and microanatomic study. Plast Reconstr Surg 117:165–176CrossRefPubMed
18.
Zurück zum Zitat Pidcock FS (2004) The emerging role of therapeutic botulinum toxin in the treatment of cerebral palsy. J Pediatr 145:S33–S35CrossRefPubMed Pidcock FS (2004) The emerging role of therapeutic botulinum toxin in the treatment of cerebral palsy. J Pediatr 145:S33–S35CrossRefPubMed
19.
Zurück zum Zitat Robert C, Crystal R, Eastwood DM (2006) Optimal injection points for neuromuscular blockade of forearm flexor muscles: a cadaveric study. J Pediatr Orthop B 15:351–355 Robert C, Crystal R, Eastwood DM (2006) Optimal injection points for neuromuscular blockade of forearm flexor muscles: a cadaveric study. J Pediatr Orthop B 15:351–355
20.
Zurück zum Zitat Sunderland S, Hughes ESR (1946) Metrical and non-metrical features of the muscular branches of the sciatic nerve and its medial and lateral popliteal divisions. J Comp Neurol 85:205–222CrossRef Sunderland S, Hughes ESR (1946) Metrical and non-metrical features of the muscular branches of the sciatic nerve and its medial and lateral popliteal divisions. J Comp Neurol 85:205–222CrossRef
21.
Zurück zum Zitat Schwarzacher HG (1957) Localization of the motor end-plates in skeletal muscles. Acta Anat (Basel) 30:758–774CrossRef Schwarzacher HG (1957) Localization of the motor end-plates in skeletal muscles. Acta Anat (Basel) 30:758–774CrossRef
22.
Zurück zum Zitat Seidel PM, Seidel GK, Gans BM, Dijkers M (1996) Precise localization of the motor nerve branches to the hamstring muscles: an aid to the conduct of neurolytic procedures. Arch Phys Med Rehabil 77:1157–1160CrossRefPubMed Seidel PM, Seidel GK, Gans BM, Dijkers M (1996) Precise localization of the motor nerve branches to the hamstring muscles: an aid to the conduct of neurolytic procedures. Arch Phys Med Rehabil 77:1157–1160CrossRefPubMed
23.
Zurück zum Zitat Sutherland DH, Davids JR (1993) Common gait abnormalities of the knee in cerebral palsy. Clin Orthop Relat Res 288:139–147PubMed Sutherland DH, Davids JR (1993) Common gait abnormalities of the knee in cerebral palsy. Clin Orthop Relat Res 288:139–147PubMed
24.
Zurück zum Zitat Thompson NS, Baker RJ, Cosgrove AP, Corry IS, Graham HK (1998) Musculoskeletal modelling in determining the effect of botulinum toxin on the hamstrings of patients with crouch gait. Dev Med Child Neurol 40:622–625PubMedCrossRef Thompson NS, Baker RJ, Cosgrove AP, Corry IS, Graham HK (1998) Musculoskeletal modelling in determining the effect of botulinum toxin on the hamstrings of patients with crouch gait. Dev Med Child Neurol 40:622–625PubMedCrossRef
25.
Zurück zum Zitat Winkel D, Matthijs O, Phelps V (1997) Diagnosis and treatment of the lower extremities. Aspen, Gaithersburg Winkel D, Matthijs O, Phelps V (1997) Diagnosis and treatment of the lower extremities. Aspen, Gaithersburg
26.
Zurück zum Zitat Woodley SJ, Mercer SR (2005) Hamstring muscles: architecture and innervation. Cells Tissues Organs 179:125–141CrossRefPubMed Woodley SJ, Mercer SR (2005) Hamstring muscles: architecture and innervation. Cells Tissues Organs 179:125–141CrossRefPubMed
Metadaten
Titel
Anatomic localization of motor entry points and intramuscular nerve endings in the hamstring muscles
verfasst von
X. C. An
J. H. Lee
S. Im
M. S. Lee
K. Hwang
H. W. Kim
Seung-Ho Han
Publikationsdatum
01.07.2010
Verlag
Springer-Verlag
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 6/2010
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-009-0609-5

Weitere Artikel der Ausgabe 6/2010

Surgical and Radiologic Anatomy 6/2010 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.