人腭扁桃体隐窝上皮内小血管的超微结构

用透射电镜观察慢性扁桃体炎患者和胎儿的腭扁桃体隐窝上皮内血管的结构及分布。发现儿童及成人腭扁桃体隐窝上皮内存在着有孔毛细血管，毛细血管后微静脉及由扁平内皮与矮立方内皮构成的过渡型血管。这３种血管周围有淋巴细胞，浆细胞等聚集，可见白细胞贴附或穿越血管壁，在胎儿扁桃体隐窝上皮内有白细胞等浸润，但未见血管，隐窝上皮基膜下组织中毛细胞管丰富，７月龄胎儿可见毛细血管突向上皮内，本研究结果表明，扁桃体隐窝上皮     

Fetal development of the transverse atlantis and alar ligaments at the craniovertebral junction

Although the fetal development of the craniovertebral junction has long been of major interest to embryologists from the viewpoint of segmentation, development of the associated ligaments has received scant attention. Using semiserial horizontal sections from 18 embryos and fetuses (six embryos with a crown-rump length (CRL) of 20-26 mm or ~6-7 weeks of gestation; five fetuses with a CRL of 32-58 mm or 8-9 weeks; seven fetuses with a CRL of 90-115 mm or 14-15 weeks) without any abnormalities of cartilage configuration such as atlas assimilation, we studied the ligamentous structures along and around the odontoid process of the axis. The transverse atlantis and alar ligaments originated from a common mesenchymal condensation possibly corresponding to the proatlas segment: the former started to develop slightly earlier than the latter, and the morphologies of both were established at 7 weeks of gestation. Development of the joint cavitation around the odontoid process began in the mid-anterior area at 6 weeks, but was not fully completed even at 15 weeks (115 mm CRL). The presumptive joint cavity expressed vimentin and CD34 and contained abundant CD68-positive macrophages. We always found a mid-anterior joint cavitation facing the basi-occipital, but the embryological meaning remained unclear. The apical ligament appeared most likely to originate from the notochord sheath. The notochord was exposed from the tip of the odontoid process toward the loose epidural tissue and entered the occipital bone, but was difficult to trace to the anterior surface of the basi-occipital.     

Morphology of the ligament of Treitz likely depends on its fetal topographical relationship with the left adrenal gland and liver caudate lobe as well as the developing lymphatic tissues: a histological study using human fetuses

To investigate the factors affecting the development of the ligament of Treitz, we examined sagittal and frontal histological sections of 35 human fetuses with a crown-rump length of 100–300 mm (approximately 16–38 weeks of gestation). The retropancreatic fascia consistently extended in a layer behind the pancreatic body and the splenic artery and vein, and also in front of the left renal vein and left adrenal. In 18 specimens, a connective tissue band was seen originating from the diaphragmatic crus around the esophageal opening and ending at the retropancreatic fascia to the left of the origin of the celiac artery. In 10 of these 18 specimens, these putative upper parts of the ligament contained striated muscles, or so-called Hilfsmuskel. Although most of other 17 specimens were larger fetuses, the left adrenal, the liver caudate lobe and the celiac ganglion made space for the ligament very limited. In 22 specimens including the above 18, the retropancreatic fascia extended inferiorly to approach the fourth portion of the duodenum (D4) or the duodenojejunal junction (DJJ). However, in 11 of the 22 examples of the putative lower part of the ligament, the connection between the duodenal muscle coat and the fascia was interrupted by developing lymphatic tissues. Consequently, the ligament of Treitz seemed to develop from both pleuroperitoneal membrane-derived cells and the retropancreatic fusion fascia, although the morphology was markedly modified by adjacent structures such as the adrenal gland. The ligament may “recover” after the adrenal becomes reduced in size after birth.     

Neurovascular structures of the ligament of the head of femur

The ligament of the head of femur (LHF), or ligamentum teres, is believed to provide blood supply to the head of femur and mechanical stability to the hip joint. But these functions in the adult are often debated. The existence and distribution of neurovascular structures within the ligament are not widely documented. This study examined the blood vessels and nervous tissue within the LHF to determine whether the ligament may have a vascular and proprioceptive function at the hip joint. Histological sections from the LHF from 10 embalmed hips (six female, four male; mean age 80.4 ± 8.7 years) were cut at three levels: the foveal attachment, mid‐length and its base where it attaches to the transverse acetabular ligament. Sections were stained with haematoxylin and eosin to study general tissue architecture or with von Willebrand factor and neurofilament to identify blood vessels and nervous tissue, respectively. The proportion of the ligament's cross‐sectional area occupied by blood vessels was expressed as a vascularity index (VI). Nerve endings within the ligament were identified and morphologically classified. Comparisons between the VI at the three levels, or between the tissue layers of the ligament, were made using 95% confidence intervals; statistical significance was set P < 0.05. The ligament tissue comprised three distinct layers: a synovial lining with cuboidal cells, a sub‐synovial zone formed of loose connective tissue and the ligament proper composed of dense collagen bundles. Patent blood vessels and nerve fibres were present both in the sub‐synovial zone and the ligament proper; Pacinian corpuscles and free nerve endings were found scattered only in the sub‐synovial zone. The VI of the ligament proper at the fovea was significantly higher than its middle (P = 0.01) and basal levels (P = 0.04); it was also higher than that of the sub‐synovial layer (P = 0.04). The LHF has three histologically distinct zones, and blood vessels and nerves are distributed both in the sub‐synovial layer and ligament proper. Higher vascularity within the ligament proper at its foveal insertion suggests a possible nutritive role of the LHF to the adult head of femur. The presence of nerves and nerve receptors indicates the ligament is involved in the perception of pain and proprioception, thereby contributing to mechanical stability of the joint.     

猪升主动脉几何形态与显微结构的增龄性变化

目的:探讨猪升主动脉几何形态与显微结构成分在增龄过程中的变化规律,为猪→人异种心脏移植吻合血管提供必要的形态学基础。方法:应用组织学和计算机图像分析方法,对42例1～7月龄猪升主动脉进行计量形态学研究。结果:猪升主动脉的管径、壁厚、管腔面积、管壁面积与月龄间呈高度直线正相关关系(r分别为0.98、0.98、0.99、0.99,各P值均<0.001),它们分别以1.54mm月、0.15mm/月、28.26mm~2/月和12.28mm~2/月的速率增加。管壁中胶原纤维含量随之增加(P<0.05);弹性纤维含量以2、3月龄最高,而后维持在相对恒定水平,平滑肌的含量在增龄过程中未见明显变化(P>0.05)。结论:与人类相似,猪升主动脉几何形态、显微结构成分含量与年龄密切相关。     

髋关节冠状断层影像解剖学

目的：为髋关节疾患的影像学诊断提供冠状断层解剖学基础。方法：成年男性右髋部标本5例(新鲜3，常规固定2)．先以解剖骨性标志画线．1例先作髋部冠状位MR1扫描．所有标本冻硬后．切制髋部冠状断层标本．结果：观察每一断层标小髓关节的主要结构、殴骨头韧带，髂股韧带和其周围组织的形态．位置、毗邻的特征及在连续断层的变化规伴；测量结果如下：股骨头垂直径41．2mm，冠状径42．9mm．髋臼冠状径52．7mm．髋臼深度29．6mm．股骨头及髋臼节软骨厚各为3.3mm与2．5mm，股骨头韧带长25．1mm，厚2．6mm．髂股韧带厚7．7mm。结论：髋关节的冠状断层解剖各结构形态、位置及变化规律．为临床骨科、影像学及髋关节镜技术诊断与治疗髋关节疾患，提供了有价值的形态学依据。     

Clinical Anatomy of the Ligament of the Head of Femur

The ligament of the head of femur (LHF) has gained clinical attention recently and is reported to contribute to hip stability. This study explores its morphology and morphometry, information that may help inform surgical decision making. Gross anatomical dissections were undertaken on 229 embalmed hips from European (n = 105) and Thai (n = 124) adult cadavers to examine LHF anatomy. Ligament morphometry was statistically compared at different sites, between sexes and sides. The origin of ligamental arteries and absence of the ligament were documented. The LHF was pyramidal or quadrangular in shape. Sub‐synovial fibrous bands originated from the transverse acetabular ligament, edges of the acetabular notch, and acetabular floor; less frequently from the hip joint capsule. Distally, the ligament flattened and converged onto the fovea capitis. The ligament was 22.3 ± 4.4 mm long and was significantly wider (P = 0.001) and thicker (P = 0.0003) at the fovea, compared to its mid‐zone. Branches of the obturator artery entered the acetabular foramen inferomedially and penetrated the middle third of the LHF. Blood vessels ran within the LHF and appeared to enter the fovea. The ligament was absent in 2.8% of Thai hips and there were no significant sex or side differences in ligament dimensions. The morphology of the LHF is complex. While individual variation was apparent, blood vessels were seen in the distal ligament. Precise information on LHF morphometry and attachment sites will help inform appropriate graft dimensions and choice of fixation sites necessary for ligament reconstruction. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.     

髌韧带与膝交叉韧带的血供及其在交叉韧带损伤重建中的意义

目的　探讨髌韧带和膝交叉韧带的血供特点,为临床韧带重建提供形态学依据。 方法　通过成人和胎儿股动脉红色乳胶灌注并解剖剥离、胎儿墨汁灌注组织透明和组织切片等方法,观察髌韧带和膝交叉韧带的动脉分布特点并测量胎儿韧带内微血管密度。 结果　髌韧带的动脉来自膝下外动脉、胫前返动脉、膝降动脉和膝下内动脉的分支;胎儿髌韧带不同区域微血管密度不同,且以韧带中心部为最低。前、后交叉韧带的动脉分别来源于膝中动脉、髌下脂肪垫以及膝下外动脉的分支。多数韧带内血管沿长轴走行,同时也有横向交通的小血管,血管网呈梯状或平行的丛状。近侧端和远侧端较密而中间部相对稀疏。 结论　①髌韧带和膝交叉韧带均存在中心部乏血管区;②韧带两端血供最丰富,且近侧段好于远侧段;③髌韧带血供优于膝交叉韧带,髌韧带重建交叉韧带具有血供基础。     

半月板的相关结构及其血供的临床意义

57例膝半月板相关结构的观察结果显示:膝横韧带出现率为50%,呈粗大、中等和线状三种类型。该韧带可使内、外侧半月板形成一个功能整体以防损伤。半月板股骨韧带出现率为70%,长3.6cm,横径4.3mm,其存在可能是外侧半月板易损伤的原因之一。外侧半月板前角与前交叉韧带之间的纤维束出现率为70%,纤维稀疏。上三种结构含丰富的血管,具有修复损伤的良好条件。半月板滑膜缘覆于半月板上、下两面的周边,宽1～2mm,其组织疏松,血管丰富,有助于伤裂半月板的修复。     

髂腹股沟入路相关解剖学研究

目的：为髂腹股沟入路如何避免易损伤结构提供解剖学依据。方法：对20侧成尸骨盆标本,按照手术进路的层次对相关结构和神经血管进行解剖观测。结果：（1）髂外血管与闭孔血管的吻合支直径为（2.56±0.72）mm,与耻骨联合的距离为（52.41±8.12）mm。（2）股神经由腰大肌和髂肌间穿出处至腹股沟韧带间的距离为（32.58±3.97）mm,在穿腹股沟韧带处与腹股沟韧带的垂直距离为（14.33±3.00）mm。（3）坐骨神经出骨盆时,与坐骨大切迹的距离为（15.53±3.6）mm。结论：在手术先后显露耻骨上支、髂窝及坐骨大切迹时,注意不要损伤髂外血管与闭孔血管的吻合支、股神经和坐骨神经。     

Development of the human sphenomandibular ligament.

The development and arrangement of the sphenomandibular ligament of 60 human embryos and fetuses were studied. Meckel's cartilage appeared as a single, continuous fibrous structure lying between the mandibular lingula and the malleus of the middle ear in fetuses of 210 mm crown-rump length (22 weeks of age) and over. This structure constitutes the malleolomandibular ligament, and two clearly differentiated portions bound by the tympanosquamosal fissure could be seen: a juxtaarticular portion, inserted on the posterior edge of the interpterygoid aponeurosis, and a tympanic portion, onto which the disc of the temporomandibular joint inserted. Some of the authors consider that if tension is applied to the sphenomandibular ligament this may injure the middle ear. The anatomical arrangement of the sphenomandibular ligament could explain these injuries.     

Embryonic development of the posterolateral structures of the knee

The development of the structures in the posterolateral corner of the knee was studied in fifteen human embryos and seventeen fetuses by means of serial sections in the coronal and sagittal planes. The attachments of the lateral meniscus and fibular head to the popliteal tendon and muscle are formed during the process of cavitation that forms the bursa. The connection between the tendon and the posterior border of the lateral meniscus forms obliquely to follow the direction of the muscle and tendon. The edge of the bursa is limited by attachments that connect the tendon to the lateral meniscus and fibular head. In this study, no direct ligamentous continuity was found to exist between the posterolateral femur and tibia during development. The only ligament that indirectly connects the lateral femur posteriorly to the proximal segment of the tibia, which has never been reported in human development, is the one that links the popliteal tendon to the fibular head. We have designated this the popliteo fibular ligament which was also found in adult specimens. This ligament should not be confused with the arcuate popliteal ligament.     

Blood supply of human fetal teeth

Injection studies were made of the blood vessels of developing human teeth, using 114 unfixed aborted fetuses and new-born infants ranging in gestation age from three through nine months. These specimens were injected with India ink-formalin, Micropaque-formalin, Microfil, or vinyl acetate solutions via the umbilical vessels; in cases where an autopsy had been performed, injection was made through the carotid artery. After further fixation by immersion in 10% neutral formalin, the head was bisected in the sagittal plane. One half was dissected and tissue obtained for microscopic study; the other half was radiographed, dissected or dehydrated and cleared. These techniques revealed that the plexus of vessels which surrounds the developing dental organs is derived mainly from the inferior alveolar and palatine arteries, respectively. However, branches from vessels in adjacent tissues also supplied this plexus. The teeth growing most rapidly, and which usually erupt the earliest, receive the largest blood supply. Odontoblasts were supplied by vessels which course through the dental pulp to their deeper surface. The ameloblasts were adjacent to vessels in the capillary plexus on the outer surface of the enamel organ. A venous sinus was located at the base of the dental organ.     

腹股沟区淋巴的应用研究

为治疗阴囊和下肢淋巴水肿，选择较满意的淋巴管静脉吻合手术部位提供解剖学依据。方法：在２９具胎儿和６具新生儿新鲜尸体上，采用间接淋巴管注射法，分别从外生殖器和下肢趾噗行间接淋巴管注射。结果；腹股沟浅淋巴结有６－２６个，来自外生殖器的输入管有４－２４条，直径为０．４－０．９ｍｍ；来自一肢的有６－１５条，直径为０．５－１００ｍｍ。     

Fetal Topographical Anatomy of the Upper Abdominal Lymphatics: Its Specific Features in Comparison With Other Abdominopelvic Regions

Using semiserial sections from 19 human fetuses of 8–30 weeks gestation, we examined the topohistology of the upper abdominal lymphatics and compared it with that of the lower abdominal and pelvic lymphatics. The upper abdominal lymphatics were characterized by an intimate relationship with the peritoneal lining, a common mesentery for the celiac trunk and superior mesenteric artery (SMA). Lymphatic connections from the upper abdominal viscera to the paraaortic and paracaval areas followed two routes: (1) from the intestinal mesentery, along the peritoneum on the left aspect of the proximal SMA, via the chain of lymph follicles (LFs) lying along the retropancreatic fusion fascia, to drain into the LFs around the left renal vein; (2) from sites along the peritoneum on the posterior wall of the omental bursa, via the root of the hepatoduodenal ligament, to drain into LFs around the vena cava. The development of these two posterior drainage routes seemed to be promoted by the peritoneum or a peritoneal remnant (i.e., fusion fascia) attaching to the great vessels, and inhibited or impeded by the developing nerves and diaphragm. No paraaortic, paracaval, or pelvic LFs lay along the peritoneum. The pelvic LFs were usually located along the bundle of lymphatic vessels originating from the femoral canal. Anat Rec, 2012. © 2011 Wiley Periodicals, Inc.     

Cell density and cell generation in the periodontal ligament of mice

The number of cell nuclei per mm² and the volume density of cell nuclei and blood vessels in the periodontal ligament at different levels of the mesial root of the first mandibular molar of the adult mouse and in different areas of the ligament at each level have been examined in the light microscope. Significantly higher numbers of cell nuclei per mm² were observed adjacent to bone, cementum, and blood vessels than in the avascular body of the ligament at all levels and on all aspects of the root. This distribution of number of cell nuclei per mm² was constant over 41/2 months of aging and a doubling of body weight. The volume density of cell nuclei was significantly higher in cells adjacent to bone and cementum and in gingival connective tissue than in both the vicinity of blood vessels and the body of the ligament. The blood vessels, which were present predominantly in the bone-related half of the ligament, were absent from the zone immediately adjacent to cementum. The labeling indexes of periodontal ligament cells were determined from autoradiographs of the mesial root of the first mandibular molar of the mouse after pulse-labeling with ³H-Tdr. Labeling indexes were highest in zones adjacent to blood vessels, and the labeling index was significantly higher in the middle of the ligament than in zones adjacent to bone and cementum, and consequently was inversely related to cell density.     

The testicular position and descent in developing human

AimThe present study aimed at reevaluating and providing a more comprehensive knowledge of position and descent of the testis.Materials and methodsThe position and descent of testis was studied on 104 male formalin fixed human fetuses in the Department of Anatomy, RIMS, Imphal. The fetuses were dissected and the location of the testes and the extent of the gubernaculum were noted. Special staining was done using Weigert's iron hematoxylin and Van Gieson's stain.ResultsThe testes were located, in the earliest specimen of the present series, retroperitoneally in the lower abdomen at L3–4 level. Left testis was usually at a lower level than the right. Testicular descent was observed earliest at 24 weeks of intra-uterine life (IUL) and 100% successful complete bilateral descent by 36 weeks IUL. Descent through the inguinal canal was rapid and no case of undescended testis was encountered. The testicular descent was symmetrical in majority of the cases except in 7 where the descent was asymmetrical with the left descending earlier. Structural changes in gubernaculum but not its contraction played a role in testicular descent.ConclusionThus, a comprehensive and thorough knowledge of the testicular descent will assist in management of cases related with testis, especially the undescended and ectopic testis.     

成人膝关节前外侧韧带的应用解剖学研究

目的 探究国人膝关节前外侧韧带(ALL)的解剖学特点,为临床膝关节ALL损伤的诊治及手术修复重建提供解剖学依据。方法 由山西医科大学解剖教研室提供的成人膝关节标本19具(膝周组织完好无破损、无畸形及手术外伤史),其中左膝关节9具、右膝关节10具。以膝前外侧为中心逐层解剖至关节囊层,寻找并观察ALL的起止点及走行等解剖学特点,测量并记录ALL的解剖数据,对ALL及其毗邻结构拍照记录,进行定性及定量描述。结果 19具膝关节标本中,17具发现ALL。ALL在中立0°位和屈曲60°并内旋5°位时的长度分别为(34.72±6.35)mm和(39.53±6.80)mm,在股骨侧止点、胫骨侧止点的宽度分别为(7.75±0.71)mm、(9.41±1.19)mm,在关节线处宽度为(6.79±1.01)mm。ALL整体是以宽扁样形态由后上向前下走行于膝关节前外侧缘,在关节线处的厚度为(1.21±0.20)mm;ALL在胫骨处以宽大的扇形结构止于外侧胫骨平台Gerdy结节与腓骨头连线中点偏上、距胫骨软骨缘的垂直距离为(11.62±1.32) mm,其胫骨侧止点距Gerdy结节的距离为(19.95±4.63) mm、距腓骨头的距离为(19.47±3.65) mm,Gerdy结节至腓骨头的距离是(33.82±4.69) mm。结论 ALL是一条位于膝关节前外侧关节囊外的独立非等长韧带结构,起于股骨外上髁的后上方,向前下走行,与外侧半月板体部相连,止于外侧胫骨平台前外部,对维持膝关节旋转稳定性发挥着一定的作用。     

The posterior part of the human cerebral arterial circle (CAC): arterial caliber from gestational weeks 13 to 24

Numerous studies have reported that all components of the cerebral arterial circle in the 4-month-old human fetus are more slender than adult vessels, and of equal caliber. After that period, a degree of caliber differentiation is present, especially at the level of the posterior communicating arteries. The aim of this study was to determine arterial diameters in the posterior part of the fetal cerebral arterial circle from the 4th month (IV) to the 6th (VI). One hundred and seventy-two fetal cerebral arterial circles were examined by means of a surgical microscope. It was determined that average diameters of the left (right) pre-communicating parts of the posterior cerebral artery ranged from 0.30 +/- 0.03 (0.29 +/- 0.02) mm in month IV, to 0.36 +/- 0.04 (0.36 +/- 0.03) mm during month V and up to 0.55 +/- 0.22 (0.50 +/- 0.18) mm in month VI. The average diameters of the left (right) posterior communicating artery ranged from 0.24 +/- 0.02 mm (0.25 +/- 0.02) in month IV, to 0.30 +/- 0.03 mm (0.29 +/- 0.05) during month V and up to 0.38 +/- 0.08 (0.44 +/- 0.10) in month VI. Gender differences between posterior cerebral artery and posterior communicating artery diameters were not significant. Average posterior cerebral artery diameters were significantly larger than posterior communicating artery diameters in months IV and V, but not in month VI. It was established that caliber differentiation in the posterior part of the cerebral arterial circle began from gestational month IV, and that gender differences in arterial diameters were not significant until month VI of gestation.     

结节间沟及其毗邻结构断层解剖学研究

目的本文旨在研究肱二头肌长头脱位的机制以及相关手术方法提供结节间沟和其毗邻结构的解剖学基础。方法成人尸体肩关节部标本3例,制成1.0～1.5 mm厚的水平位、矢状位、冠状位火棉胶连续切片。结果①肩胛下肌肌腱发出之后沿肩关节囊前方走行,在小结节前侧,与关节囊紧密结合,横过结节间沟,扩展到大结节外侧面与冈上肌肌腱指点相融合。②肱二头肌长头通过结节间沟部分表面由肌腱腱鞘所包绕。③结节间沟出口平面,喙肱韧带内侧分支和盂肱上韧带形成复合体结构,加强肱二头肌长头内侧。结论①肩胛下肌肌腱不止于小结节,而是越过结节间沟表面和冈上肌肌腱止点融合;②喙肱韧带和盂肱上韧带是防止肱二头肌长头脱位的重要的结构之一;③手术治疗此种损伤造成的肱二头肌长头脱位应重建其解剖学结构,以防止再脱位的发生。