脑卒中后肩痛的病因及处理
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N –Musculocutaneous F–
GH flexion, adduction, Hor. Adduction
Major – T2-T5 spinous processes
Minor – Ligamentum nuchae, C7-T1 spinour processes
I–
Major – Medial borde of scapula between spine and inferior angle
Superior lip of spine of scapula
N – Spinal accessory F–
源自文库 Scapular retraction
Lower Trapezius
O–
T6-T12 spinous processes
I–
Tubercle at apex of root of spine of scapula
N – Musculocutaneous
F–
Shoulder – flexion
Elbow – flexion, forearm supination
Coracobrachialis
O–
Coracoid process
I–
Medial surface of midhumerus, opposite to deltoid tuberosity
Shoulder Joint Complex
盂肱关节： Glenohumeral
肩锁关节： Acromioclavicular
喙锁关节： Coracovicular
肩胛胸壁关节： Scapulothoracic
胸锁关节
Levator Scapulae
O – Transverse processes of C1-C4
Fascia overlying corresponding intercostal muscles
I–
Medial border, superior surface of coracoid process
N–
Medial Pectoral
F–
Scapular depression, downward rotation, protraction
N – spinal accessory
F–
Scapular depression, retraction and upward rotation
Serratus Anterior
O–
Outer surfaces and superior border of ribs 1-8
I–
Ventral scapular surface on medial border from superior angle to inferior angle
引言
➢ 近年来,随着康复治疗的发展，脑卒中偏瘫后出现 的一些并发症逐渐受到关注，如肩痛、肩关节半脱 位以及肩手综合征等。
➢ 由于对肩关节的解剖和运动原理不清楚，致使其临 床治疗效果不佳。目前，对于脑卒中后肩痛的治疗 对策的研究成为热点。
引言
➢ 肩关节是人体最复杂的关节之一，由于其组成复杂， 国外学者引入了肩关节复合体(Shoulder Joint Complex)的概念。
N–
Long Thoracic
F–
Scapular protraction, upward rotation
Scapular depression (lower fibers)
Scapular elevation (upper fibers
Pectoralis Minor
O–
Superior margins and outer surface ribs 3-5 near cartilages
脑卒中后肩痛的病因及处理
目录
➢ 引言 ➢ 第一章 概论 ➢ 第二章 病因及发病机制 ➢ 第三章 预防及对因处理 ➢ 第四章 对症处理 ➢ 结论
引言
引言
➢ 统计资料显示，我国每年大约有150万人因脑卒中 而死亡，其发病率、病死率及致残率均很高。
➢ 康复治疗逐渐发展成为一门重要的学科，它成为减 少脑卒中患者致残率、提高其生活质量的主要手段。
Rotation of head to opp. Side
Lateral flexion of head to opp. side
Middle Trapezius
O–
Inferior part of ligamentum nuchea
T1-T5 spinous processes
I–
Medial margin of acromion process
I – Medial border of scapula between superior angle and root of spine of scapula
N – Nerve root C3-5
F
scapular elevation retraction
Rhomboid Major
O–
Minor – medial border at root of spine of scapula
N – Dorsal Scapular
Upper Trapezius
O–
Occiptal protuberance Medial 1/3 of nuchal line Upper part of
ligamentum nuchae C7 spinous process
I–
Posterior border of lateral 1/3 of clavicle
Acromion process
N – spinal accessory F–
Scapular elevation, retraction
Glenohumeral Muscles
Biceps Brachii
O
Short head – coracoid process
Long head – supraglenoid tubercle of scapula
I–
Radial tuberosity
Biceps brachii aponeurosis
GH flexion, adduction, Hor. Adduction
Major – T2-T5 spinous processes
Minor – Ligamentum nuchae, C7-T1 spinour processes
I–
Major – Medial borde of scapula between spine and inferior angle
Superior lip of spine of scapula
N – Spinal accessory F–
源自文库 Scapular retraction
Lower Trapezius
O–
T6-T12 spinous processes
I–
Tubercle at apex of root of spine of scapula
N – Musculocutaneous
F–
Shoulder – flexion
Elbow – flexion, forearm supination
Coracobrachialis
O–
Coracoid process
I–
Medial surface of midhumerus, opposite to deltoid tuberosity
Shoulder Joint Complex
盂肱关节： Glenohumeral
肩锁关节： Acromioclavicular
喙锁关节： Coracovicular
肩胛胸壁关节： Scapulothoracic
胸锁关节
Levator Scapulae
O – Transverse processes of C1-C4
Fascia overlying corresponding intercostal muscles
I–
Medial border, superior surface of coracoid process
N–
Medial Pectoral
F–
Scapular depression, downward rotation, protraction
N – spinal accessory
F–
Scapular depression, retraction and upward rotation
Serratus Anterior
O–
Outer surfaces and superior border of ribs 1-8
I–
Ventral scapular surface on medial border from superior angle to inferior angle
引言
➢ 近年来,随着康复治疗的发展，脑卒中偏瘫后出现 的一些并发症逐渐受到关注，如肩痛、肩关节半脱 位以及肩手综合征等。
➢ 由于对肩关节的解剖和运动原理不清楚，致使其临 床治疗效果不佳。目前，对于脑卒中后肩痛的治疗 对策的研究成为热点。
引言
➢ 肩关节是人体最复杂的关节之一，由于其组成复杂， 国外学者引入了肩关节复合体(Shoulder Joint Complex)的概念。
N–
Long Thoracic
F–
Scapular protraction, upward rotation
Scapular depression (lower fibers)
Scapular elevation (upper fibers
Pectoralis Minor
O–
Superior margins and outer surface ribs 3-5 near cartilages
脑卒中后肩痛的病因及处理
目录
➢ 引言 ➢ 第一章 概论 ➢ 第二章 病因及发病机制 ➢ 第三章 预防及对因处理 ➢ 第四章 对症处理 ➢ 结论
引言
引言
➢ 统计资料显示，我国每年大约有150万人因脑卒中 而死亡，其发病率、病死率及致残率均很高。
➢ 康复治疗逐渐发展成为一门重要的学科，它成为减 少脑卒中患者致残率、提高其生活质量的主要手段。
Rotation of head to opp. Side
Lateral flexion of head to opp. side
Middle Trapezius
O–
Inferior part of ligamentum nuchea
T1-T5 spinous processes
I–
Medial margin of acromion process
I – Medial border of scapula between superior angle and root of spine of scapula
N – Nerve root C3-5
F
scapular elevation retraction
Rhomboid Major
O–
Minor – medial border at root of spine of scapula
N – Dorsal Scapular
Upper Trapezius
O–
Occiptal protuberance Medial 1/3 of nuchal line Upper part of
ligamentum nuchae C7 spinous process
I–
Posterior border of lateral 1/3 of clavicle
Acromion process
N – spinal accessory F–
Scapular elevation, retraction
Glenohumeral Muscles
Biceps Brachii
O
Short head – coracoid process
Long head – supraglenoid tubercle of scapula
I–
Radial tuberosity
Biceps brachii aponeurosis