Lesione del muscolo grande dorsale

Anatomia e funzione: Il grande dorsale è un muscolo  largo a forma di ventaglio che prende origine dal processo spinoso da  T7 a L5, la fascia toracolombare, la cresta iliaca, le 3-4 coste più inferiori e l’angolo inferiore della scapola (schema anatomico a sinistra). Dalla sua estesa origine le fibre muscolari superiori decorrono orizzontalmente , le fibre mediana obliquamente superomedialmente e le fibre muscolari inferiore verticalmente per convergere  e sormontare l’angolo inferiore della scapola. Il muscolodecorre intordo il bordo inferiore del muscolo grande rotondo of the teres major muscle e ruota su se stesso cosicche’ le fibre superiori diventano posteriori e poi inferiori, le fibre inferiori diventano anteriori e poi superiori.

La visione posteriore mostra la forma a ventaglio del muscolo grande dorsale (LD) che curva anteriormente e inferiormente al muscolo grande rotondo (TM e termina in un lungo tendine di 7 cm che decorre anteriormente al grande rotondo con il quale è intimamente associato, separato solo daa una borsa in sede inserzionale.   La visione anteriore mostra il tendine e muscolo del grande dorsale (LD) che decorrono intorno al muscolo grande rotondo (TM), per inserirsi anteriormente e lateralmente ad esso, medialmente all’inserzione del grande pettorale (PM). Il tendine e muscolo capo lungo del bicipite  (LHB),il capo corto del muscolo e tendine bicipite (SHB), il muscolo coracobrachiali (CB) sono stati parzialmente resecati per visualizzare l’inserzione del tendine grande dorsale.

PATOLOGIA

La Risonanza Magnetica è la metodica più sensibile nel riconoscimento delle lesioni muscolari in quanto in grado di visualizzare soprattutto gli stadi di modesta distrazione ove presente edema nel ventre muscolare. In questi casi una non accurata valutazione ecografica o un non esperto ecografista spesso non identifiano la lesione. Di versamente l’ecografia per la superficialità del tendine e del muscolo ugualmente alla Risonanza Magnetica è la metodica più indicata per l’identificazione delle lesioni tendinee inserzionali o le lacerazioni muscolo-tendinee (vedi diapositiva sottostante).

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    Feel free to visit my site; dupd.cayetano.edu.pe

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