经翼点入路鞍区手术间隙解剖学研究

目的　为鞍区显微外科手术提供解剖学参数。方法　对 10具成人尸体头颅的鞍区手术间隙及邻近血管、神经进行解剖学观察、测量。结果　大脑中动脉M1段在距颈内动脉分叉部 18.4± 3.2mm处形成初级分叉 ,向后上方发出约 14支穿支 ,分布至基底节区。鞍结节后缘至视交叉前缘相距 5 .6± 1.1mm ,两侧视神经内侧缘间最大距离 10 .5± 1.4mm。颈内动脉从内侧壁发出 3.2支垂体上动脉 ,终止于视神经、视交叉、视束和垂体柄 ;视神经 -颈内动脉三角三边长度分别为 6 .6± 0 .6mm ,6 .9± 0 .7mm ,4 .0± 0 .4mm。颈内动脉 -小脑幕三角三边长度为 8.8± 0 .7mm ,6 .7± 0 .7mm ,4 .4± 1.0mm ,后交通动脉起自颈内动脉后外壁距分叉部 7.7± 0 .5mm ,止于大脑后动脉 ,全长 18.7± 2 .3mm ,途中发出 7.4条穿通支。脉络膜前动脉从距分叉部 4 .4± 0 .6mm处发出 ,向后方走行 ,发出细小分支 ,分布于钩回、脉络丛。前交通动脉全长 1.9± 0 .3mm ,在前交通动脉上方 0 .9± 0 .2mm ,大脑前动脉A2段前外壁发出Heubner回返动脉 ,分布于胼胝体、基底节、下丘脑及额叶脑组织。结论　应用这些间隙的解剖学测量可指导与鞍区相关的手术 ,安全显露鞍区解剖结构 ,不损伤重要的血管和神经。     

收肌管压迫综合征的解剖学研究

目的 :为收肌管压迫综合征的临床诊断和手术治疗提供相关的解剖学依据。方法 :使用游标卡尺 ,对 6 0侧福尔马林固定下肢标本的收肌管及其血管鞘的相关形态结构进行观测。结果 :收肌管长为 (6 7.2 9± 9.33)mm ,收肌管大收肌腱板厚、长和上口处宽径分别为 (1.2 3± 0 .4 5 )mm、(5 7.6 1± 7.0 1)mm、(13.11± 2 .6 6 )mm ,血管鞘在收肌管上口处的前后径和左右径分别为 (13.5 5± 3.4 5 )mm、(9.84± 2 .70 )mm ,下口处的前后径和左右径分别为 (8.4 6±2 .36 )mm、(18.17± 5 .4 0 )mm ;收肌管上口的横断面为三角形 ,可分为前壁、后壁和外侧壁 ,三者宽度分别为 (16 .15±2 .4 9)mm、(17.11± 3.16 )mm、(17.33± 3.5 9)mm ;下口 (收肌腱裂孔 )的横断面为近椭圆形 ,左右径和前后径分别为(30 .10± 5 .77)mm、(11.73± 2 .19)mm。结论 :收肌管相关结构测量结果可为收肌管压迫综合征的病因诊断及手术治疗提供参考。     

家猪心脏三尖瓣复合体的形态学观测

目的　观测家猪心脏三尖瓣复合体 ,为家猪心脏研究和心脏移植积累资料。方法　甲醛固定的家猪心脏 35例 ,大体解剖并观测三尖瓣复合体。结果　家猪心脏三尖瓣复合体由瓣环、瓣膜、腱索和乳头肌构成 ,瓣环周长为 70 75± 8 4 5mm ,前瓣、后瓣、隔侧瓣、前隔连合、前后连合、后隔连合的高度分别为 14 5 8±2 6 4、14 16± 2 5 0、12 84± 2 37、6 2 9± 1 97、6 86± 1 0 1、6 5 1± 1 36mm。前隔连合、前后连合、后隔连合的宽度分别为 6 4 0± 1 5 4、6 78± 1 2 3、6 4 3± 1 4 6 ;前乳头肌起始 ,腱索附着于前瓣、后瓣和前后连合的条数分别为 3 0 0± 0 97、3 0 9± 1 0 9、2 4 4± 1 16 ;后乳肌起始 ,腱索附着于后瓣、隔侧瓣和后隔连合的条数分别为 2 6 0± 0 6 9、3 0 9± 1 6 3、1 14± 0 4 3。隔侧乳头肌起始 ,附着于前瓣、隔侧瓣、前隔连合的腱索条数分别为1 71± 0 6 7、2 37± 1 2 6、0 94± 0 4 2。结论　家猪心脏三尖瓣复合体中各结构与人类相似 ,但大小有一定差异。     

心传导系统综合创新实验案例

目的 为了可视化、立体呈现心传导系统,达到基础结合临床的教学效果.方法 采用20个新鲜市售猪心作为实验对象,对其进行解剖.对进行Todaro腱定位、测量和分级,采用线性回归方程对数据进行分析,以心脏的重量为自变量,Todaro腱腱长为因变量;并取3个猪心行房室分离环形切开术,进行观察.结果 Todaro腱与心脏重量无明...     

腹股沟三角的应用解剖学及其临床意义

目的　为解剖学和临床应用提供解剖学资料。方法　采用成人尸体标本 5 1具 (男 4 1,女10 )、10 1侧 ,解剖、观察腹沟韧带 ,腹直肌外侧缘 ,腹壁下动脉起点、行程和闭孔支。测量腹壁下动脉起端外径和腹股沟三角 (Hesselbach’sTriangle)的境界。 结果　腹股沟三角的a -b间距男、女性分别为 5 .4 3± 1.2 9cm和 4 .99± 1.2 3cm ;b -c间距分别为 6 .98± 1.35cm和 6 2 5± 1 0cm ;c -a间距分别为 5 0 3± 0 73cm和 4 82± 0 5 9cm。男、女合计 ,a -b ,b -c和c -a间距分别为 5 35± 1 3cm ,6 84± 1 34cm和 4 99±0 71cm。腹壁下动脉起端外径为 0 2 4± 0 0 4cm ,起点在腹股沟韧带平面以上者占 5 9 4 1% ,平均距腹股沟韧带上 1 0 6± 0 6cm。异常闭孔动脉出现率为 14 85 % ,平均直径为 0 2 3± 0 0 8cm。结论腹股沟三角的境界无性别和侧别差异 (p >0 0 5 ) ;通过腹部 3点 1面可确定腹股沟三角的体表投影。腹壁下动脉的外径和长度足以用于冠状动脉旁路移植物。异常壁孔动脉出现率较高 ,其直径与腹壁下动脉相近 ,在股疝手术时容易损伤。     

山羊心脏三尖瓣复合体的解剖学特征

目的　观测山羊心脏三尖瓣复合体形态特征 ,为心脏研究和比较解剖学积累资料。方法　 1 0 %甲醛固定的山羊心脏 1 0 5例 ,解剖并观测三尖瓣复合体 ,保留隔缘肉柱和羊心腔特有结构。结果　山羊心脏三尖瓣复合体前瓣、后瓣 ,隔侧瓣的高度分别为 :8 4 3± 2 0 0mm、8 1 3± 1 90mm、7 6 8± 2 .1 0mm ;宽度分别为 :1 4 0 3± 3 1 6mm、1 4 35± 2 70mm、1 6 78± 3 4 6mm。前乳头肌腱索总条数为 :7 79± 1 72。后群乳头肌腱索条数为 :7 4 2± 2 1 7,后群乳头肌的个数为 2 36± 0 92。隔侧群乳头肌腱索总条数为 :1 0 4 2± 2 4 9,隔侧群乳头肌的个数为 4 0 5± 1 4 4。隔缘肉柱的长度为 9 5 3± 3 4 6mm。结论　山羊心脏三尖瓣复合体和人类心相似 ,但其心腔结构有其特异性     

家猪心脏二尖瓣复合体的形态学观测

目的　观测家猪心脏二尖瓣复合体 ,为家猪心脏研究和心脏移植积累资料。方法　甲醛固定的家猪心脏 3 5例 ,解剖并观测二尖瓣复合体。结果　家猪心脏二尖瓣复合体由瓣环、瓣膜、腱索和乳突肌构成 ,瓣环周长为 73 0 0± 9 71mm ;前瓣、后瓣、前外侧连合、后外侧连合的高度分别为 17 45± 1 99mm、16 3 3±2 2 2mm、5 68± 1 3 7mm、5 3 5± 1 11mm ,前外侧连合、后内侧连合的宽度分别为 4 3 1± 0 80mm、4 40±0 63mm ,前乳头肌起始 ,腱索附着于前瓣、后瓣和后内侧连合的条数为 4 0 0± 1 3 0、5 2 1± 1 84、2 44±1 16,后乳头肌起始 ,腱索附着于前瓣、后瓣和前外侧连合的条数为 3 76± 1 78、5 3 8± 2 2 0、2 12± 0 91。结论　家猪心脏二尖瓣复合体中各结构与人类相似 ,但大小有一定差异     

下腰椎骶椎相关结构的测量与单枚斜向椎间融合器的应用研究

目的 :探讨下腰椎骶椎相关结构的解剖特点 ,为单枚斜向椎间融合器的研制及应用提供理论依据。方法 :对 39具中国成人腰骶椎骨标本进行形态学测量及分析。结果 :L3 至L5椎板峡部宽分别为 14 .2 7± 1.6 2mm、16 .6 7± 2 .34mm和 2 0 .5 6± 2 .2 1mm ,下关节突最外侧缘至后正中矢状面距离分别为 16 .72± 2 .31mm、19.88± 2 .82mm和 2 4 .17± 2 .79mm。L3 ～L4、L4～L5和L5～S145°斜径分别为 39.74± 3.2 8mm、39.35± 3.11mm和 36 .36± 2 .76mm ,30°斜径分别为 36 .2 4± 2 .88mm、35 .6 4± 2 .87mm和 32 .5 4± 2 .2 4mm。结论 :解剖测量表明 30°斜径适合单枚斜向椎间融合器置入 ,单枚斜向椎间融合器比后路双枚椎间融合器可保留较多的关节突关节和椎板 ,减少术后对脊柱稳定性的破坏     

人脐静脉内皮胞在支架上粘附的影响因素研究

目的　研究人脐静脉内皮细胞 (HUVEC)在支架上的粘附生长的影响因素 ,寻求最佳细胞粘附条件 .方法　HUVEC培养按文献方法进行 .利用免疫组化方法 (Sp法 )检测Ⅷ因子以鉴定细胞纯度 ,分别比较细胞代数、Fibronectin、poly-L -lysine及Ca2 浓度对HUVEC在支架上的粘附率的影响 .结果　 (1)第 2、3、4代HUVEC在裸支架上的粘附率分别为 (2 0 .0 5± 2 .1) %、(16 .12± 4.0 2 ) %、(10 .6 1± 5 .0 1) % (n =4) ;(2 )Fibronectin(n =6 )、poly-L -lysine(n =4)处理支架 ,HUVEC的粘附率分别为 (6 4.3± 6 .19) %、(39.88± 1.31) % ;(3)与 1mM、2mM、3mM、4mM、5mMCa2 相对应的细胞粘附率分别为 (5 9.81± 2 .5 8) %、(6 6 .88± 3.15 ) %、(78.35± 3.43) %、(81.6 7± 1.91) %、(84.83± 1.31) % .结论　 (1)Fibronectin、poly -L -lysine可提高HUVEC在支架上的粘附 .(2 )Ca2 在一定剂量范围内呈剂量依赖性地提高HUVEC在Fibronectin包被支架上的粘附 .     

大鼠面神经颅外段的解剖及其应用

目的 :为大鼠面神经损伤模型的制备提供解剖学依据。方法 :解剖和观测大鼠面神经颅外段。结果 :大鼠面神经出茎乳孔后可分为两段。第 1段长度为 (5 .2 1± 0 .4 8)mm ,中点外径为 (1.31± 0 .13)mm ,第 2段分三个终末支 ,其中耳睑神经较短为(8.97± 0 .95 )mm ,颊肌神经和下颌缘神经平均长度分别为 (2 5 .2 3± 1.4 1)mm、(2 6 .6 1± 1.2 2 )mm ,中点外径为 (1.0 5± 0 .2 0 )mm、(0 .95± 0 .2 0 )mm。二者在口角外侧汇合成神经节样体。结论 :大鼠面神经的第 1段宜作钳夹、结扎损伤模型 ;第 2段的颊肌神经和下颌缘神经宜作神经断离自体静脉套接、神经断端外膜缝合及电生理检测等。     

人体心脏房室结、房室环及主动脉后结的巨微解剖

目的解剖分离人体心脏房室结和房室环的结构,阐述它们的形态特征及相互关系。方法通过体视显微镜解剖12例人体心脏的房室结、主动脉后结及房室环,再进行组织学观察,并绘图演示它们的结构关系。结果在二尖瓣环和三尖瓣环靠近冠状窦前缘处分别暴露了左、右房室环(12/12),直径分别为(0.69±0.12)mm、(0.78±0.13)mm。此处的左、右房室环穿行在房室隔内的心房肌与心室肌之间的间隙中,向房室结方向延伸。主动脉后结在主动脉根后方的房间隔中被探查到(7/9),它的后上方的房间隔间隙中有肌纤维与其相连,它的前下方分出左、右房室环,并且此处的左环比右环粗。在中心纤维体后方的心内膜下的深部,主动脉后结与房室结之间有直接的心肌组织连接通路,这条通路有别于另两条通路(左、右房室环)。结论主动脉后结和房室环可通过体视显微镜解剖暴露,主动脉后结与房室结之间有3条通路。     

山羊心脏二尖瓣复合体的应用解剖学研究

目的观测山羊心脏二尖瓣复合体的解剖结构,为比较解剖学积累资料。方法利用大体解剖方法观测山羊二尖瓣复合体的形态结构。结果山羊心脏二尖瓣复合体由二尖瓣瓣环、瓣膜、腱索和乳头肌构成,二尖瓣瓣环周长为47.00±7.39mm,前瓣的高度为7.93±2.03mm,宽度为21.58±4.17mm,后瓣的高度为9.89±1.90mm;宽度分别为20.61±4.22mm;前乳头肌起始点至前瓣、后瓣和后内侧连合的腱索条数分别为5.06±1.71,3.19±1.11,1.25±0.48;后乳头肌起始点附着于前瓣、后瓣和前外侧连合的腱索条数分别为4.50±1.88,4.16±1.84,1.32±0.54。结论山羊心脏二尖瓣复合体的结构与人类相似,但形态有特异性。     

山羊肺静脉心肌袖解剖学观测

目的观察山羊肺静脉心肌袖的形态特征,为异位房颤动物模型提供形态资料。方法解剖30例山羊肺静脉,充分暴露心肌袖,进行形态学观测。结果30例羊心均出现肺静脉心肌袖,其中斜形47.6%,环形40.9%,纵形11.5%。右上、右下、左下、左上肌袖厚度分别为0.46±0.14mm、0.35±0.16mm、0.35±0.11mm、0.37±0.13mm,长度分别为10.75±3.15mm、9.46±2.20mm、11.41±2.87mm、9.20±2.88mm。结论30例山羊肺静脉心肌袖出现率为100%,可能与局灶性房颤的发生有关。     

Anatomy of the pig heart: comparisons with normal human cardiac structure

Transgenic technology has potentially solved many of the immunological difficulties of using pig organs to support life in the human recipient. Nevertheless, other problems still remain. Knowledge of cardiac anatomy of the pig (Sus scrofa) is limited despite the general acceptance in the literature that it is similar to that of man. A qualitative analysis of porcine and human cardiac anatomy was achieved by gross examination and dissection of hearts with macrophotography. The porcine organ had a classic ‘Valentine heart’ shape, reflecting its location within the thorax and to the orientation of the pig's body (unguligrade stance). The human heart, in contrast, was trapezoidal in silhouette, reflecting man's orthograde posture. The morphologically right atrium of the pig was characterised by the tubular shape of its appendage (a feature observed on the left in the human heart). The porcine superior and inferior caval veins opened into the atrium at right angles to one another, whereas in man the orifices were directly in line. A prominent left azygous vein (comparable to the much reduced left superior caval or oblique vein in man) entered on the left side of the pig heart and drained via the coronary sinus. The porcine left atrium received only 2 pulmonary veins, whereas 4 orifices were generally observed in man. The sweep between the inlet and outlet components of the porcine right ventricle was less marked than in man, and a prominent muscular moderator band was situated in a much higher position within the porcine right ventricle compared with that of man. The apical components of both porcine ventricles possessed very coarse trabeculations, much broader than those observed in the human ventricles. In general, aortic-mitral fibrous continuity was reduced in the outlet component of the porcine left ventricle, with approximately two-thirds of the aortic valve being supported by left ventricular musculature. Several potentially significant differences exist between porcine and human hearts. It is important that these differences are considered as the arguments continue concerning the use of transgenic pig hearts for xenotransplantation.     

Obstructive Thebesian valve: anatomical study and implications for invasive cardiologic procedures

Thebesian valve is the embryological remnant of the right sinoatrial valve, guarding the coronary sinus (CS) ostium. Advanced invasive and interventional cardiac diagnostic and management tools involve cannulation of the CS ostium. The presence of obstructive Thebesian valves has been reported to lead to unsuccessful cannulation of the CS. We studied the morphology of the Thebesian valve and CS ostium to assess the possible impact of these structures on invasive cardiological procedures. One hundred fifty randomly selected human cadaveric heart specimens fixed in 10 % formalin were dissected in the customary routine manner. The Thebesian valves were classified according to their shape as semilunar/fenestrated/biconcave band like and according to their composition as membranous/fibromuscular/fibrous/muscular, and the extent to which the valve covered the CS ostium was also noted. An obstructive Thebesian valve that could interfere with the cannulation of the CS was defined as non-fenestrated (semilunar/biconcave band like) and non-membranous (fibromuscular/fibrous/muscular) valves covering >75 % of the CS ostium. Thebesian valves were present in 118 (79 %) heart specimens, of which 27 (18 %) met the criteria of being obstructive. Semilunar was the most common type of Thebesian valve in terms of shape and was observed in 65 (65/118; 55 %) hearts. This type was associated with the least mean craniocaudal (7.9 ± 0.6 mm) and mean transverse (6.25 ± 0.6 mm) diameters of the CS ostium. The mean craniocaudal diameter of the CS ostium (9.4 ± 2.1 mm) was significantly larger (p = 0.004) than the mean transverse diameter (7.15 ± 1.5 mm) in specimens with Thebesian valves, and the cranial margin of the CS ostium was free from any attachment of the Thebesian valve in all the types observed (in terms of shape). Hence, attempts to direct the tip of the catheter toward the cranial margin of the CS ostium under direct vision may lead to successful cannulation of the same when conventional techniques have been unsuccessful because of the presence of an obstructive Thebesian valve.     

Weights of the heart in northwest Indian adults

Weights of apparently normal hearts were obtained from 1,344 male and 313 female adults from the Chandigarh region of northwest India, on whom a medicolegal autopsy was performed. The average weight of the heart was 296.7 ± 48.5 gm in males and 238.9 ± 45.1 gm in females. Partial correlations between heart weight and body weight and supine length were significant. The correlation between heart weight and age was, however, not statistically significant. Multiple regression constants with standard errors were generated for estimating the weight of the heart for intervals of body weight and supine length in living subjects. © 1994 Wiley-Liss, Inc.     

Comparison of human and porcine aortic valves

We compared the anatomy of human and porcine aortic valves. Porcine hearts were collected from the abattoir. Human hearts from patients who had died of non-cardiac causes were examined in the mortuary; only undamaged and anatomically normal hearts were used. Silicon casts were prepared by injecting engineering silicon at 80 mm Hg into the aortic arch. Various features of the aortic valve were measured: circumference, length between the commissural end point and central point of coaptation, surface diameter, and surface area. In total, 12 porcine and 12 human aortic valves were studied. The average circumferences of the human and porcine aortic valves were 8.00 +/- 0.2 (SD) cm and 7.90 +/- 1.0 cm, respectively. The central point of coaptation in human valves was skewed toward the left coronary cusp, whereas in porcine valves it was skewed toward the non-coronary cusp. In human aortic valves, the non-coronary cusp had the largest surface diameter and surface area with mean measurements of 3.6 +/- 0.2 cm and 1.230 +/- 0.228 cm(2), respectively; the left coronary cusp was smallest for the same variables with measurements of 3.1 +/- 0.3 cm and 0.898 +/- 0.357 cm(2). In porcine valves, the right coronary cusp had the largest surface diameter and surface area with mean measurements of 3.9 +/- 0.7 cm and 1.716 +/- 0.81 cm(2), respectively; the non-coronary cusp was the smallest for the same variables with measurements of 2.9 +/- 0.5 cm and 1.023 +/- 0.659 cm(2). These differences suggest that when using porcine valves as transplant material (e.g., stentless valves), geometric considerations, such as commissural length, may be important.