胫后动脉腓动脉变异1例

患者男性 ,30岁 ,因“右小腿被电线杆砸伤 6ｈ”入院。查体 :右小腿中下段前侧可见多个不规则皮肤裂伤 ,创腔内有散在碎骨块 ,渗血。右足凉 ,足背动脉和胫后动脉搏动消失。右足感觉丧失。初步诊断 :(1)右胫前后动静脉损伤 ;(2 )右胫腓骨中下段粉碎性骨折。急诊行“血管探查吻合术”。术中见 :胫后动静脉断裂 ,动脉血管外径 1.5ｍｍ ,于胫神经内侧伴行 ,近断段可见胫骨骨膜分支 ,踝上 10ｃｍ胫后动脉走向前内分布于内踝内侧 ,踝上 6ｃｍ有一分支与腓动脉相通。胫神经外侧方 2ｃｍ处腓动静脉断裂 ,动脉血管外径 2 .0ｍｍ ,于小腿下段走向内侧 …     

胫前胫后动脉终端发育不全1例

胫前胫后动脉终端发育不全１例苑芳昌①葛文学①王卫中①胫前、胫后动脉终端发育不全的解剖学变异较少见，作者偶遇１例，经血管造影和手术探查证实，报道如下：女性，４０岁，农民，因左小腿车祸挤压伤致左胫腓骨中下段粉碎性骨折伴胫前皮肤软组织缺损，急诊于当地某医院...     

动脉高位分支伴腓动脉发出胫前动脉一例

女尸,约60岁,右下肢动脉于肌上缘处(肌下缘上方5 2 .7mm)分为胫前动脉和胫后动脉。胫前动脉于肌表面下行至肌下缘处发出腓动脉后,穿过小腿骨间膜至小腿前区;胫前动脉胫后段起始处外径3 .8mm ,穿入骨间膜处2 .7mm ;长度为5 6.9mm。腓动脉起始处外径2 .8mm ,在腓静脉的外侧下行于足母长屈肌与腓骨之间,沿途发支至腓骨和邻近肌肉。胫后动脉起始处外径3 .4mm ,与同名静脉、胫神经伴行,下行于小腿浅深两层肌肉之间,沿途未见腓动脉分支。腓静脉注入腓侧胫后静脉。左下肢动脉、腓动脉未见异常。国人资料表明,动脉末端平面最高在肌上…     

腘动脉高位分支伴腓动脉发出胫前动脉一例

女尸，约60岁，右下肢腘动脉于腘肌上缘处(腘肌下缘上方52．7mm)分为胫前动脉和胫后动脉。胫前动脉于腘肌表面下行至肌下缘处发出腓动脉后，穿过小腿骨间膜至小腿前区；胫前动脉胫后段起始处外径38mm，穿入骨间膜处2．7mm；长度为56．9mm。腓动脉起始处外径2.8mm，在腓静脉的外侧下行于足母长屈肌与腓骨之间，沿途发支至腓骨和邻近肌肉。胫后动脉起始处外径3．4mm，与同名静脉、胫神经伴行，下行于小腿浅深两层肌肉之间，沿途未见腓动脉分支。     

CTA发现单侧腓动脉胫后动脉变异1例

<正>腓动脉是小腿的重要血管之一,腓动脉穿支皮瓣已在临床上被广泛运用。CT血管造影(CTA,CT angiography)检查被证实是术前设计皮瓣的可靠方法之一~([1,2])。在1例患者的双下肢CTA检查中,发现其左侧腓动脉及胫后动脉发生变异,现报道如下。本例患者,男,38岁,主因"右手机器伤清创术后3天"入院。入院诊断:右手背皮肤缺损并肌腱外露。拟行游离腓动脉穿支皮瓣移植修复术。为保证     

胫前动脉缺如1例

患者男,３５岁。因左小腿被石块砸伤２ ｈ于１９９８年１２月５日入院。查体：左小腿中下１／３处不规则裂口,畸形,异常活动,有碎骨块外露,足远端血运良好。ｘ线检查示左胫腓骨粉碎骨折。诊断：左胫腓骨开放粉碎骨折。急诊清创外固定支架固定。术后左小腿中下 １／３处胫前皮肤坏死,约 ８ ｃｍ ｘ １０ ｃｍ,行右侧胫后动脉为蒂的小腿内侧皮瓣游离移植修复。术前检查右足背及胫后动脉搏动良好,做交通试验示足背及胫后动脉通畅。术中见右胫后动脉于小腿下１／３处与胫神经分离并走向前外侧,到小腿骨间膜处再折回内踝后与胫神经一同…     

双侧胫后动脉腓动脉变异一例

<正> 作者在解剖1例成人男性经福尔马林液固定的教学标本过程中发现其双侧胫后动脉和腓动脉变异,现报道如下: 双侧下肢胫后动脉缺如,其供血区域由腓动脉所代替。     

回结肠动脉发出变异脐动脉1例

回结肠动脉发出变异脐动脉１例庞玉田①王建武②彭东②薛延军②唐继林②在解剖一成年男性标本时，见回结肠动脉发出一支变异的右侧脐动脉，报道如下：正常脐动脉仍然发自左、右髂内动脉，远部成索状，已形成脐外侧襞。变异的右侧脐动脉，起自回结肠动脉的回肠支，全长２２...     

胫前动脉及腓动脉变异1例

作者在解剖一具老年女性尸体标本时发现该尸体左足背动脉来源于腓动脉穿支,胫前动脉及腓动脉亦有变异[1].仔细观察其走行和毗邻,测量其管径,并用数码相机拍照,现报告如下.     

异常闭孔动脉1例

在解剖一老年女性盆腔血管标本时，发现其闭孔动脉出现变异情况，现报道如下（图1）。     

胫前动脉踝上皮支皮瓣的显微外科解剖

目的 :报道胫前动脉踝上皮支皮瓣的显微外科解剖学基础。方法 :在 14侧经动脉灌注红色乳胶成人下肢标本 ,解剖观测胫前动脉踝上皮支的起始、走行、外径、长度及分支等 ,2侧成人下肢标本灌注墨汁观察该皮支的墨染范围。结果 :胫前动脉踝上皮支于踝间连线上方 ( 3 .5± 0 .6)cm自胫前动脉发出 ,然后向小腿内侧方向绕过胫骨前缘分出升支和降支 ,升支紧贴胫骨前内侧骨面 ,向内上方向行至一段距离后穿深筋膜入皮。踝上皮支长 ( 2 .1± 0 .6)cm ,起点外径 ( 1.1± 0 .2 )mm ,伴行静脉 2条。升支入筋膜前外径 ( 0 .4± 0 .1)mm。降支向内下方向走行 ,并与踝前血管网吻合。结论 :胫前动脉踝上皮支是胫前动脉在小腿踝上部的主要皮血管 ,分支营养骨膜 ,可在小腿中下段设计以此血管为蒂的皮瓣、骨膜瓣、骨膜皮瓣或骨皮瓣。     

A vermian artery originating from the posterior cerebral artery: an anatomical case report

During the dissection of a posterior fossa in a cadaveric head, we found a solitary superior vermian artery (VA) originating from the posterior cerebral artery (PCA). On the right side, the VA arose from the precommunicating segment of the PCA. The VA distributed by giving off some branches to the interpeduncular fossa, cerebral peduncle, midbrain, cerebellar cortex, inferior colliculus, lingula, vermis and superior medullary velum. The right superior cerebellar artery (SCA) had a normal origin from the basilar artery (BA) and supplied the righ tentorial surface of the cerebellum by means of bifurcating into two major trunks. The left SCA had duplicated origin from the BA.     

肾动脉少见变异1例

在解剖一具成年女性标本时，见其两侧肾动脉起始、走行和分支异常，均有副肾动脉的变异（图1），此种变异较少见，报道如下：     

The medial branch of the lateral branch of the posterior ramus of the spinal nerve

In the needle insertion of epidural anesthesia with the paramedian approach, the needle can pass through the longissimus muscle in the dorsum of the patients. When the needle touches a nerve in the muscles, the patients may experience pain in the back. Obviously, the needle should avoid the nerve tract. To provide better anesthetic service, analysis of the structure and where the concerned nerves lie in that region is inevitable. Material and method: We studied five cadavers in this study. Two cadavers were fixed with Thiel’s method. With these cadavers, we studied the nerve running of the posterior rami of the spinal nerve from the nerve root to the distal portion. Three of them were used for the study of transparent specimen, with which we studied the course and size of the nerve inside the longissimus muscle. Results: We observed there were three branches at the stem of the posterior rami of the spinal nerves between the body segment T3 and L5, i.e. medial branch, medial branch of the lateral branch and lateral branch of the lateral branch. The medial branch of the lateral branch supplied to the longissimus muscle. With the transparent specimen, we found that there were different nerve layouts between the upper thoracic, lower thoracic, upper lumbar, and lower lumbar segments in the medial branch of the lateral branch in the longissimus muscle. In the lower thoracic and upper lumbar segments, the medial branch of the lateral branch of the upper lumbar segments produced layers nerve network in the longissimus muscle. L1 and L2 nerves were large in size in the muscle. Conclusion: In the upper lumbar segments the medial branch of the lateral branch of the posterior rami of the spinal nerve produced dense network in the longissimus muscle, where the epidural needle has high possibility to touch the nerve. Anesthetists have to consider the existence of the medial branch of the lateral branch of the posterior rami of the spinal nerve when they insert the needle in the paramedical approach to the spinal column.     

外踝长度短缩时踝关节应力改变的研究

目的：分析外踝长度短缩与踝关节稳定性的关系,探讨创伤性踝关节炎发生的生物力学机制.方法：选取8例新鲜冷冻尸体下肢,分别在外踝正常长度、短缩1/3、短缩2/3和短缩3/3的情况下,测量和分析胫距关节的接触面积和应力变化.结果：正常的胫距关节接触区呈三角形,外踝短缩后胫距关节接触区向外侧移位,胫距关节接触面积明显减小.胫距关节面平均应力明显增加,以向前、内、外侧压力增高最为显著,且应力随外踝短缩程度的加重而增加.结论：外踝正常长度是维持踝关节稳定性的重要指标.因此,在处理踝关节损伤时应尽可能恢复外踝的解剖长度.