骨盤隔膜, 内閉鎖筋, 大腿方形筋並びに双子筋に分布する神経の肉眼的観察

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タイトル別名
  • A Macroscopical Observation of the Nerves to the Pelvic Floor Muscles, the Obturator Internus, the Quadratus Femoris and the Gemelli

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Using nineteen human cadavers （11 males, 8 females）, the nerves to the levator ani, the coccygeus, the obturator internus, the quadratus femoris and the gemelli were observed macroscopically. The main findings obtained are summarized as the following: 1. The origin most frequently observed of both the nerves to the levator ani and the coccygeus was from the third（S3） and the fourth（S4） sacral nerves. The number most frequently observed of both the nerves to the levator ani and the coccygeus was two. 2. The frequency of the common trunk which was formed by the nerve to the levator ani and the pelvic splanchnic nerve was 63.6%. 3. The nerves to the obturator internus arose from the confluence of the truncus lumbosacralis （Tr）, the first （S1） and the second （S2） sacral nerves （40.0%） or S1-S2 （22.9%）. 4. The nerves to the quadratus femoris arose from Tr（37.1%） or the confluence of Tr-S1（60.0%）. 5. The frequency of the common trunk which was formed by the originating root of the nerve to the obturator internus and that of the nerve to the quadratus femoris was 60.0%. 6. The following three types were classified according to the arising position of the nerves to the obturator internus and the quadratus femoris. Type 1. Sciatic nerve type; the nerve arises from the main trunk of the sciatic nerve or it's originating root. Type 2. Transitional type; the nerve arises from the point where the bigeminal nerve joins the sciatic nerve. Type 3. Pudendal nerve type; the nerve arises from the pudendal nerve or it's originating root. Among these three types, the most frequent type of the nerve to the obturator internus was the sciatic nerve type. The nerve to the quadratus femoris was only the sciatic nerve type. 7. The frequency at which the gemellus superior was supplied by the branch of the nerve to the obturator internus was 82.9%. The frequency at which the gemellus inferior was supplied by the branch of the nerve to the quadratus femoris was 94.3%. As a result of the above mentioned observations it can be assumed that the gemellus superior and the gemellus inferior are innervated separately by different nerves. The term "gemellus", which has been used up to the present time, should be considered as inappropriate. 8. Sato and Sato's hypothesis may account for the relationships between （1）the muscles of the pelvic outlet and the obturator internus, （2）the nerve to the the levator ani and the pelvic splanchnic nerve, （3）the nerve to the obturator internus and the pudendal nerve, and （4）the course of the nerve to the obturator internus.

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