经鼻内镜翼腭窝区手术相关的显微解剖学研究

目的:为经鼻内镜翼腭窝区手术提供显微解剖学基础。方法:选用30例(60侧)成人头颅湿标本,对翼腭窝区进行显微解剖观测,并模拟鼻内镜手术入路,观测翼腭窝区穿行结构及毗邻关系。结果:①翼腭窝内有上颌动脉、上颌神经及其分支,以及翼腭神经节等重要结构;②由蝶腭孔至前鼻棘的距离为(52.99±4.95)mm;③上颌神经出圆孔处至前鼻棘的距离为(62.90±3.81)mm;④翼管神经至前鼻棘的距离为(58.83±3.91)mm。结论:熟悉翼腭窝区穿行结构位置及毗邻关系,对经鼻内镜翼腭窝区手术的开展具指导意义。     

鞍侧腔外侧壁手术切开的应用解剖学研究

目的为经鞍侧腔(LSC)外侧壁手术切开提供解剖学基础。方法对15例(30侧)成人头颅标本的LSC外侧壁进行解剖观测。结果①硬膜内途径沿前岩床皱襞分离LSC外侧壁脑膜时却可将LSC外侧壁明确的分为3层;②动眼神经鞘膜袋前部深(4.69±1.31)mm,后部深(6.50±1.58)mm;③滑车神经LSC段可分为4型:近眼神经型30%(9侧)、近动眼神经型33.3%(10侧)、"S"型10%(3侧)、直型26.7%(8侧)。结论熟悉LSC外侧壁膜层次、动眼神经鞘膜袋及滑车神经走行特点,有助于减少或避免LSC外侧壁手术切开的并发症,有助于扩大手术显露。     

颅底段展神经的应用解剖

目的 :为颅底外科提供展神经的显微解剖学资料。方法 :观测 15例 ( 3 0侧 )成人头颅湿标本展神经的位置、行径及重要毗邻关系。结果 :①展神经在硬脑膜入口处两侧间距 ( 19.71± 1.79)mm ;②Dorello管顶与底间最大垂直距离 ( 2 .14± 0 .70 )mm ;③展神经在海绵窦内距破裂孔硬膜环 ( 5 .69± 1.45 )mm。结论 :在颞骨岩部、海绵窦及眶上裂区手术 ,展神经必须予以辨认和保护     

膝周血管的应用解剖与骨肿瘤保肢术受区血管的选择

目的:为临床施行带血管骨移植修复膝关节周围肿瘤性骨缺损、选择恰当的受区吻合血管提供解剖学依据。方法:在30具(60侧)成人尸体下肢标本上,观测膝关节周围血管来源、走行、管径、可游离长度等。结果:膝降动脉于股骨内上髁最高点近侧(11.23±1.30)cm处起自股动脉前内侧壁,外径(2.39±0.32)mm,主干长3.2cm;半膜肌支于股骨内上髁最高点近侧7.9cm处起自腘动脉后壁,外径(2.17±0.20)mm,蒂长(5.39±1.09)cm;腓肠动脉内侧支于股骨内上髁最高点近侧(0.69±0.57)cm处起自腘动脉内侧壁,起始外径(2.16±0.24)mm,主干长(3.90±0.95)cm;腓肠动脉外侧支于腓骨头最高点近侧(4.3±0.80)cm处起自腘动脉外侧壁,起始外径(2.09±0.22)mm,主干长(4.03±1.16)cm。结论:①选取最佳的受区血管应综合考虑血管的解剖位置、变异情况、外径、蒂长以及是否受肿瘤侵犯等因素;②腓肠血管可作为膝周骨肿瘤保肢术的首选吻合血管,膝降血管、半膜肌血管可作为备选血管;③腘动脉关节支不适于作为骨肿瘤保肢术的受区吻合血管;④行同种异体全关节或半关节移植时应选下肢的主干血管作为吻合血管。     

锁孔入路治疗基底动脉瘤的应用解剖

目的 :研究眶上、颞下锁孔入路到达基底动脉顶端的入路解剖 ,探讨其治疗基底动脉分叉部动脉瘤的可行性。方法 :在 2 1例福尔马林固定尸体头颅标本上测量入路相关数据 ,在 9例新鲜尸体头颅标本上模拟行内窥镜辅助经眶上锁孔入路、经颞下锁孔入路基底动脉分叉部动脉瘤夹闭的手术操作 ,观察显露范围及操作范围 ,入路中各解剖结构对手术区显露及操作的影响。结果 :眶上孔、角突及颧弓上缘颞颧缝处与同侧及对侧后床突尖的距离分别为 (61.5± 1.7)mm、(92 .1± 3 .6)mm、(3 3 .5± 3 .1)mm、(73 .6±1.1)mm、(95 .6± 1.7)mm、(5 2 .3± 2 .2 )mm ;眶上孔、角突及颧弓上缘颞颧缝处与同侧及对侧后床突尖分别连线与中线的夹角分别为 (3 6.6± 1.2 )°、(8.5± 2 .3 )°、(82 .6± 3 .0 )°、(4 5 .1± 3 .0 )°、(3 0 .5± 3 .4)°、(83 .5± 4.0 )°。眶上、颞下锁孔入路均能通过多种神经血管间隙达到靶区 ,显露良好 ,照明充分 ,操作空间充分。结论 :采用内窥镜辅助的锁孔入路能满意的治疗基底动脉分叉部动脉瘤。     

骶骨上关节突关节面5点7点螺钉进钉点的应用解剖学

目的 :研究以骶骨上关节突关节面 5点 7点处为螺钉进钉点的解剖学基础。方法 :在成人 115块干燥骶骨标本上观测上关节突关节面形态 ,确定其 5点 7点处的部位 ,观测该点与骶骨外侧沟的关系及该点进钉时的角度、深度。并在横断面标本上进行观测 ,在干燥骶标本上进行模拟手术。结果 :骶骨上关节突关节面呈圆形者 63 .5 % ( 14 6侧 ) ,椭圆形者 3 6.5 % ( 84侧 ) ;5点 7点低于骶骨外侧沟最低点的距离 ,左侧 ( 7.4± 1.5 )mm ,右侧 ( 7.3± 1.6)mm。横断面标本上自此点向前与矢状面平行 ( 0°)时 ,进钉深度 ,左侧 ( 3 1.3± 4.3 )mm ,右侧 ( 3 1.9± 4.9)mm。当钉尖向内侧与矢状面呈 10°角时 ,进钉深度 ,左侧为 ( 3 4.1± 4.3 )mm ,右侧 ( 3 4.0± 4.9)mm。结论 :骶骨上关节突恒定存在 ,将每侧上关节突关节面看成一个时钟表盘 ,右侧关节面相当于 5点处、左侧相当于 7点处为螺钉进钉点。其 5点 7点进钉点的确定较为客观 ,不受上关节突关节面方向的影响 ,也不受退变影响 ,可很容易地确定 5点 7点的部位。     

喉切除术相关血管神经的解剖学研究

目的:为喉切除手术提供相关血管神经的形态学依据。方法:在20具(40侧)成人头颈部标本上解剖观测喉的血管和神经的走行及分布。结果:喉上动脉的入喉处在甲状软骨上角前下方左侧(14.91±3.83)mm、右侧(15.96±3.56)mm;喉上神经喉内支的入喉处在甲状软骨上角前下方左侧(12.80±4.42)mm、右侧(13.24±3.68)mm;喉下神经入喉处距离甲状软骨下角左侧(5.38±1.57)mm、右侧(5.69±1.78)mm。进行左右比较时,表现为右侧优势。结论:本研究对喉切除手术以及其他颈前区手术具有一定的参考意义。     

带腓肠外侧皮神经及其营养血管筋膜皮瓣的应用解剖

<正> 为带腓肠外侧皮神经及其营养血管筋膜皮瓣的临床应用提供解剖学基础.在32侧成人下肢标本上,对腓肠外侧皮神经及其营养血管进行解剖观测.结果:腓肠外侧皮神经在腓骨头平面上方(7.l±2.4)cm处起于腓总神经,横径为(2.6±1.0)mm,沿腘窝及小腿后外侧面下行,腓骨头平面的横径为(3.0±0.9)mm,发出1-3个终支,分布于小腿后外侧上半或上2/3的皮肤.其营养动脉主要为:①腓肠外侧皮动脉;起自腘动脉外侧壁,在排骨头平面上方(5.0±1.5)cm处浅出,外径为(0.9±0.3)mm,穿出前长度为(3.11.2)cm,伴腓肠外侧皮神经及其主要分支下行;②肌间隔筋膜皮支:起自胫后动脉(占54.5%)和腓动脉(占45.5%),向后外行,自小腿三头肌与腓骨长、短肌之间的肌间隔穿出,穿出点分别在腓骨头平面下方(9.2±3.8)cm和(15.8±3.8)cm,外径为(0.7±0.3)mm和(0.9±0.4)mm,穿出前长度分别为(3.6±1.1)cm和(3.6±1.4)cm.该营养动脉除在腓肠外侧皮神经主干及其分支旁或其内呈相互吻合,形成纵行的动脉丛(网)外,沿途还发出分支至周围的筋膜皮肤,并借吻合支     

带血管蒂阔筋膜张肌及腱膜转位修补巨型腹股沟疝的应用解剖

目的　为带血管蒂阔筋膜张肌及腱膜转位修补巨型腹股沟疝提供解剖学基础。方法　在 30侧成人下肢标本上解剖观测了阔筋膜张肌的动脉血管分布、神经支配、肌腹和肌腱的长度等。结果　阔筋膜张肌动脉来源有旋股外侧动脉和臀上动脉 ;该肌由臀上神经支配 ,肌腹长度为 (1 1 2 31± 3 1 3)mm ,髂胫束的长度为 (31 5± 6 8)mm ,髂前上棘水平至腹直肌外侧缘的距离 ,男性为 (1 68± 7 5)mm ,女性为 (1 76± 6 8)mm。结论　阔筋膜张肌血供丰富 ,肌腱膜长 ,位置邻近腹股沟区 ,可作为巨型腹股沟疝修补的供区     

脑神经海绵窦段的显微解剖及其临床应用

目的　为海绵窦 (cavernoussinus,CS)直接手术提供解剖学基础。方法　在手术显微镜下对 15例 (30侧 )成人头颅标本CS内脑神经位置、行径以及与颈内动脉CS段的毗邻关系进行观测。结果　①动眼神经入窦点在前床突尖后方 (4 5 7± 1 0 5 )mm ,与滑车神经、眼神经垂直距离分别为 (2 2 0± 0 6 7)mm和 (4 37± 1 35 )mm。②滑车神经入窦点与眼神经垂直距离为 (5 5 2± 1 0 6 )mm。滑车神经CS段行程形状可分为三型。③颈内动脉后曲顶高出眼神经和展神经上缘分别为 (5 5 2± 1 84)mm和 (6 6 0± 1 94)mm。④经前床窦尖外侧或外下方时 ,动眼神经、滑车神经及眼神经与前床突尖垂直距离分别为 (1 85±0 75 )mm、(5 30± 1 0 4)mm和 (6 6 1± 1 6 3)mm。结论　掌握脑神经CS段的显微解剖对CS的直接手术具有重要意义。     

上矢状窦旁大脑上静脉末段的形态特点及其临床意义

目的:通过显微解剖和铸型方法观察上矢状窦旁大脑上静脉末段形态特点,为上矢状窦血栓发生及其准确及时的诊断提供形态学依据。方法:分别观测30例(60侧)静脉内灌注蓝色乳胶的成人头颅湿标本和观察12例胎儿和幼儿的脑静脉血管铸型。结果:上矢状窦前部和后部分别有一缺乏桥静脉注入段;前段上矢状窦旁大脑上静脉平均为5.2支,直径为(1.99±0.86)mm,末段可顺行、垂直和逆行注入上矢状窦;后段上矢状窦旁大脑上静脉为6.0支,直径为(2.96±1.13)mm,末段大部分逆行注入上矢状窦。结论:大脑上静脉末段的形态可能与上矢状窦内血栓发生密切相关,影响上矢状窦血栓的影像学观察。     

Relation of the external branch of the superior laryngeal nerve to the superior pole of the thyroid gland: an anatomical study

The external branch of the superior laryngeal nerve (ELN) is intimately associated with the superior thyroid artery (STA) in relation to the superior pole of the thyroid gland, rendering it vulnerable to injury during the ligation of this vessel during thyroidectomy. Although most texts acknowledge the fact that the nerve is in close relation to the STA, there has not been an anatomical study to relate the position of the ELN to the superior pole of the thyroid gland. The aim of this study was to determine the shortest distance, from the most superior point of the thyroid gland, to the ELN. Bilateral micro-dissection on 43 adult cadavers, excluding those with thyroid pathology and previous thyroidectomies, was undertaken. The most superior point of the superior pole of the thyroid gland was identified and the shortest distance to the ELN was measured with a digital calliper (accuracy 0.01 mm). The metric study indicated a mean distance from the ELN to the superior pole of a normal sized thyroid gland of 5.76 mm (range: 2.00-11.26) on the right, and 6.17 mm (range: 2.78-13.48) on the left. From the literature, it is clear that the ELN may even be closer to the superior pole of an enlarged thyroid gland. The recommendation to stay on the substance of the superior pole of the thyroid gland when ligating the STA remains valid, as the nerve is extremely close in relation to the superior pole of the normal thyroid gland.     

Microsurgical anatomy of the superior orbital fissure

The microanatomy of the superior orbital fissure (SOF) was studied in 96 sides of cadaver specimens. The SOF is a narrow bony cleft that lies at the apex of the orbit between the greater and lesser wings of the sphenoid. Through this fissure, many important structures enter the orbit from the middle cranial fossa including the third, fourth, sixth cranial nerves, and the ophthalmic branch of the fifth nerve. In addition, the superior opthalmamic vein exits the orbit to drain into the cavernous sinus via the SOF. The fissure can be divided into three anatomical regions by the annulus of Zinn (common annular tendon): the lateral, central, and inferior regions. The lateral wall of the SOF can also be divided between the upper and lower segments, and the angle between them was measured to be 144.27 degrees +/- 20.03 degrees . Defining these regions is useful in describing the course and placement of the nerves and vasculature in the SOF. Managing lesions at the orbital apex requires an extensive knowledge of the cranial base and the intracranial and extracranial relationships of the anatomical structures coursing through the SOF. The goal of this study was to describe the microanatomy of the SOF region in detail and to provide a reference for surgical procedures involving the orbital apex.     

臀上动脉深上支髂骨骺移植的解剖学研究

目的 :为带血供的髂骨骺移植提供解剖学依据。方法 :在 40侧经动脉灌注红色乳胶的成人臀部标本以及 2侧儿童标本上 ,观测臀上动脉深上支的行程、分支及滋养支 ;选用 5 0块髋骨 ,观察髂骨嵴前外侧部的滋养孔。结果 :儿童臀上动脉深上支的分支、分布与成人相似 ,位于臀中肌深面和臀小肌上缘 (相当臀前线 ) ,循髂骨嵴弓形向前 ,达髂前上嵴 ,沿途分出平均 (4 .2± 1.1)支外径 0 .5～ 1.1mm的髂嵴支 ,分布髂嵴骨膜 ,并发细小分支进入滋养孔。从髂前上棘至结节区 ,在距髂嵴缘下方 2cm范围内 ,平均有(2 2 .4± 6.7)个滋养孔。结论 :以臀上动脉深上支及其分支为蒂 ,在髂嵴前部可切取带骺骨瓣 ,以修复长管骨骨骺缺损。     

带臀上血管深上支蒂的髂骨移位修复股骨颈疾患的应用解剖

观察了31具(男24,女7)经红色乳胶灌注的成年尸体及8侧下肢血管铸型腐蚀标本,证明了以臀上动脉深上支为蒂的髂骨移位修复股骨颈的可行性,分析了移位的优缺点及其它有关问题。     

上斜肌的动脉和神经

解剖了成人眶腔40个.上斜肌动脉1-3支不等,以一支为多见.主支直接发自眼动脉三段的占61.54±7.79%.主支自上斜肌后1/3份的外侧面进入者较多.主支长度均值右为8.23±0.57mm,左为6.60±0.51mm.主支外径均值右为0.60±0.03mm,左为0.66±0.04mm.滑车神经前支自上斜肌前2/3、后1/3交界处的内侧面进入者为多.其入肌前主干的外径均值左、右均为1.23±0.05mm.筛后动脉横跨滑车神经上方的占61.54±7.79%,动脉在神经下方的占35.90±7.68%.     

Responsiveness of cells in the cat's superior colliculus to textured visual stimuli

Summary Responses to texture motion (visual noise) were investigated in the superior colliculus of paralysed cats, lightly anaesthetized with N₂O/O₂ supplemented with pentobarbitone or Althesin. Within the superficial layers two classes of texture-sensitive neurones were found: Type I units with weak responses to noise, often related to specific elements in the texture and Type II units which were driven independently of the texture structure, and tended to be recorded deep to the Type I units. Type III units recorded from the deep collicular layers were insensitive to texture. Anatomical bases for this differential sensitivity and the notion of two collicular subsystems are discussed.     

Effect of the superior colliculus on function of the contralateral lateral geniculate body in cats

Laboratory of Neurophysiology of Brain Integrative Activity and Section Brain and Behavior,, A. I. Karaev Institute of Physiology, Academy of Sciences of the Azerbaijan SSR, Baku. (Presented by Academician of the Academy of Medical Sciences of the USSR O. S. Adrianov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 111, No. 3, pp. 227–229, March, 1991.     

Control of conduction of afferent impulses through the lateral geniculate body by the superior colliculus in conscious rabbits

A. I. Karaev Institute of Physiology, Academy of Sciences of the Azerbaidzhan SSR, Baku. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 108, No. 10, pp. 387–389, October, 1989.     

A detailed study of the relationship between the external laryngeal nerve and superior thyroid artery,including its glandular branches

The external layrngeal nerve (ELN) may be at risk during thyroidectomy. Because the relationship between the ELN and superior thyroid artery (STA) can be variable, we aimed to investigate their relationship in detail. In human cadavers, 81 ELN and STA and their branches were carefully dissected. The position of the nerve was classified as medial (Group I, on 76.5% sides), lateral (Group II, on 20.9% sides), or posterior (Group III, on 2.4% sides) to the origin of the STA. In Group Ia, the nerve did not cross the artery while it did cross the artery in Group Ib. In Group II, the nerve was located lateral to the origin of the artery and crossed it. In Group III, the nerve coursed downward posterior to the artery. In conclusion, the topography of the ELN showed much more variability in its relationship to the STA than is described in the literature. Such variations should be kept in mind during surgery of the anterior neck. It is our hope that such data will decrease surgical morbidity following surgery of the anterior neck. Clin. Anat. 26:814–822, 2013. © 2012 Wiley Periodicals, Inc.