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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2024.tde-25042024-122226
Document
Author
Full name
Luis Carlos Fernandez Garrido
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2024
Supervisor
Committee
Jacomo, Flávia Emi Akamatsu (President)
Hojaij, Flavio Carneiro
Amore, Ricardo
Camargo, Cristina Pires
Title in Portuguese
Bases anatômicas dos pontos-gatilho do músculo temporal
Keywords in Portuguese
Anatomia
Dor musculoesquelética
Inervação
Músculo temporal
Pontos-gatilho
Abstract in Portuguese
Introdução: A síndrome da dor miofascial (SDM) é uma forma crônica ou aguda de dor musculoesquelética que afeta quase três quartos da população mundial. É caracterizada por dor muscular e rigidez, com nódulos palpáveis e áreas de hiperirritabilidade chamadas pontos-gatilho miofasciais (PGMs). Esses PGMs são o diferencial entre outras formas de dor muscular, como distúrbios inflamatórios ou a fibromialgia. O músculo temporal é frequentemente envolvido na SDM. Quatro PGMs no músculo temporal foram descritos na literatura, mas nenhuma descrição anatômica dos PGMs foi relatada. O conhecimento adequado da inervação do músculo temporal pode ajudar a entender a fisiopatologia das síndromes miofasciais e fornecer uma base racional para abordagens intervencionistas ou conservadoras e evitar lesões iatrogênicas na lesão dos nervos temporais profundos. Objetivo: Descrever os pontos de entrada dos nervos temporais profundos no ventre do músculo temporal e relacionar com os PGMs descritos na literatura. Método: Foram estudados os músculos temporais de 14 cadáveres adultos. Os ventres musculares foram divididos em seis áreas: três superiores (1, 2 e 3) e três inferiores (4, 5 e 6), de acordo com um plano cartesiano, para analisar e descrever os pontos de entrada dos ramos dos nervos temporais profundos no músculo. Os pontos de entrada dos nervos foram submetidos à análise por meio dos testes de Poisson Loglinear com post-hoc de Bonferroni para comparação entre grupos (sextantes (p<0,05). Resultados: Foram encontrados pontos de entrada dos nervos temporais profundos no músculo temporal em todas as áreas. A maioria dos pontos de entrada foi observada nas áreas 2 e 5, que coincidem com as fibras musculares responsáveis pela elevação da mandíbula e menos pontos de entrada foram encontrados nas áreas 1 e 6, onde a contração produz retração da mandíbula. Conclusão: Pode-se concluir que existe uma relação anatômica entre o padrão de ramificação dos nervos temporais profundos e os pontos-gatilho do músculo temporal
Title in English
Anatomical bases of the trigger points of the temporal muscle
Keywords in English
Anatomy
Innervation
Musculoskeletal pain
Temporal muscle
Trigger points
Abstract in English
Background and purpose: Myofascial pain syndrome (MPS) is a chronic or acute form of musculoskeletal pain that affects nearly three-quarters of the worlds population. It is characterized by muscle pain and stiffness, with palpable nodules and hyperirritability areas called myofascial trigger points (MTPs). These MTPs constitute the differential diagnosis from other forms of muscular pain, such as inflammatory disorders or fibromyalgia. The temporal muscle is frequently involved in MPS. Four MTPs in the temporal muscle have been described in the literature, but no anatomical description of the MTPs has been reported. Adequate knowledge of the innervation of the temporal muscle may help elucidate the pathophysiology of myofascial syndromes and provide a rational basis for interventional or conservative approaches and avoid iatrogenic lesions to the deep temporal nerves lesion. The present study described the entry points of deep temporal nerves in the temporal muscle belly and related these points to the MTPs described in the literature. Method: Temporal muscles of 14 adult cadavers were studied. The muscle bellies were divided into six areas: three superior (1.2 and 3) and three inferior areas (4, 5 and 6) lower, according to a cartesian plan, to analyze and describe the entry points of the branches of the deep temporal nerves into the muscle. The branching distribution was analyzed using Poisson log-linear tests with Bonferroni post hoc tests for comparison between groups (sextants). (p<0.05). Results: Deep temporal nerve entry points were found in the temporal muscle in all areas. Most of the branches were observed in areas 2 and 5, which coincide with the muscle fibers responsible for mandible elevation and related to the previously described MTPs. Fewer branches were found in areas 1 and 6, where contraction produces mandible retraction. Conclusion: Can be conclude that there is an anatomical relation between the branching pattern of the deep temporal nerves and temporal muscle trigger points
 
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Publishing Date
2024-05-03
 
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