경추 전면부 근육들(platysma, SCM, scalens, sternohyoid, omohyoid, thyrohyoid, stylohyoid, mylohyoid, digastric)

[문형철]

경추 전면 표면부 근육은 관심이 덜한 편이다. 

한번만 기억해두면 "잘 낫지 않는 두통, 턱관절 통증, 목디스크, 구안와사, 어지러움, 이명, 난청"등 치료에 매우 유용하게 적용할 수 있다. 

구안와사로 마비되어 있을때 광경근

정상호흡(늑간근, 횡경막근 등)을 못하고, 부호흡인 scm, 사각근을 과사용하면 경추 전면부 근육들은 비정상적인 긴장

스트레스로 긴장하며 두통이 있을 때,

상부교차증후군, 사경 등으로 부정렬일 때

임상적으로 어떤 의미가 있는지 본격적으로 관찰 시작!!

(platysma, SCM, scalens, sternohyoid, omohyoid, thyrohyoid, stylohyoid, mylohyoid, diagastric)

이중 하악이복근(digastric muscle)은 논문에 자주 등장하고, Trp에서도 설명되고 있다. 

그만큼 중요한 듯....

참고)

경추 전면부 심부근육은 일자목, reverse curve개선, 경추 stabilizer로 매주 중요한 역할을 한다.

longus colli, longus capitis 

panic bird...

광경근(plastysma)

- 신경지배 : 안면신경의 가지

- 다른 근육과 다르게 피부와 직접적으로 연결된 근육

- 얼굴 표정을 만드는 중요한 근육.. 구안와사되었을때 반드시 kabat rehabilitation이 필요한 근육

- The platysma is a paired flat, superficial neck muscle. It is counted among the mimic musculature. The platysma extends from the facial skin slightly above the insertions of the lower jaw to about the height of the second rib. It proceeds upward along the front side of the neck crossing the collar bone.

The platysma is a superficially proceeding muscle and – unlike other muscles – directly connected to the skin. It completely covers both front sides of the neck. Due to the direct insertion to the skin it can change the facial expression‎ along with other facial muscles. The platysma belongs – as all other facial muscles – to the group of cross-striated musculature.

In comparison to humans the equivalent of the platysma (e.g. in horses) has a much more important function. For example the platysma in horses helps to get rid of insects by contraction of the skin muscles – a function a human rather does not have to rely on. The platysma changes the facial expression‎ which plays an important role in human social behavior. In elderly people – when the skin increasingly loses its elasticity – both inner faces of the platysma form two longitudinal wrinkles on the neck.

The platysma is intensely innervated – similar to the tongue and eye muscles. Damage to the platysma may lead to dysfunction of the facial expression‎ in terms of paralysis (masklike face or amimia).

- 광경근 마비되면 "가면같은 얼굴"로 표정을 짓지 못함. 

- 그래서 안면신경마비에서 광경근 근육운동이 매우 중요함. 

흉쇄유돌근, 사각근은 너무 중요한 근육이라 따로 정리함.

흉설골근(Sternohyoid muscle)

-  C1-3 by a branch of ansa cervicalis(경신경올가미)지배

- 설골을 하방으로 내리는 역할

The sternohyoid muscle is a thin, narrow muscle attaching the hyoid bone to the sternum, one of the paired strap muscles of the infrahyoid muscles serving to depress the hyoid bone. It is innervated by the ansa cervicalis.

The muscle arises from the posterior border of the medial end of the clavicle, the posterior sternoclavicular ligament, and the upper and posterior part of the manubrium sterni. Passing upward and medially, it is inserted by short tendinous fibers into the lower border of the body of the hyoid bone.

견갑설골근(Omohyoid muscle)

- C1-3 경신경 올가미의 신경지배

- 견갑골상각-설골근을 연결하는 근육

It arises from the upper border of the scapula, and occasionally from the superior transverse scapular ligament which crosses the scapular notch, its extent of attachment to the scapula varying from a few millimetres to 2.5 cm. This muscle has two separate bellies: superior and inferior.^[1] From this origin, the inferior belly forms a flat, narrow fasciculus, which inclines forward and slightly upward across the lower part of the neck, being bound down to the clavicle by a fibrous expansion; it then passes behind the sternocleidomastoid, becomes tendinous and changes its direction, forming an obtuse angle.

It ends in the superior belly, which passes almost vertically upward, close to the lateral border of the sternohyoid, to be inserted into the lower border of the body of the hyoid bone, lateral to the insertion of the sternohyoid.

The central tendon of this muscle varies much in length and form, and is held in position by a process of the deep cervical fascia, which sheaths it, and is prolonged down to be attached to the clavicle and first rib; it is by this means that the angular form of the muscle is maintained. The tendon overlies the internal jugular vein, and can be used as a landmark for this vein during surgery.

갑상설골근(thyrohyoid muscle)

- C1, hypoglossal nerve 지배

- 갑상연골과 설골을 연결하는 근

The thyrohyoid muscle is a small, quadrilateral muscle appearing like an upward continuation of the sternothyreoideus. It belongs to the infrahyoid muscles group. It arises from the oblique line on the lamina of the thyroid cartilage, and is inserted into the lower border of the greater cornu of the hyoid bone.

It is innervated by C1, which joins the hypoglossal nerve for a short distance, and depresses the hyoid and elevates the larynx.

경돌설골근(stylohyoid muscle)

- 안면신경의 지배

It arises from the posterior and lateral surface of the styloid process of the temporal bone, near the base; and, passing inferior and anterior, it is inserted into the body of the hyoid bone, at its junction with the greater cornu, and just superior the omohyoid muscle. It thus belongs to the group of suprahyoid muscles. When contracted, it elevates the hyoid, this action is primarily brought about during swallowing. It is perforated, near its insertion, by the intermediate tendon of the digastric muscle.

하악설골근(mylohyoid muscle)

- mylohyoid nerve, mandibular nerve지배

The mylohyoid muscle is flat and triangular, and is situated immediately superior to the anterior belly of the digastric muscle. It is classified as an anterior suprahyoid muscle.^{[clarification needed]} Together, the paired mylohyoid muscles form a muscular floor (diaphragm) for the oral cavity (the mouth).^[3] :212

The two mylohyoid muscles arise from the mandible at the mylohyoid line, which extends from the mandibular symphysis in front to the last molar tooth behind. The posterior fibers pass inferomedially and insert at anterior surface of the hyoid bone. The medial fibres of the two mylohyoid muscles unite in a midline raphe (where two muscles intermesh). ^[1] :987-8

The mylohyoid muscle separates the sublingual space from the submandibular space, which communicate in a lateral gap between the mylohyoid and geniohyoid muscles.^[4] The submandibular gland wraps around the edges of the mylohyoid, and is divided into superficial and deep lobes above and below the muscle.^[1] :997

Innervation[edit]

The mylohyoid muscle is innervated by a branch of the mandibular nerve, the inferior alveolar nerve. A specific branch of this nerve, the mylohyoid nerve, emerges to give motor supply to the muscle.^[1] :987

하악설골근의 임상적 중요성

- 하악설골근이 이빨과 직접 연결되어 있어 염증이 발생하면 바로 이빨로 염증이 옮겨감.

The mylohyoid may be imaged by CT or MRI. ^[4] The mylohyoid separates the submandibular space below from the sublingual space above. Around the posterior border of mylohoid, these spaces communicate. Infections, especially odontogenic infections can spread from one space to the other via this communication, or alternatively penetrate the mylohyoid which is a poor barrier to the spread of infection. Due to the fact that the attachment of mylohyoid (the mylohoid line) becomes more superior towards the posterior of the mandible, posterior infected teeth are more likely to drain into the mandibular space, and infected anterior teeth are more likely to drain into the sublingual space, since the apices of the teeth are more likely to be below and above the mylohoid line respectively (see diagram).

악이복근(digastric muscle)

- 삼차신경, 안면신경 지배

- 악이복근의 스트레칭은 입을 크게 벌려 턱을 앞으로 ..

The digastricus (digastric muscle) consists of two muscular bellies united by an intermediate rounded tendon.

The two bellies of the digastric muscle have different embryological origins, and are supplied by different cranial nerves.

Posterior belly[edit]

The posterior belly, longer than the anterior belly, arises from the mastoid notch which is on the inferior surface of the skull, medial to the mastoid process of the temporal bone. The mastoid notch is a deep groove between the mastoid process and the styloid process. The mastoid notch is also referred to as the digastric groove or the digastric notch.  The posterior belly is supplied by the digastric branch of facial nerve.

The digastric muscle stretches between the mastoid process of the cranium to the mandible at the chin, and part-way between, it becomes a tendon which passes through a tendinous pulley attached to the hyoid bone. It originates from the second pharyngeal arch.

Anterior belly[edit]

The anterior belly arises from a depression on the inner side of the lower border of the mandible called the Digastric Fossa, close to the symphysis, and passes downward and backward.

The anterior body is supplied by the trigeminal via the mylohyoid nerve, a branch of the inferior alveolar nerve, itself a branch of the mandibular division of the trigeminal nerve. It originates from the first pharyngeal arch.

Intermediate tendon
[edit]

The two bellies end in an intermediate tendon which perforates the Stylohyoideus muscle, and is held in connection with the side of the body and the greater cornu of thehyoid bone by a fibrous loop, which is sometimes lined by a mucous sheath.

하악이복근 Trp