双侧膈神经走行异常伴卡压1例

在解剖一成年男性尸体标本时发现双侧膈神经走行变异并伴有明显卡压,现报道如下：     

正中神经肘部走行变异一例

在一例女性左肘部刀伤手术中,发现正中神经肘部走行变异,未见有类似报道。为积累资料,报告如下:患者女性,18岁,因左肘部刀砍伤入院。体查:左肘窝上2.5cm 见一外上内下斜行伤口长6cm,肱二头肌腱、腹移行处完全断裂,     

双侧甲状腺下动脉走行异常1例

双侧甲状腺下动脉变异较为罕见,笔者在制作标本时,发现双侧甲状腺下动脉走行异常1例。查文献此类报道罕见,为积累解剖学资料,现报告如下。1材料与方法经10%福尔马林固定的成年男尸1具,身高156 cm。常规方法解剖显露颈部结构时,发现其双侧甲状腺下动脉走行异常,仔细观察动脉的起始、走行及其与毗邻结构间的关系,认真测量动脉的起止点外径及长度,详细做好记录并用数码相机拍照。     

右侧正中神经走行异常一例

笔者在1具男性老年尸体右侧上肢进行局解操作时,发现其正中神经走行异常,极为少见.现报道如下.该正中神经是由起自臂丛内、外侧束的正中神经内、外侧根在腋动脉的前内侧汇合而成.此后正中神经于腋、肱动脉的内侧下行至臂中部行于肱动脉的外侧,至臂下部,肱骨内、外上髁连线中点上方13.1 cm处,由肱动脉外侧经其后方至动脉内侧.此处(正中神经与肱动脉交叉处)平对第6肋.其他未见异常.     

86例肘部尺神经卡压神经-肌电图结果分析

鉴于肘部尺神经卡压的某些症状易与运动神经元病(MND)、胸廓出口综合征(TOS)等相混淆及双卡的存在,我科肌电图室于2007年制定了一套完整的肘部尺神经卡压的神经-肌电图诊断方案,用以区别TOS、腕尺管段尺神经卡压或双卡、腕管、MND等.通过两年来对我科收诊的86例92侧临床拟诊肘部尺神经卡压应用此电诊断方案进行诊断,准确率达100%.本文介绍了这一电诊断方案,并比较诊断肘部尺神经卡压各电诊断参量的敏感性,更好地对卡压点精确定位.同时结合检查结果对诊断过程中出现的某些问题予以讨论.     

双侧睾丸动脉走行变异1例

笔者在解剖一具成年男尸时发现,右侧睾丸动脉穿过下腔静脉深面,左侧睾丸动脉勾绕左肾静脉沿其浅面下行(如图1).现报道如下: 右侧睾丸动脉在右肾动脉起点下方约0.5cm处,以直角起自腹主动脉的右前外侧壁,向右行于下腔静脉深面(此段睾丸动脉上邻右肾动脉下缘,下贴右肾静脉上缘),约行经4.2 cm,在右肾静脉汇入下腔静脉外侧壁形成的夹角处跨过右肾静脉浅面向下走行,并与同名静脉会合,经腰大肌和输尿管浅面下行进入右侧腹股沟管.     

双侧椎动脉走行异常及左椎动脉压迫星状神经节1例

笔者在解剖1具男尸过程中,发现其两侧椎动脉起始处走行均异常,且与交感神经节关系密切。现为积累解剖学资料,报道如下。10%甲醛固定的男尸1具,年龄约60岁,身高约162 cm,解剖出颈部各层次,充分暴露及修洁颈部的血管、神经,观察拍照,并测量血管外径及长度。本例标本左、右两侧椎动脉均起自锁骨下动脉,呈“S”形上行。左侧椎动脉自发出处即开始向内前方弯曲,然后向外前方上行,最后向内走行进入第六颈椎横突孔;右侧椎动脉先竖直上行1.04 cm后由内弯向外,再向内前方旋转,之后向内上走行进入第六颈椎横突孔(见图1①-④)。     

肘部尺神经卡压的解剖学研究进展

肘部尺神经卡压的解剖学研究进展彭峰①综述陈德松①审校肘部尺神经卡压，又称创伤性尺神经炎、迟发性尺神经炎、肘管综合征等，是临床上最常见的尺神经卡压病变，也是最常见的上肢神经卡压症之一。早在１８７８年，Ｐａｎａｓ就对本病作了描述。但直到Ｆｅｉｎｄｅｌ（１...     

臂丛神经走行变异1例

患者女,26岁。因右手尺侧麻木,疼痛,大小鱼际肌萎缩2年入院。X线片示右第7颈椎横突肥大,左则颈肋。入院诊断“胸廓出口综合症”。入院后在肌间沟阻滞麻醉下行右第7颈椎肥大横突切除及前斜角肌切断术。术中见前斜角肌挛缩肥大,压迫粘连锁骨下动脉,锁骨下动脉距第1肋高度约1.8cm,经斜角肌三角穿出,臂丛神经被纤维束带包绕,经斜角肌。三角表面,前斜角肌外缘垂直下行,与锁     

腋神经走行变异1例

在解剖一具成年(约30岁,身高约175 cm)男性尸体时,发现右侧腋神经部分穿行于肩胛下肌中,查阅文献,未见此类变异的描述,现报道如下: 此例标本右侧腋神经从臂从后束发出1.28cm后,有一段长约2.13cm的腋神经穿行与肩胛下肌内,穿入段宽度为4.59mm,穿出段宽3.7mm,穿出肩胛下肌后走行约2.3cm后伴旋肱后血管穿过四边孔.     

双侧下腹壁隐睾1例

解剖一具成年（约30岁）男性标本时，见其两侧睾丸位置异常（图1），此种变异较少见，报道如下。     

低位尺浅动脉1例

在解剖一具成年男性标本时，发现其右侧低位尺浅动脉，桡动脉发骨间总动脉的异常，此种变异较为少见。现报道如下：     

Bilaterality of ulnar neuropathy at the elbow.

The electrodiagnostic records of 49 patients with ulnar neuropathy at the elbow (UNE) on at least one side were reviewed. Of these, 18 (36.7%) had contralateral and 1 (2.0%) had probable contralateral involvement, for a total of 19 patients (38.8%) with bilateral UNE. The upper extremity presenting symptoms were unilateral in 13 (68.4%) of the patients with bilateral UNE. Differences in associated clinical history data and concurrent electrodiagnostic findings were not clinically or statistically significant between the unilateral and bilateral UNE groups. This pilot study suggests the incidence of UNE bilaterality may be high in some populations and that, when UNE is encountered electrodiagnostically, the contralateral extremity should also be tested. Further studies to determine what factors are related to the bilaterality of UNE appear indicated.     

肘部副脊索瘤一例

患男,22岁。发现右肘部伸侧肿物2年余,外伤后肿物增大10d于2005年6月入院。体检2cm×2cm×1cm皮下肿物,质韧,界清,活动,无压痛,与周围组织无粘连。临床诊断：纤维囊肿？术中见肿瘤位于肘后皮下,与关节囊有粘连。肿物实性,有包膜,完整切除。[第一段]     

Schwannomatosis involving peripheral nerves: a case report

Schwannomatosis or neurilemmomatosis has been used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF-2). In our case, schwannomatosis, multiple schwannomas were present in a 21-yr-old woman with no stigmata or family history of NF-1 or NF-2. She had no evidence of vestibular schwannoma or other intracranial tumors. Multiple peripheral tumors were found in the carotid space of the neck, and soft tissue of posterior shoulder, lower back, ankle and middle mediastinum. All of those tumors were completely limited to the right side of the body. All surgically removed tumor specimens in this patient proved to be schwannomas.     

Unique distribution by the peroneal nerves: a case report

Purpose

Among the branches of common peroneal nerve, the superficial peroneal provides cutaneous innervation to major part of the dorsum of the foot and deep peroneal nerve supplies the skin over the first interdigital cleft region.

Methods

The present rare case was observed during routine dissection of leg for undergraduate students, in a 52-year-old male, formalin fixed cadaver.

Results

The superficial peroneal nerve provided solely motor branches to peroneus longus and brevis, whereas cutaneous branches were provided by deep peroneal nerve. In the lower one-third of the leg deep peroneal nerve divided into medial and lateral branches. The medial branch supplied tibialis anterior and the lateral branch supplied skin of medial three and half toes. Moreover, the sural nerve supplied the skin of lateral one and a half toes.

Conclusion

Awareness of this type of variations in the course of nerves helps to alert the surgeons when there are complaints of atypical or unique pain in that particular region.     

Bilateral total renal dysplasia: a case report

Bilateral total renal dysplasia is an extremely rare congenital anomaly associated with Potter's facies. We report an autopsy case of a stillborn male child. Histopathology is showing persistence of structures not seen in normal development.     

双侧巨大胸小肌1例

我们在对一具年龄28岁的男性尸体进行解剖的过程中，发现其双侧胸小肌异常巨大，报道如下：     

尺浅动脉变异1例

尺动脉是前臂前区的重要血管,在解剖1例女性标本时,见其右侧尺动脉的分支及走行变异。与以往见到的尺动脉变异不同[1,2],此例尺动脉走行变异较为罕见,报道如下。
　　本例标本于肱动脉(外径4.00 mm)在肘窝内发出桡动脉和尺动脉之前,约平肘窝上界处发出1条尺浅动脉(图1),起始处外径为1.20 mm。此动脉行经掌长肌腱下方并与之相交,大部分走行于前臂前群肌的浅面,经屈肌支持带的浅面及手腕中部到达手掌,在腕部尺浅动脉的外径为0.7 mm。尺浅动脉进入手掌后,斜行横过手掌与桡动脉的掌浅支吻合形成掌浅弓,掌浅弓分支正常。肱动脉还发出外径为3.74 mm的骨间总动脉,在距肱动脉末端5.39 cm处,骨间总动脉发出尺动脉深支,尺动脉深支与尺神经伴行止于豌豆骨上部。通过对掌深支的解剖发现,此标本掌深支为桡动脉穿第1骨间背侧肌进入手掌后,穿过拇收肌横、斜头之间到达骨间肌深面与营养小指短肌及小指对掌肌的血管吻合形成,随后分支成正常掌心动脉。     

双侧高位尺浅动脉变异1例

在正常情况下,腋动脉自第1肋外缘由锁骨下动脉延续而来,至背阔肌下缘续为肱动脉;肱动脉在下行途中发出肱深动脉、尺侧上副动脉、尺侧下副动脉等分支,互肘窝桡骨颈平面分为桡动脉、尺动脉两支.作者在解剖一老年男尸时发现其左、右两侧尺动脉高位分支,右侧高位尺动脉在肘平面处通过一交通支与肱动脉相连,同时肱动脉发出桡动脉、骨间总动脉,其变异形式较罕见.现报道如下: