Variation in the Origin of Cystic Artery

In recent years, an extensive development in laproscopic surgery has made surgeons to obtain a clear appreciation and knowledge of variations in the blood supply of gall bladder. The study was done on specimens including 35 embalmed cadavers and 15 fresh postmortem specimens by dissection method at JSS Medical College. In the present study we observed that the cystic artery from right hepatic was seen only in 54% cases. Whereas from hepatic artery proper in 22%, from common hepatic in 12%, from gastroduodenal in 8%, and from superior mesenteric in 2% of cases. Cystic artery from superior mesenteric passes through head of pancreas. This variation is very important for surgeons during resection of pancreas. Because of very limited field of vision during laproscopic surgery, haemorrhage could be a problem if these variations are overlooked. Sound knowledge of cystic artery variations is helpful for surgeons while performing upper abdominal surgeries.     

选择性腹腔动脉、肠系膜上动脉、肾动脉及肠系膜下动脉造影的局部解剖学研究

本文利用70具成人尸体(男性40具,女性30具)进行了经股动脉插管至腹腔动脉、肠系膜上动脉、肾动脉及肠系膜下动脉之间的距离,各动脉的直径,以及用圆形分布理论统计分析各动脉干与主动脉腹部间的平均夹角,并对动脉干纵轴的方向,动脉起始部与脊柱的对应关系,动脉干的类型做了解剖学观察,并讨论了相应的临床意义。     

Multiple variations of internal iliac artery – A case report

IntroductionInternal iliac artery (IIA) is the vessel predominantly supplying the pelvic viscera and the pelvic wall. The main stem of IIA is usually devoid of any branches. Its two divisions give rise to all its branches.MethodA case of multiple variations of IIA was noted during routine dissection of a male cadaver on the right side.ResultsInferior gluteal artery and middle rectal artery which are usually branches of the anterior division of IIA arose from the posterior division. Iliolumbar artery, usually a branch of the posterior division arose from the main stem of IIA. Obturator artery arose from external iliac artery instead of IIA.DiscussionThe knowledge of such variations aids in performing various surgical and radiological procedures in this region.     

Anatomy of renal arterial supply

A thorough knowledge of the variations of the renal artery has grown in importance with the increasing numbers of renal transplants, vascular reconstructions, and various surgical and radiologic techniques. The literature indicates that multiple renal arteries are found in 9- 76% of cadavers. The purpose of this study is to establish the incidence and characteristics of variations of renal arteries in Thais. A total of 267 Thai cadavers were dissected in the anatomy laboratory. The anatomical findings included: a single hilar artery in 82% of cases; double renal arteries in 17% of cases (one hilar artery with an upper polar artery occurred in 7%; two hilar arteries in 7%, and one hilar artery combined with one lower polar artery in 3%); and triple renal arteries occurred in 1% (two hilar arteries with one upper polar artery in 0.4% and two hilar arteries with one lower polar artery in 0.6%). In preparation for interventions, such as living renal donation, vascular reconstruction, renovascular hypertension, or radical nephrectomy, the results indicate that preoperative renal imaging is necessary and that operative techniques with attention to multiple renal arteries should be considered.     

Coronary artery aneurysms and coronary artery fistula as a cause of angina pectoris

Coronary artery aneurysm is an uncommon disease. Coronary artery fistulae are infrequent congenital anomalies. A extremely rare case report of combination of coronary artery aneurysms and coronary artery fistula is presented with a brief literature review.     

人心脏冠状动脉房室支与室房支的观察

解剖５０例成人心脏冠状动脉，观察由冠状动脉发出的分布于心房与心室的共同的动脉小干及其返支。由心房动脉支发出的返支向下越过冠状沟入心室壁的称炎这房室外，由心室动脉支发出的返支向上越过冠状沟入心房壁的称之为室房支。     

胸腰段后髓动脉的起源及其临床意义

目的:为选择性脊髓血管造影和椎管内显微外科提供解剖学资料。方法:采用尸体标本30例,于节段性动脉内逐一注入红色乳胶,在完整脊髓上解剖观察。结果:每例脊髓胸腰段的后髓动脉数目5～13支,平均8.4支。后髓动脉起始情况分3型10亚型,其中后髓动脉与前髓动脉由同一肋间后动脉发出仅34支(13.5％)。胸下部及腰部后髓动脉呈典型“发卡”样折曲。后髓动脉平均外径0.37±0.12mm。约1/3标本在T_(11)～L_3间有1支后髓动脉较粗(>0.5mm),它是脊髓后下部血供的主要来源。结论:多数后髓动脉单独起始,较大的后髓动脉应引起注意。     

老年组与中成年组髂外动脉的形态学比较

本文观微和测量了50具国人髂外动脉(左右合计100侧),并将所有观测项目按年龄分为老年组(60岁以上者)和中成年组(19—60岁)进行了统计学处理。结果发现:髂外动脉的长度、外径、髂外动脉与髂内动脉之间的夹角以及髂外动脉的弯曲程度在老年组与中成年组之间均有高度显著性差异。     

胃网膜右动脉与胸廓内动脉在冠状动脉旁路术中应用的比较研究

目的：为将胃网膜右动脉应用于冠状动脉旁路术提供依据。方法：观测了３８具成人尸体的胃网膜后动脉和胸廓内动脉，并对其中３０例进行了组织学观察及体视学计量。     

Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature

A total of 192 embalmed cadavers were examined in order to present a detailed study of arterial variations in the upper limb and a meta-analysis of them. The variable terminology previously used was unified into a homogenous and complete classification, with 12 categories covering all the previously reported variant patterns of the arm and forearm.     

以桡动脉为移植体行冠状动脉旁路术的局解手术学研究

本文对104侧上肢桡动脉第一段和63例成人离体心脏之冠状动脉及其主要分支,根据临床应用进行了观测。结果:桡动脉长度为22.10±1.2cm;外径(下同):上端为3.00±0.6mm,下端为2.60±0.6mm。后降支(房室交点下1cm处)为2.41±0.4mm,左右心耳与肺劝脉交角下1cm处的前降支为3.83±0.6mm,右冠状动脉主干为3.79±0.7m。距离:自主动脉前窦上2cm至前降支中点的长度为6.61±0.5cm,经右冠状沟至房室交点的长度为11.80±1.5cm。测量数据提示:以桡动脉为移植体足以吻接任何冠状动脉。本文尚阐述和讨论了该术式的局解手术学基础和操作程序,对冠状动脉旁路术(CABO)中常用的几种移植体之利弊进行了评     

Branching patterns of the popliteal artery and its clinical importance

Purpose  The aim of this study was to evaluate the popliteal artery branching patterns and related measurements. Methods  A cadaveric study in forty lower limbs was performed to improve the understanding of anatomy of the popliteal artery and its main branches. Results  Normal branching of the popliteal artery was present in 36 specimens (90%). High origin of the anterior tibial artery was seen in two specimens (5%). The bifurcation was at the level of proximal border of popliteus, but the posterior tibial artery originated directly from the popliteal artery in one specimen (2.5%). Trifurcation pattern with no trunk was observed in one specimen (2.5%). Conclusions  We believe that a review of the anatomic characteristics of the popliteal artery and its branches will be beneficial for the surgical approaches and the choice of suitable arterial graft sites. This study was presented at 9th Congress of European Association of Clinical Anatomy in Prague, 5–8 September 2007.     

Heubner回返动脉的显微解剖及其临床意义

目的:研究Heubner回返动脉的显微解剖及其与A1的关系,以及与眶额动脉和额极动脉的区别。方法:成人尸体头颅标本15例(30侧),经翼点入路,在手术显微镜下对Heubner回返动脉及相关结构进行观察后,取出脑组织块,解剖观察和测量回返动脉、眶额动脉和额极动脉。结果:(1)根据回返动脉与A1的关系,将其分为:远外侧型占22.2%、周围型占69.4%、内侧型占8.3%。(2)回返动脉直径为(0.77±0.12)mm,绝大部分起源于前交通动脉周围2mm的大脑前动脉;眶额动脉的直径为(0.63±0.16)mm,均起源于A2段,距前交通动脉的距离平均(5.51±3.4)mm;额极动脉的直径为(0.66±0.18)mm,距前交通动脉的距离为(1.41±0.51)cm。结论:识别回返动脉并明确其与A1、眶额动脉和额极动脉的关系对手术中Heubner回返动脉的保护具有重要意义。     

肋间动脉与冠状动脉搭桥的应用解剖

为肋间动脉与冠状动脉搭桥术提供解剖学资料,在40侧成年尸体上对第七、八对肋间动脉进行了观察.左侧第七肋间动脉至液后线长平均为19.5cm.至锁骨中线为26cm;左侧第八肋间动脉长分别为19.7cm和27.5cm;右侧第七肋间动脉长分别为20.7cm和27.5cm;右侧第八肋间动脉长分别为21.2cm和28cm.     

左侧肋间后动脉用于冠状动脉搭桥术的应用解剖

目的：为左侧肋间后动脉冠状动脉搭桥术提供解剖学基础。方法：在３０具成人尸体标本上,对左侧肋间后动脉及心脏冠状动脉的后降支和左缘支进行了观察。结果：左侧第８、９、１０肋间动脉到后降支（房窒交点下方１ｃｍ处＿平均外径分别为２．５、２．６、２．８ｍｍ,与冠状动脉后降支此点处外径（２．５ｍｍ）较为接近;到左缘支点处的平均外径为２．７、２．８、２．６ｍｍ,与左缘地此点处外径（２．１ｍｍ）较为接近;到后降支中     

Variability in the Origin of the Obturator Artery

INTRODUCTION

General surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper’s ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported.

MATERIALS AND METHODS

The present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted.

RESULTS

In 79% of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19% of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2% of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity.

CONCLUSION

The data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.     

An unusual variation of the superficial ulnar artery

Anomalous superficial ulnar arteries were found bilaterally during routine dissection of the upper limbs of a 60-year-old male cadaver. In the left arm, the superficial ulnar artery originated from the axillary artery. It crossed the median nerve anteriorly and ran anteromedial to this nerve and the brachial artery. The superficial ulnar artery was also rudimentary and gave rise to only a narrow muscular branch to the biceps brachii. In the hand, it anastomosed with the radial artery, completing the superficial palmar arch. The radial artery was larger than usual and the deep palmar arch was formed only by the radial artery. In the right arm, the superficial ulnar artery originated from the brachial artery at the level of the inter-epicondylar line. Additionally there were “inverse palmaris longus muscles” bilaterally. This was a rare case in which the superficially ulnar artery originated from a different source on each side accompanied by anomalies of the palmar arches on one side.     

Comparative histological and biometric study of the coronary,radial and left internal thoracic arteries

In an attempt to elucidate the causes of occlusion of radial arteries used for coronary artery bypass grafts and to improve the results of these procedures, we studied the biometry and histology of the coronary, radial and left internal thoracic arteries. These arteries were harvested from 20 cadavers (13 males, 7 females). The specimens were calibrated to the various bypass graft sites using coronary calibrators, and were then submitted to histological examination to determine the structure and innervation of the vessel wall. No correlation was observed between the internal calibers of these various arteries, with the exception of the anterior interventricular and right coronary arteries. Intimal changes and the presence of atheromatous plaque were observed in coronary and radial arteries, but never in the internal thoracic artery. Like the coronary arteries and their branches, the radial artery is a muscular artery. Aging of muscular arteries results in thickening of the intima, which becomes fibrotic due to migration of myocytes from the media and duplication of the internal elastic lamina. The media becomes fibrous, hypertrophic or atrophic. The walls of the radial and coronary arteries contain several adventitial nerves (sympathetic and parasympathetic nerve fibers), but these nerve fibers were not observed in the wall of the left internal thoracic artery. In contrast, the internal thoracic artery, like the aorta, is an elastic artery. Aging of elastic arteries is first observed between the ages of 20 and 29 years and is characterized by loss of one or several elastic laminae of the media and more marked intimal thickening, over a variable length. Even if a radial artery's caliber is similar to that of the coronary artery, histological evolution and graft patency depend on its muscular identity.

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Etude comparative et histologique entre les artères coronaires, radiales et thoracique interne gauche

Résumé Pour tenter de comprendre les causes d'occlusion des artères radiales utilisées comme greffons dans les pontages aorto-coronariens et améliorer les résultats, la biométrie et l'histologie des artères coronaires, radiales et thoracique interne gauche ont été étudiées. Nous avons prélevé ces trois types d'artères chez 20 cadavres (13 hommes et 7 femmes). Ces prélèvements ont été calibrés aux différents sites de pontages avec des calibreurs coronaires, puis analysés en histologie afin de déterminer la structure et l'innervation de la paroi. Nous n'avons pas trouvé de corrélation entre les calibres internes de ces différentes artères, à l'exception des artères interventriculaire antérieure et coronaire droite. Le remaniement de l'intima et la présence de plaques d'athéromes ont été observés dans les artères coronaires et radiales, jamais dans l'artère thoracique interne. Comme les artères coronaires et leurs branches, l'artère radiale est de type musculaire. Leur vieillissement se traduit par un épaississement de l'intima qui se fibrose, par une migration myocytaire de la média et par un dédoublement de la limitante élastique interne. La média devient fibreuse, hypertrophique ou atrophique. A l'opposé l'artère thoracique interne est une artère élastique comme l'aorte. Le vieillissement se caractérise par la disparition, sur une étendue variable, d'une ou de plusieurs lames élastiques de la média et un épaississement intimal plus marqué. Même si, anatomiquement, le calibre reste adapté entre artère radiale et artère coronaire, le devenir histologique et donc la perméabilité des artères radiales est en relation avec sa nature musculaire.

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人体动脉连续组织切片的计算机三维重建

在Ｉｎｔｅｌ ４０４８６主机下，采用３Ｄ ＶＩＥＷＮＩＸ软件对正常股动不粥样硬化冠状动脉的连续组织切片进行计算机三维重建，重建的动脉图像色泽鲜艳，外形逼真，立体感强，可单独或同时显示粥样硬化斑块，中膜和外膜的外形轮廓有其相互关系，并可进行任意角度旋转和不同方位的断面剖割，较好地实现了对动脉形态结构的三维立体显示，为影像诊断学提供了有价值的形态学资料。     

国人胃后动脉的应用解剖学观察

本文调查76具尸体,61例有胃后动脉,出现率为80.26±4.56%。胃后动脉起于脾上极动脉31例,占50.82±6.40%;起于脾动脉26例;占42.62±6.33%;起于脾动脉及脾上极动脉2例;占3.28±2.38%;起于胰尾动脉1例,占1.64±1.62%,起于胃左动脉1例,占1.64±1.62%。胃后动脉按支数可分四型:1支型,占75.41±5.51%;2支型,占18.03±4.92%;3支型,占4.92±2.77%;4支型,占1.64±1.62%。该动脉外径平均为1.42±0.43mm。胃后动脉于腹膜后间隙向左上斜行,经膈胃韧带入胃后壁,距胃底缘2.07±0.70 cm,距贲门左侧为2.68±0.94 cm。分布于胃体上部近贲门侧及食管腹段后面。