旋股外侧动脉旋髂浅动脉和旋髂深动脉起始变异1例

笔者在解剖一具成年男性尸体时,发现其右侧旋股外侧动脉、旋髂浅动脉和旋髂深动脉的起始变异,为积累资料和为临床提供参考,现报道如下：1.右旋股外侧动脉起于股动脉,起始处外径3.8 mm,距股深动脉起始处2.42cm发出,发出后行向外侧0.85 cm后继而行向下,分支分布于缝匠肌、股直肌、股外侧肌。2.右旋髂浅动脉起于旋股外侧动脉,距股动脉0.85 cm发出,起始处外径1.8mm,发出后行向外上,分布于缝匠肌、阔筋膜张肌。3.正常情况下：旋髂深动脉在距髂前上棘附近分为髂嵴支和腹壁肌支(升之),前者分布至髂嵴及附近肌及皮肤,后者分布至肌。本例右旋髂深动脉起于股动脉,起始处外径为3.0 mm,距腹股沟韧带1.22 cm,以短干发出后分为上、下两支,起始处外径分别为2.4 mm、2.2 mm。上支向上穿腹股沟韧带后行向外上,分布于髂肌和腹横肌的下份内面,上支起始段还发出两较大分支,分布于耻骨肌;下支行向外上于腹股沟深面入腹内斜肌和腹横肌之间,分布于此二肌的下份。     

旋股外侧动脉与旋髂深动脉共干起始一例

在教学过程中,在一例女性成人左下肢标本上,见其旋股外侧动脉与旋髂深动脉共干起自股动脉。为给临床有关术式提供参考,现报道如下:左旋股外侧动脉、旋髂深动脉共干平腹股沟韧带中点深面从股动脉外侧发出,共干长约5mm、起始处外径为3.8mm,距共干起点约5mm 处发出左旋髂深动脉,外径为1.9mm。该动脉沿腹股沟韧带后面斜向外上走行,至髂     

股深动脉起自髂外动脉伴分支异常1例

股深动脉起始于髂外动脉 ,实属罕见。教学过程中 ,在一例经红色乳胶灌注的成人女尸上 ,发现其右侧股深动脉高位起始 ,并分支异常动脉。现报道如下 :股深动脉在腹股沟韧带中点上方 1.2ｃｍ处起自髂外动脉 (附图 ) ,其外径 9ｍｍ ,总干长 5.3ｃｍ ,伴股动脉外侧下行。在腹股沟韧带中点下方 1.5ｃｍ处 ,股深动脉向内侧发出阴部外动脉 ,外径 1.0ｍｍ ,穿筛筋膜内侧行 ,分布于阴阜 ,大阴唇 ;同时向外侧发出旋髂浅动脉 ,外径 1.2ｍｍ ,向外上斜行至髂前上棘附近 ,分布于皮肤和浅筋膜。距髂前上棘 9.9ｃｍ ,腹股沟韧带中点下方 5.5ｃｍ处 ,旋股内 ,…     

双侧股深动脉及旋股外侧动脉变异一例

笔者在解剖1具中年男性尸体标本时,发现其双侧股深动脉及旋股外侧动脉均有变异,较为罕见,现报道如下,供解剖学和临床参考. 右侧股动脉(外径为0.90 cm)在腹股沟韧带下方4.1 cm处的后壁发出股深动脉,起始部外径为0.52 cm.同时,在此处由股动脉外侧壁发出1条旋股外侧动脉,起始部外径为0.55 cm,旋股外侧动脉发出后行向外下方2.85 cm后,随即发出5条终支,即1条升支(外径为0.36 cm)、2条横支(外径均为0.40 cm)和2条降支(外径分别为0.20 cm和0.40 cm).股深动脉主干下行4.30 cm处发出旋股内侧动脉,起始部外径为0.30 cm.在此行程中均有静脉伴行.     

少见的旋股外侧动脉分支异常一例

正笔者在解剖一具男性尸体下肢时,发现旋股外侧动脉发出的分支有异常,具体如下:股动脉在腹股沟韧带下方4 cm处分出股深动脉,股深动脉发出旋股内、外侧动脉和穿动脉,旋股外侧动脉发出3支分支,其中一支降支直接向下进入股直肌上段。股动脉再向下延伸4 cm处,发出另一支旋股外侧动脉降支(直径约3 mm),该动脉自股动脉后侧分出2个分支:一升支细小(直径约2 mm),斜向下进入股直肌;一降支较粗,继续下行6 cm     

股深动脉变异二例

笔者在解剖2具标本时,发现股深动脉变异,查阅文献,该变异较少见,为积累国人体质调查资料,现报道如下. 变异1:40～50岁女性标本.右侧股深动脉缺如.股动脉起始处外径为8.14mm,旋股内侧、外侧动脉平腹股沟韧带高度直接发自股动脉.旋股外侧动脉起始处外径为5.00mm,在缝匠肌和股直肌的深面分为升、横和降支;旋股内侧动脉起始处外径为5.36mm,经髂腰肌与耻骨肌间向后走行.右侧穿动脉直接发自于股动脉后壁.对侧同名结构无任何异常.变异2:30～45岁男性标本.     

双侧旋股外侧动脉变异一例

<正>笔者在解剖1具中年男性尸体标本过程中,发现其双侧旋股外侧动脉均有变异,较为罕见,现报道如下。右侧股动脉(外径9.6mm)距腹股沟韧带下方29.0 mm处于其内下方发出股深动脉(外径5.5 mm),股深动脉下行15.5 mm处于其内下方发出旋股内侧动脉(外径3.1 mm),股深动脉继续下行42.0 mm处于其内下方发出穿动脉。在股动脉距腹股沟韧带下方6.0 mm处于其外下方发出旋股外侧动脉(外径4.5mm),旋股外侧动脉斜向外下方走行51.0 mm处于其外侧发出旋股外     

右侧股动脉分支变异一例

正笔者在解剖1具中年男性尸体时,发现右侧股动脉分支变异,为丰富国人解剖学数据资料,现报道如下。右侧股动脉(外径11.1 mm)在腹股沟韧带中点深面接续髂外动脉,在起始处立即向外上方发出1条变异升支(外径3.2mm);股动脉主干继续下行,在腹股沟韧带下方8.1 mm处,向外下方发出旋股外侧动脉(外径3.4 mm)。旋股外侧动脉向外下方行走7.2 mm处,向外侧发出1横支,继续下行21.1 mm     

股动脉分支变异标本一例

笔者在解剖1具中年男尸时,发现股动脉分支存在多处变异,现报告如下.本例变异尸体为男性,50岁左右,身高约170 cm.通过解剖暴露股三角,分离股动脉及其分支,观察动脉走行,游标卡尺(精度0.05 mm)动脉管径,照相记录.本例标本右侧股动脉(外径10 mm)在腹股沟韧带下方5 cm处的内侧发出股深动脉,起始部外径为8mm,股深动脉发出后随即跨过股神经转向外下,然后走行于股前群肌之间,分布于股四头肌深层.股动脉本干下行4 cm处发出旋股外侧动脉,起始部外径为8 mm(而在该部位的股动脉外径为7 mm),随即发出2支升支(外径为3 mm)、1支横支(外径为2 mm)和2支降支(外径为3.5mm).在此行程中均有静脉伴行.     

腹股沟区皮瓣的血管——一、旋髂浅动脉和静脉的巨微解剖

教科书和不少文献提及的旋髂浅动脉只有一支,即浅主支,忽略了还具有一条恒定的深主支。本文共观察50例标本,由旋髂浅动脉干分为浅、深两主支的占56％。浅主支的出现率为86％,发出后迅速穿深筋膜进入浅层,穿出点多在以股动脉起点外侧15毫米、向下10毫米处为中心的附近。浅主支的行程以股动脉起点下15毫米处与髂前上棘的连线为轴线,末支多转入腹外侧部。浅主支主要分布于腹股沟外侧半的两侧。深主支恒有,其行程以腹股沟韧带下15毫米处一条与韧带平行的线为轴线,末支多转入臀部,主要分布股外侧部上份和臀部。深主支穿深筋膜处,多在髂前上棘之下20毫米处的附近。旋髂浅动脉两主支起始处的管径各与其分布的范围大小密切相关。旋髂浅静脉的走向和旋髂浅动脉的一个主支相似,或在两主支之间(70％)。讨论了采用有关皮瓣的轴、厚薄和范围等问题。     

股深动脉及旋股外侧动脉起始行程异常1例

有关股深动脉的行程变异报道较少，仅见陈子华、刘万胜报道2例，笔者在解剖成年一男性标本时见其右侧股深动脉行程特殊,报道如下：     

旋股内侧动脉解剖在股骨颈骨折患者临床疗效中的评估意义

[摘要]目的 评估旋股内侧动脉（MFCA）的解剖结构对股骨颈骨折内固定术后股骨头血运的影响及临床疗效分析。方法 回顾性分析苏州大学附属太仓医院2014年1月至2019年1月收治的股骨颈骨折患者,筛选其中行超选数字减影血管造影（DSA）检查并最终行内固定治疗的患者共81例,根据旋股内侧动脉的起源分为股深动脉组（65例）和股动脉组（16例）,比较两组旋股内侧动脉开口处内径及流速,分析两组手术时间、复位质量、骨折愈合时间、末次髋关节功能Harris评分及并发症发生情况,对比分析MFCA不同解剖结构对影像学及临床结果的影响。结果 本组共纳入行内固定治疗股骨颈骨折患者81例,所有患者均已行DSA检查,按照旋股内侧动脉解剖起源分为股深动脉组和股动脉组。两组患者在性别、年龄、骨折类型组成以及血流动力学数据方面均无显著差异。所有患者获得18 ～ 23（19.26±4.17）个月的随访,均获得骨折愈合,截至末次随访,股深动脉组有5例发生股骨头坏死,股动脉组有2例发生股骨头坏死。股深动脉组患者平均手术时间（37.81±12.44）min,股动脉组平均手术时间（34.35±10.49）min;股深动脉组复位质量优44例,良18例,可3例;股动脉组复位质量优12例,良3例,可1例;股深动脉组骨折愈合时间为（17.63±6.26）周,股动脉组骨折愈合时间为（18.02±4.79）周;股深动脉组患者末次随访平均Harris评分（85.74±7.06）分,股动脉组患者末次随访平均Harris评分（82.03±6.19）分。术后所有指标比较,差异均无统计学意义。结论 旋股内侧动脉解剖起源存在变异,但是其在血流动力学方面无明显差异,对股骨颈骨折内固定治疗的疗效及总体预后无显著影响。     

Rare origin of the inferior epigastric artery from an anomalous medial circumflex femoral artery

Mathes & Bostwick (1977) surgically manipulated the rectus abdominis myocutaneous flap to repair defects in the anterior abdominal wall. Subsequently this flap was used in breast reconstruction (Robbins, 1981; Hartrampf et al. 1982) as a donor for free-tissue transfer (Bunkis et al. 1983) and to repair defects in the groin (Logan & Mathes, 1984; Ramasastry et al. 1989). Disadvantages of this flap are that it can be too thick to use effectively and a direct abdominal hernia may occur through the inguinal triangle (Mathes & Bostwick, 1977; Pennington & Pelly, 1980; Ramasastry et al. 1989; Itoh & Arai, 1993). To overcome these disadvantages the rectus abdominis and the fascia covering the inguinal triangle must be intact. Surgeons therefore harvested the inferior epigastric skin flap for free-tissue skin transfer; this flap contained little or no rectus abdominis muscle or transversalis fascia (Koshima & Soeda, 1989). Previous investigators determined the anatomical basis for the use of this skin flap and used it to repair defects following resection of ulcers and scar tissue on the head, neck and extremities (Itoh & Arai, 1993).     

Anatomical variants of the lateral femoral circumflex artery: an angiographic study

The descending branch of the lateral femoral circumflex artery (LFCA) has found recent use as a new arterial graft for coronary artery bypass grafting (CABG). Anatomical variants of the LFCA were assessed on femoral arteriograms obtained before CABG in 131 adult patients. The most common pattern, found in 78.6% of extremities, consisted of the LFCA arising from the deep femoral artery, and the arterial graft was selected from this pattern in 92.3% of patients in whom the descending branch of the LFCA was used for CABG.     

Clinical significance of understanding lateral and medial circumflex femoral artery origin variability

The common femoral artery (CFA) divides into the superficial femoral artery (SFA) and deep femoral artery (DFA). The lateral circumflex femoral artery (LCFA) and medial circumflex femoral artery (MCFA) are most often branches of the DFA, although a large number of different variations in their origin has been described. We performed microdissection on both lower limbs of 30 fetuses, gestational age from 7 to 10 lunar months. Our results show that the LCFA and MCFA usually arise from the DFA. In 78.3% of cases, the MCFA originated from the DFA. In 11.7% of cases, the MCFA originated from the CFA, and in 5% of cases from the SFA. One case showed a common trunk with the DFA. Also, the MCFA was missing in one case, and it had a common trunk with the LCFA in one case. In 83.3% of cases, the LCFA arose from the DFA and in 6.7% of cases from the CFA. In one case, it had a common trunk with the DFA, and in one case with the MCFA. In 3.3% of cases, the LCFA was missing. In 66.7% of cases, both arteries originated from the DFA, in 15% of cases one originated from the DFA and the other from the CFA or SFA. Our results are in accordance with some published studies but also differ from the outcomes of other studies. Comprehensive knowledge of different variation types is imperative in order to prevent complications during surgical and orthopedic interventions.     

旋股外侧动脉降支骨膜支为蒂的股骨中上段骨膜瓣的应用解剖

目的 :提供以旋股外侧动脉降支骨膜支骨膜瓣转位治疗股骨颈骨折、股骨头缺血性坏死和股骨干中下段骨不连的解剖学基础。方法 :在 3 2侧灌注红色乳胶的成人标本上 ,对旋股外侧动脉降支骨膜支的起始走行、分支分布进行解剖学观测 ;2侧新鲜标本注入墨汁观察骨膜支的供血范围。结果 :88%的降支发自旋股外侧动脉 ,其骨膜支于降支起始 4.0± 1.1cm处发出 ,外径 1.2± 0 .5mm ,长 7.1± 1.8cm ,经股内侧肌与股中间肌之间或穿股中间肌 ,分布于股骨中上段前内侧骨膜。结论 :以旋股外侧动脉降支骨膜支为蒂的骨膜瓣 ,可顺行修复股骨头颈骨折 ,逆行修复股骨中下段骨不连、股骨头缺血性坏死。     

闭孔、旋股内侧和腹壁下动脉共干1例

作者在解剖一具成年女性盆腔标本时，发现其右侧闭孔、旋股内侧和腹壁下动脉异常，报道如下（图1）。