椎动脉起点异常一例

成尸 ,女 ,身高 15 9ｃｍ ,发育正常 ,解剖操作时发现左侧椎脉发自主动脉弓。本例主动脉弓自左向右依次发出头臂干、左颈总动脉、左椎动脉和左锁骨下动脉。左椎动脉其始后 ,在左颈总动脉的左后方 ,气管的左侧上行到颈部 ,在颈部走行未见异常。该动脉在其始处外径约 3 0ｍｍ ,穿入横突孔的外径约 2 6ｍｍ ,起始处到穿入横突孔处的长度为 81 0ｍｍ ,沿途无分支。右侧椎动脉起点、走行未见异常。左椎动脉通常起自左锁骨下动脉第一段。而其起点的变异在临床经股动脉插管到左锁骨下动脉行椎动脉插管造影检查或治疗时 ,如找不到左椎动脉开口 ,此…     

右侧椎动脉高位入横突孔变异一例

在局部解剖学实验操作中,发现1例老年男性标本右侧椎动脉走行异常,报道如下. 右侧椎动脉在距右颈总动脉和右锁骨下动脉分叉处0.90 cm,起自右侧锁骨下动脉.右侧稚动脉在起始处外径宽0.45 cm,走行在颈长肌的浅面,走行方向基本与右颈总动脉平行,于环状软骨平面上方4.90 cm处,进入第4颈椎横突孔,末端外径宽为0.42 cm.椎动脉从起始至进人第4颈椎横突孔全长为7.80 cm.左侧椎动脉未见异常.     

左椎动脉发自主动脉弓及其临床意义

椎动脉通常起自锁骨下动脉第1段,在第6～1颈椎横突孔上行经枕骨大孔至颅腔.作者在1例学生局解用男性尸体上见左侧椎动脉发自主动脉弓,现报道如下:主动脉弓自右向左的分支依次为头臂干、左颈总劲脉、左椎动脉和左锁骨下动脉.左椎动脉起始后在左颈总动脉的后方、气管与食管的左侧面上行至颈部,在前斜角肌内侧、椎前肌表面上行,入第4颈椎横突孔,依次经第3～1颈椎横突孔上行至枕骨大孔入颅腔.该动脉起始处外径3.3mm,穿入横突孔处的外径为3.0mm,起始处至穿入横突孔处的长度为97mm,沿途未见分支.同侧的椎静脉于第6颈椎横突孔穿出后注入左锁骨下静脉.右侧椎动脉起源、走行未见异常.左椎动脉起源的此种变异,在临床经股     

右锁骨下动脉分支变异一例

笔者在解剖1例国人成年男性尸体颈部时,观测到右锁骨下动脉分支变异1例,现报道如下.该标本右锁骨下动脉第1段未见椎动脉和甲状颈干,其前下壁距右侧头臂干分叉点20.22mm处发出胸廓内动脉(始端外径10.36 mm);其前上壁距右侧头臂干分叉点26.12mm处发出颈升动脉(始端外径4.82 mm),紧贴前斜角肌内侧缘向后上方上升,行走在前斜角肌的表面,至颈总动脉分叉水平.右锁骨下动脉第2段距右侧头臂干分叉点32.22mm处发出甲状腺下动脉(始端外径3.84 mm),沿前斜角肌内侧缘上行,转而向内在颈升动脉、右迷走神经、右颈总动脉的后方达甲状腺下极,沿途发出2个小分支;锁骨下动脉后上壁距右侧头臂干分叉点49.68mm处发出颈深动脉(始端外径7.50 mm);锁骨下动脉上壁距右侧头臂干分叉点37.00mm处发出椎动脉(始端外径11.36mm).     

左侧椎动脉起自主动脉弓一例

在解剖一成年男尸时发现左侧椎动脉起自主动脉弓一侧。变异给椎动脉造影增加了难度 ,故对临床具有一定的参考意义 ,为积累资料 ,现报道如下 :左侧椎动脉起于主动脉弓 ,位于左锁骨下动脉与左颈总动脉起始部之间 ,该动脉起始部距左锁骨下动脉根部 2 .7mm,距左颈总动脉根部 2 .2 mm。左侧椎动脉从主动脉弓发出后先行于左颈动脉鞘外侧 ,直行一段后行至左颈动脉鞘后方 ,向上穿经第 6颈椎横突孔 ,其后的行径与正常椎动脉的走行一致。左侧椎动脉起始部自然状态下的外径为 3 .2 mm,起始部至穿入第 6颈椎横突孔处的长度 (即椎前段 )为 78.5mm。左侧椎…     

左椎动脉变异伴双侧甲状腺最下动脉共干一例

正解剖1具老年男性尸体时,见其左椎动脉起自主动脉弓,双侧甲状腺最下动脉共干起自头臂干,该变异较为少见,为积累国人解剖学数值,现报道如下。主动脉弓发出4支分支,从右至左依次为头臂干、左颈总动脉、左椎动脉和左锁骨下动脉。左椎动脉外径为2.54 mm,距左颈总动脉左侧7.18 mm处发出,在左颈总动脉(外径7.26 mm)和左锁骨下动脉(外径7.18 rnm)之间于颈长肌前方、甲状腺下     

椎动脉椎前部的解剖研究及其临床意义

在正常情况下，椎动脉在胸膜顶前斜角肌间隙内上方发自锁骨下动脉第一段，于颈前方上行，穿经第6颈椎（C6）及其上各颈椎的横突孔后出现于枕下三角，再经过寰枕后膜经枕骨大孔入颅，最后与颈内动脉分支共同组成椎一基底动脉系。椎动脉按其行程可分为四部分，即椎前部、横突部、寰椎部和颅内部。其中椎前部是指椎动脉自其起始处至进入颈椎横突孔之间的一段。目前对于椎动脉其它三段的研究较多。本文对椎动脉的起始部位、进入横突孔的部位及其起始部位的外径进行了观测，以期为颈椎手术提供参考。     

右锁骨下动脉起始异常二例

例一:一岁左右女尸,死因不明,全身检查无其他异常。主动脉弓位置正常,右颈总动脉适于气管之前发出,右上方斜行,于第六顼椎处至气管右缘。并发出右椎动脉,繞气管右侧进入第六颈椎横突孔。左颈总动脉紧靠前者之左侧起始。在左颈总动脉与左锁骨下动脉之间,有左椎动脉直接起于主动脉弓,几乎垂直上升,进入第四颈椎横突孔。右锁骨下动脉为主动脉弓最末分支,起于主     

胸锁乳突肌锁骨头锁骨瓣修复下颌骨缺损的应用解剖

目的:为带胸锁乳突肌锁骨头为蒂锁骨瓣移位术提供解剖学基础。方法:在40侧成人尸体标本上,解剖观察胸锁乳突肌的形态,血供来源,分布特点及其与锁骨的关系;2例新鲜标本上作模拟术式。结果:胸锁乳突肌血供丰富,其锁骨头的主要血供为甲状腺上动脉胸锁乳突肌支,外径1.52±0.1mm,其入肌点相当于胸锁乳突肌前缘中下1/3交界处;锁骨内侧端主要血供由甲状腺上动脉胸锁乳突肌支(82.5%)的骨膜支及其与颈横动脉(10%)或肩胛上动脉的锁骨支(2.5%)构成的丰富吻合支供血。结论:以胸锁乳突肌锁骨头带半片锁骨瓣转位修复下颌骨缺损是可行的。     

双侧椎动脉变异1例

<正>作者在解剖一具成年的男性标本时,发现其两侧的椎动脉起始及行程异常,现报道如下(图1):主动脉弓外径26mm,于凸部自右向左发出头臂干、左颈总动脉、左椎动脉、左锁骨下动脉4大分支,其外径依次为:11.4 mm、7.6mm、5.0mm、6.4mm。左椎动脉长77mm,与左锁骨下动脉起始部紧靠,相互向上移行3.0mm后分开,与椎静脉伴行沿气管食管外侧前斜角肌内侧上行,于3.5mm处发出1肌支,外径1.3mm,营养椎前肌,向上穿第5-1颈椎横突孔经枕骨大孔入颅。     

Anatomical study of the vertebral artery in japanese adults

The aim of the present study was to examine the vertebral arteries. The origins of the right and left vertebral arteries and their entrance points into the cervical transverse foramen were examined in dissections of 515 Japanese cadavers (303 males, 212 females) at Kurume University School of Medicine from 1990 to 2003. There were 515 right vertebral arteries and 514 left vertebral arteries. The right vertebral artery originated from the right subclavian artery in 514 of 515 arteries and one of the arteries arose from the bifurcation of the brachiocephalic trunk. The mean distance between the origin of the right subclavian artery and the right vertebral artery was 20.9 mm. The left vertebral artery originated from the left subclavian artery in 484 of 514 arteries and the mean distance between the origin of the left subclavian artery and the left vertebral artery was 32.1 mm. The remaining 30 arteries (5.8%) originated from the aortic arch between the left common carotid artery and the left subclavian artery and this frequency is similar to previously published data. There was no right-left difference for the entrance point of the vertebral arteries into the cervical transverse foramen and the 6th cervical vertebra (C6) was the most common entrance point. Seventy-eight percent of our cases had right and left vertebral arteries that originated in the subclavian arteries and entered the cervical transverse foramen at C6. Among the 30 left vertebral arteries that originated from the aortic arch, 20 arteries (66.7%) entered a cervical transverse foramen at a level higher than C6. This frequency was higher than that for the left vertebral artery that originated from the subclavian artery.     

Abnormal origin of internal thoracic and vertebral arteries

The aim of this study was to evaluate the variability of the origin of the internal thoracic and vertebral arteries after a cadaver demonstrated abnormal origins for both vessels. The arteries were studied in 60 adult cadavers and measurements taken to adjacent structures. In one cadaver the right internal thoracic artery originated from the third part of the subclavian artery (one of 120 arteries; 0.83%). The same cadaver presented with the left vertebral artery originating directly from the aortic arch between the left common carotid and left subclavian arteries. Two other cadavers also presented with abnormal vertebral arteries, making it three of 60 left vertebral arteries (5%). These results are comparable to the established range in the literature. The internal thoracic artery is used for revascularization in coronary artery diseases and as this area is also used for subclavian vein catheterization, it is important to be aware of this rare variation concerning the internal thoracic artery. This study reports an important variation in the origins of the internal thoracic and vertebral artery in a singular cadaver. Clin. Anat. 11:33–37, 1998. © 1998 Wiley-Liss, Inc.     

下颈椎血供的解剖研究及其临床意义

目的为颈椎前路减压手术中减少出血量,改善显露和减少手术并发症的发生提供解剖学基础。方法在15具成人尸体标本上,解剖观测C3～7椎体前后部血供的起源、走行、分支及吻合。结果椎体前部血供来自颈升动脉脊支、甲状腺下动脉和颈深动脉脊支,C4～7椎前动脉在椎体上的分支相互吻合,在颈长肌的内侧缘处常吻合成一纵行动脉链;椎体后部血供来自椎间动脉发出的椎后动脉,其分支在颈椎体后部吻合形成节段性弧形动脉吻合链。结论阻断术椎的椎前动脉及其与相邻椎前动脉的纵行动脉吻合,并在颈椎后部减压时注意对硬膜囊外侧缘及椎体中部处的椎后动脉及其分支的处理,可减少颈椎前路减压手术的术野出血,改善手术显露。     

The terminal insertional segments and communications of the vertebral nerve in the human cervical region

Twenty-four cadavers (48 sides) were used to clarify the terminal insertional segment and communications of the vertebral nerve in the cervical region under a surgical microscope. After displacing the prevertebral muscles (longus colli and longus capitis) laterally, the ventral parts of the transverse foramen of vertebrae (from C2 to C6) were removed, and the insertional segment and communicates of the vertebral nerve surrounding the vertebral artery were observed. The results showed: (1) the vertebral nerve ascended along the ventral or mediodorsal vertebral artery and terminated mainly at C3 (22/36 sides) but not terminated at C4 or C5 only; (2) the superficial communicates from the cervical sympathetic trunk ran in a proximal and distal direction when the fibers entered the anterior branches of the cervical nerves. The fibers running to the proximal direction communicated with the vertebral nerve in the part of transverse foramen; (3) motor and/or sensory rami supplying the prevertebral muscles, corpus vertebrae and intervertebral discs could pass through an "arched-shaped" fiber bundle on the ventral surface of the vertebral artery. In conclusion, the vertebral nerve and the fibers surrounding the vertebral artery could be considered as a stable deep pathway of cervical sympathetic nerves. The deep pathway (vertebral nerve and its branches) with the superficial pathways (cervical sympathetic trunk and its branches) formed a sympathetic nervous "plexus" in the cervical region. This sympathetic nervous "plexus" may be involved in the effects of cervical ganglionic blockade.     

Anomalous origin and cervical course of the vertebral artery in the presence of a retroesophageal right subclavian artery

The vertebral artery is usually described as the first branch of the subclavian artery, originating medial to the scalenus anterior muscle. During its cervical course, the vertebral artery presents a prevertebral segment and then enters the foramen transversarium of the sixth cervical vertebra. We describe a case of an unusual origin and course of the right vertebral artery in a cadaver specimen wherein the right vertebral artery originates from the right common carotid artery at the inferior border of the thyroid gland. In its cervical course the vertebral artery ascends outside and anteriorly to the foramen transversarium of vertebrae C VI to C III, and enters the foramen transversarium of the axis. In the same specimen, a retroesophageal right subclavian artery is also present. These vascular abnormalities are presented for physicians to keep in mind such variations during diagnostic investigation and surgical procedures of the neck.     

Right-Sided Aorta: A cadaver report and brief discussion of human aortic arch anomalies

We observed an unusual right-sided aorta during routine laboratory dissection. The short aortic arch passed to the right side of the esophagus and trachea and had four branches, from proximal to distal: left common carotid, right common carotid, right subclavian, left subclavian arteries. The ligamentum arteriosum connected the pulmonary trunk to the left subclavian artery and lay to the left of the esophagus and trachea. The left recurrent laryngeal nerve passed under the ligamentum arteriosum while the right recurrent laryngeal nerve passed under the aortic arch. The descending thoracic aorta was situated near the midline, anterior to the vertebral bodies; consequently, the right posterior intercostal arteries were shorter than normal. The large veins of the thorax and the other thoracic organs appeared normal.     

Anomalous origin of both vertebral arteries

The authors describe a case of an unusual origin of both vertebral arteries in a singular cadaver. On the left, the artery arises directly from the common trunk of vertebral and subclavian artery at the aortic arch and enters the transverse cervical foramina at C VI. On the right, the artery originates from the right common carotid artery and enters the transverse foramina at C III. Additional anomalies were observed on the aortic arch: the common trunk of both common carotid arteries, the common trunk of the left vertebral and subclavian artery, and as a last branch, the retroesophageal right subclavian artery. The morphometric measurements of the vertebral arteries were performed. The literature on the variations of the vertebral arteries is reviewed and their clinical importance for diagnostical procedures and head and neck surgery stressed. Clin. Anat. 12:281–284, 1999. © 1999 Wiley‐Liss, Inc.     

Aortic arch origin of the left vertebral artery

Complications from anterior approaches to the cervical spine are uncommon with normal anatomy. However, variant anatomy might predispose one to an increased incidence of injury during such procedures. We hypothesized that left vertebral arteries that arise from the aortic arch instead of the subclavian artery might take a more medial path in their ascent making them more susceptible to iatrogenic injury. Fifty human adult cadavers were examined for left vertebral arteries having an aortic arch origin and these were dissected along their entire cervical course. Additionally, two radiological databases of CTA and arteriography procedures were retrospectively examined for cases of aberrant left vertebral artery origin from the aortic arch over a two‐year period. Two cadaveric specimens (4%) were found to have a left vertebral artery arising from the aortic arch. The retrospective radiological database analysis identified 13 cases (0.87%) of left vertebral artery origin from the aortic arch. Of all cases, vertebral arteries that arose from the aortic arch were much more likely to not only have a more medial course (especially their preforaminal segment) over the cervical vertebral bodies but also to enter a transverse foramen that was more cranially located than the normal C6 entrance of the vertebral artery. Spine surgeons who approach the anterior cervical spine should be aware that an aortic origin of the left vertebral artery is likely to be closer to the midline and less protected above the C6 vertebral level. Clin. Anat. 30:811–816, 2017. © 2017Wiley Periodicals, Inc.     

Right vertebral artery as the fourth branch of the aortic arch

The present report describes an anomalous case of the right vertebral artery arising as the last branch of the aortic arch identified in a 76-year-old Japanese male cadaver during dissection in the anatomical laboratory of Kanazawa Medical University. The aortic arch itself coursed normally but the right vertebral artery was uniquely situated at the fourth branch next to the brachiocephalic artery, the left common carotid artery, and the left subclavian artery. The anomalous right vertebral artery branched into the esophageal branch, the prevertebral branch, and the second right posterior intercostal artery, and finally entered the first costotransverse foramen at the thoracic region as it passed upward through the first to the seventh transverse foramina of the cervical vertebra. The left vertebral artery was normal. The development of the right vertebral artery may be described as follows: (i) the distal portion of the right dorsal aorta, which usually disappears, persisted and became united, via post-costal longitudinal anastomosis; (ii) the right dorsal aorta between the seventh and eighth intersegmental arteries lost its connection to the main structure; and (iii) the fusion of the originally paired dorsal aorta extended around the 11th segment, which was two segments away from the normal portion of the structure.