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.     

股骨头韧带的研究进展

股骨头韧带是髋关节内的一个重要结构 ,由于位置深在 ,普通影像学及临床查体不容易对其进行细致的观察 ,因此长期以来未受到人们的普遍关注。迄今 ,人们对股骨头韧带结构与功能的认识仍停留于浅显的水平 ,对其是否具有生物力学功能争议较大 ,对其病损的临床表现、治疗与转归更是知之甚少。本文就现有对股骨头韧带研究及文献进行综述如下 :1　股骨头韧带的形态股骨头韧带为髋关节囊内扁平的三角形纤维带 ,基底部附着于髋臼横韧带及髋臼切迹两部分 ,尖部连续股骨头凹的前上部 ,韧带周围有滑膜包绕。此韧带的发育程度常因人而异 ,有时可完全缺…     

Definition of the capsular insertion plane on the proximal humerus

The aim of this work was quantitatively to establish the relationship between the plane that hosts the humeral head lateral margin (anatomical neck) and that of the capsular insertion. Eight cadaveric shoulders were used. These were dissected, exposing the humeral head margin and the root of the capsular humeral insertion to extract digitally their outlines using a mechanical 3-d digitizer. The datasets of the digitized outlines were applied and the geometric planes they best fitted mathematically calculated. Vector analysis techniques were finally applied to the two planes to quantify the relationship between them. The humeral head margin is circular (± 2.2% of radius), having each of its outlining points on the same plane (within ± 1.5 mm.) The capsular attachment outlining points also insert on a plane (± 1.4 mm). The two planes are related to one another by an inclination of 14.5 ± 3.6°. The relationship described here would allow for in vivo prediction of humeral attachment of capsular structures by using radiological datasets of the anatomical neck. This would be useful in patient-specific modelling to study and understand the glenohumeral ligament kinematics during clinical examinations and to plan surgical reconstructive procedures.     

冠脉分支交错分布的研究

为了证实大白鼠的冠脉分支在心肌中相互交错分布的问题,我们在大白鼠的冠脉左室支和左旋支之间,将心肌的外2/3层作阻断性处理。结果阻断线两侧的局部血流量出现明显的对称性下降。这种变化很可能是由于阻断了向对侧互相交错分布的冠脉分支引起的,因此可以认为,大白鼠冠脉分支在心肌中是互相交错分布的。     

Associations of isokinetic and isotonic knee strength with knee function and activity level after anterior cruciate ligament reconstruction: a prospective cohort study

Background

Although isokinetic dynamometry often serves as a reference to assess the concurrent validity of weight-machine isotonic strength testing, it is unknown whether isokinetic knee strength is associated with knee function and activity level more strongly than isotonic knee strength in patients with an anterior cruciate ligament reconstruction (ACLR). This study aimed to compare the associations of isokinetic and isotonic knee strength with knee function and work-and-sports activity levels in patients with ACLR.

Femoral head of the rectus femoris muscle

Variability of the muscles of the anterior thigh is minimal. After review of the extant medical literature, we believe this to be the first reported case of a femoral head of the left and right rectus femoris muscles. In addition to this anomaly, our anatomic specimen demonstrated an accessory head of the right brachialis muscle and the quadratus plantae muscles inserted into the tendons of both the flexor hallucis longus and flexor digitorum longus. In clinical practice, knowledge of the possibility of an anomalous accessory femoral head of the rectus femoris muscle in clinical practice would be useful for those who might palpate this unusual muscle or encounter it surgically.     

成人阴茎血管的分布特点及其意义

目的：为临床阳萎手术治疗、阴茎再植等提供形态学基础。方法：应用血管铸型法对７例新鲜成人阴茎制作血管铸型标本，然后进行观察和测量。结果：阴茎背动脉为２支，环动脉１０～１８支。阴茎背深静脉起源于冠后丛静脉，半数以上为双支，为一支较粗的主支和一支较细的副支，在阴茎根部汇成一支主干。环静脉仅在远端２／３出现，起于尿道海绵体上表面，汇入背深静脉。４例在阴茎海绵体两侧各有１条或两条侧静脉。结论：环静脉起于尿道海绵体上表面，而不是阴茎海绵体；阳萎的手术治疗，应注意阴茎血管的分布特点，以防并发症的发生或影响手术效果。     

The prenatal development of the human femur

The study reported here is the result of a detailed investigation of the changes in shape of the femur with growth and torsion, the type, rate and character of ossification, and the onset, subsequent course, and general features of remodeling. Forty pairs of femurs, from a series of embryos and fetuses ranging from 26 to 342 mm in crown-rump length, were measured, radiographed, and sectioned for microscopic study. A primary bony collar was present before the end of the embryonic period, and in a 27 mm embryo it extended for about one-fifth of the length of the femur. Erosion of the collar was evident at 34 mm. and invasion and destruction of calcified cartilage were occurring by 37 mm. Cartilage canals first appeared in the proximal epiphysis at 57 mm and in the distal epiphysis at 61 mm. Along with the progression of endochondral ossification proximally and distally and the establishment of growth zones, periosteal bone formation also proceeded in both directions, and, until 275 mm, extended about 1 mm beyond the zones of cartilage destruction. After 275 mm, the extents of periosteal and endochondral ossification were the same and at term occupied almost four-fifths of the length of the femur. Trabeculation of the bony collar was first noted at 37 mm. Fusion of endochondral trabeculae with the inner aspect of the periosteal shell began by 61 mm. A central marrow cavity free of trabeculae was present at 86 mm and thereafter. Evidence of reconstruction appeared in both proximal and distal ends by 92 mm, and was consistently present in both ends in all specimens of 111 mm and larger.     

椎骨肋头关节肋凹的解剖学及其临床意义

目的:为临床诊治脊柱胸段及胸廓疾患提供解剖学依据并填补国人人类学数据。方法:观察成人成套椎骨标本及新鲜尸体脊柱(C7~T12)。结果:T1上肋凹单独形成肋头关节的占81.8%,T1下~T9上绝大部分为复合肋凹关节面,构成肋头关节肋凹的大部分属上小下大型,少数为上下相等型和上大下小型;其余大部分为单肋凹;T1~T9形成的肋凹大部分上为平面、下为凹面;肋头关节肋凹的位置,C7~T3属体为主型,T4以下逐向后移,T12是根为主型。结论:部分C7和T1形成肋凹关节面;肋头关节肋凹及其位置均有3种类型,T2~T7多为复合球窝形肋凹,其形态变异较多、活动度较大,故易发生劳损、错位。     

以旋髂深血管为蒂的髂骨瓣和血管束联合移植的应用解剖学(治疗股骨头缺血性坏死的新术式)

在41侧成人尸体上观测了旋髂深血管的起始和外径。依据旋髂深血管的髂骨支和腹壁肌支的局部解剖学,设计了以旋髂深血管为蒂的髂骨瓣和血管束联合移植治疗股骨头缺血性坏死的新术式,并讨论了该术式的意义及应用解剖学要点。     

Initial stage of vascular bed development in telencephalon of human embryo

It was found that intracerebral blood vessels in human embryo telencephalon first appear on the 7th week of prenatal development as capillaries with poorly differentiated walls and signs of functional immaturity. The formation of the basal capillary membrane consisting of laminin and type IV collagen starts immediately after the formation of primary capillary network. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 129, No. 5, pp. 598–600, May, 2000     

The role of calcium in the mechanism of changes in vascular reactivity due to reserpine

Under the influence of reserpine there is a marked decrease in the calcium concentration in segments of the distal aorta and femoral arteries of rabbits, incubated in salt solution. These changes develop parallel with changes in the character of responses of the vascular segments to direct electrical stimulation (weakening of the effects of contraction, followed by relaxation). A decrease in the calcium concentration in the vascular wall is suggested as one cause of the change in vascular reactivity.All-Union Cardiologic Scientific Center, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR E. I. Chazov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 88, No. 7, pp 45–48, July, 1979.     

胎儿及新生儿骶椎椎体软骨区的血管

用血管灌注和透明法观察了49具新鲜胎儿和新生儿骶椎椎体软骨区的血管。结果表明,软骨区的动脉主要来自骶骨周围的动脉吻合网,这些动脉末端呈球状或串殊状膨大:骶椎软骨区内的静脉大多注入骶椎体前后面的椎静脉丛.静脉起始部也呈现球状或椭圆状膨大。各动脉间以及各静脉间均未见吻合。     

髂股韧带与股骨头韧带黏弹性实验研究

目的 研究新鲜成人尸体髋关节髂股韧带和股骨头韧带的黏弹性力学性质,为临床提供生物力学参数.方法 取正常国人髂股韧带和股骨头韧带各10个试样进行应力松弛、蠕变实验.结果 得出了应力松弛、蠕变实验曲线,以回归分析的方法处理实验数据,得出了回归系数.结论 髂股韧带7200s应力松弛蠕变量显著大于股骨头韧带.     

经后外侧入路仅切断股方肌的股骨头置换术疗效分析

目的　探讨仅切断股方肌的改良后外侧入路与传统后外侧入路行股骨头置换术的近期临床疗效。 方法　选取行单侧人工股骨头置换术的患者60例,其中20例采用仅切断股方肌的改良后外侧入路手术（改良组）,40例实施常规后外侧入路手术（传统组）。比较两组患者的手术时间、出血量、手术前后血红蛋白差值、VAS评分及Harris评分、术后并发症及首次下地时间。 结果　60例患者均顺利完成手术。与传统组相比,改良组术中出血量较少、术后首次下地时间较早、手术时间较长、手术前后血红蛋白差值较小、术后2周髋关节Harris评分较高、术后24 h VAS评分较低,差异有统计学意义（P<0.05）。两组切口均Ⅰ期愈合,传统组1例患者出现术后假体后脱位,予手法复位外展支具固定1月后未再发生脱位。术后半年随访,两组Harris评分无统计学差异（P>0.05）。末次随访时两组均未发生假体松动、感染等并发症。 结论　仅切断股方肌的改良后外侧入路具有围手术期出血少,术后疼痛轻、恢复快等优势,但其远期疗效有待进一步观察。     

活体肾上腺血管的解剖观测及临床意义

目的：研究活体肾上腺血管的应用解剖。方法：对１８例２４侧肾上腺手术时分离出血管，测量血管外径及长度，对６个完整肾上腺灌注染色。结果：右膈下动脉从下腔静脉右缘至末支肾上腺上动脉长８．５（７．５～１１．０）ｃｍ，外径２．５～３．０ｍｍ；左膈下动脉从腹主动脉左缘至末支肾上腺上动脉长８．０（７．０～９．０）ｃｍ，外径２．５～３．１ｍｍ；肾上腺上动脉１～６支，均源于膈下动脉。肾上腺中动脉右侧长１．７～２．２ｃｍ，外径１．０～１．５ｍｍ；左侧长１．５～２．０ｃｍ，外径１．０～１．５ｍｍ。肾上腺下动脉两侧基本相同，长１．５～２．０ｃｍ，外径１．０～２．０ｍｍ。肾上腺中心静脉右侧长０．４～０．８ｃｍ，左侧长３．０～４．０ｃｍ，外径３．０～４．０ｍｍ。结论：肾上腺血管加部分膈下血管的长度可供带血管蒂肾上腺转位治疗柯兴氏病；活体切取供移植的肾上腺；选择性肾上腺血管造影等。