髂总动脉分支及其临床意义

在78具成年尸体上详细观察了髂总动脉的分支。髂总动脉外侧支的出现率为30.76%,多起于髂总动脉远侧1/3段(43.33%),始端外径为2.38±0.06(0.90～4.20)mm.起自髂总动脉的髂腰动脉的出现率为10.26%,也多起于髂总动脉远侧1/3段,其始端外径为3.03±0.14(2.50～3.80)mm。记录了此两支动脉的走行和分布,并讨论了它们的临床意义。     

髂内动脉及其分支的观察

测量了 90侧成人尸体髂内动脉及其分支和输尿管数值 ,解剖观察了髂内动脉分支的起源、髂内动脉与输尿管及子宫动脉与输尿管的关系。为国人体质调查积累资料 ,同时也为经髂内动脉插管及结扎双侧髂内动脉和子宫动脉时 ,保护输尿管提供临床应用数据。结果如下 :1　材料与方法1 2　成年尸体 45具 (90侧 ,男 5 0 ,女 40 )。对髂内动脉及其分支用游标卡尺进行了测量。2　结果和讨论2 1　髂内动脉及其分支测量数值 ,见表 1。表 1　髂内动脉及其分支的测量 ( ｘ±ｓ ｘ ,ｍｍ)测量项目 侧别 男 (左 2 5 ,右 2 5 ) 侧别显著性 女 (左 2 0 ,右 2 0 …     

髂总动脉和髂外动脉弯曲畸形1例

髂外动脉是髂总动脉的直接延续,很少发生畸形.作者在指导临床医学本科生局部解剖时,发现l例髂总动脉和髂外动脉弯曲畸形,为积累国人体质资料,给临床检查、诊断与治疗提供参考.现报告如下. 1资料与方法 10％的福尔马林固定的男尸1具,约45岁,身高155 cm,发育正常,双下肢对称等粗,外观无任何畸形.解剖显露腹后壁及盆部的腹主动脉、髂总动脉、髂外动脉,用量角器测量其夹角,游标卡尺测量其径线.     

髂总动脉分支穿髂总静脉变异1例

笔者在解剖一具老年男性尸体时 ,发现其右侧髂总动脉分支穿髂总静脉隧洞的异常 (附图 ) ,现报道如下 :右侧髂总静脉在走行于腰大肌表面的部位出现一隧洞 ,洞口为一卵圆形裂孔。该裂孔长轴为 1.5ｃｍ ,与静脉平行 ,短轴为 0 .7ｃｍ ;近侧端距左右髂总静脉汇合处 5 .5ｃｍ ,远侧端距右侧髂内静脉与髂外静脉汇合处4 .3ｃｍ。右侧髂总动脉在距左右髂总动脉分叉处 4 .1ｃｍ的部位发出一动脉 ,穿过该隧洞进入腰大肌 ,上行并分支于腰大肌。该动脉直径为 0 .5ｃｍ ,距隧洞近侧端 0 6ｃｍ ,远侧端 0 .4ｃｍ。进一步解剖显示 ,该动脉沿腰大肌上行与第…     

多处动脉行程显著曲折各一例

解剖发现肱、腋、肾和髂总、髂外动脉以及脾动脉行程显著弯曲的中年女尸1例。该例左侧肱动脉和腋动脉呈波浪状。左肾动脉前支在入肾门之前环绕左肾静脉呈近似“0”形。左侧髂总动脉向外侧弯曲呈弧形。左髂外动脉在冠状面呈“S”形。同结构右侧均无明显异常。该例脾动脉从腹腔干     

下腔静脉变异一例

正在对标本进行解剖的过程中发现下腔静脉异常走行1例,现报道如下。标本为老年男性1例。解剖前标本保存完好,表面结构完整。采用人体非测量性观察和人体测量学方法,对比正常解剖学结构进行分析。右侧髂总静脉沿同侧髂总动脉左后下方走向左髂总静脉,于腹主动脉分叉处下方,左髂总动脉后方相汇于左髂总静脉。     

右髂总动脉弯曲畸形一例报道

<正>笔者在解剖一具40岁男性尸体标本时,发现其右侧髂总动脉有弯曲畸形,现报道如下。成尸发育正常,双下肢对称等粗。动脉弯曲畸形有一处,为右髂总动脉跨越左、右髂总静脉分叉处。左侧髂总动脉主干及左、右髂总动脉的分支无异常。畸形中点距离右髂总动脉根部约8.8 cm,距离肠系膜下动脉根部约15.8 cm,距离右髂内动脉和髂外动     

老年组与中成年组髂外动脉的形态学比较

本文观微和测量了50具国人髂外动脉(左右合计100侧),并将所有观测项目按年龄分为老年组(60岁以上者)和中成年组(19—60岁)进行了统计学处理。结果发现:髂外动脉的长度、外径、髂外动脉与髂内动脉之间的夹角以及髂外动脉的弯曲程度在老年组与中成年组之间均有高度显著性差异。     

指掌侧总动脉与指掌侧总神经的关系及其临床意义

目的:探索指掌侧总动脉及其分支是否对指掌侧总神经形成卡压,为临床诊断和治疗提供解剖学基础。方法:选用60侧手,在手掌部解剖,观测指掌侧总动脉的出现率、记录指掌侧总动脉分支出现的数量、分支对指掌侧总神经骑跨的数量、指掌侧总动脉对指掌侧总神经骑跨的数量,及指掌侧总神经被骑跨处的形态学观察,并对数据进行统计学分析。结果:60侧手指掌侧总神经在与指掌侧总动脉及其分支骑跨处有5例发现压痕的形态学改变,占指掌侧总动脉及其分支数量的10.3‰。统计结果为样本P=1.47%,样本标准误Sp=0.65%,卡压率:(1.47±0.65)%,95%的可信区间为(0.20%-2.74%)。结论:指掌侧总动脉可以造成指掌侧总神经的卡压,是导致指掌侧总神经卡压的原因之一。     

新生儿肝动脉的解剖学研究

用解剖剥离的方法对50例新鲜新生儿尸体的肝动脉及分支作了观察测量,测得肝总动脉长8.94±3.27mm;外径1.99±0.31 mm;肝固有动脉长4.89±3.35 mm;外径1.81±0.61mm,同时对胃右动脉和副肝右动脉的起源及迷走肝动脉作了观察和分析.     

带臀上血管深上支蒂的髂骨移位修复股骨颈疾患的应用解剖

观察了31具(男24,女7)经红色乳胶灌注的成年尸体及8侧下肢血管铸型腐蚀标本,证明了以臀上动脉深上支为蒂的髂骨移位修复股骨颈的可行性,分析了移位的优缺点及其它有关问题。     

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。     

吻合双血管蒂髂骨瓣移植修复下颌骨巨型缺损的应用解剖

本文设计了吻合旋髂深血管和髂腰血管髂支的髂骨瓣移植修复下颌骨巨型缺损的新术式,并在41侧成人尸体上对有关血管进行了观测。依据观测结果,对手术操作中有关应用解剖学的要点进行了讨论。     

Variation of Origin of Obturator Artery in Eastern Indian Population - A Study

Obturator artery is a medium-calibre parietal branch of internal iliac artery having wide variations in its origin. Since there was no previous investigation of variations of origin of obturator artery in a large series of eastern Indian subjects, it was decided to undertake this study. 56 pelvic halves from formaldehyde preserved cadavers were dissected in Calcutta National Medical College, Kolkata and B.S. Medical College, Bankura over a period of 3 years. Obturator artery originated in maximum number (44.6%) of cases from the anterior division of the internal iliac artery, the next common site (23.2%) being the inferior epigastric artery. Relatively late appearance of the obturator artery amongst the branches of internal iliac artery is most likely to be the cause of such a wide variation.     

多血管神经蒂腹内斜肌瓣修复面瘫的解剖学基础

目的：为多血管神经蒂腹内斜肌瓣修复晚期面瘫提供解剖学基础。方法：在３６侧成尸标本上,对腹内斜肌的形态、血供及神经支配进行解剖观测。结果：腹内斜肌中部上１／２肌腹主要由第１１肋间神经支配,下１／２肌腹主要由肋下神经支配。上１／２肌腹的血供６６．７％来自第１１肋间后动脉,３３．３％来自旋髂深动脉的髂嵴支;下１／２肌腹的血供主要来自旋髂深动脉的腹壁肌支。第１１肋间神经、肋下神经在腋后线横径分别为２．２ｍｍ和２．４ｍｍ,入肌点距腋后线长分别为１３．３ｃｍ和１３．８ｃｍ。第１１肋间后动脉在腋后线外径为１．７ｍｍ,入肌点距腋后线长为１３．１ｃｍ;旋髂深动脉腹壁肌支和髂嵴支的起始外径分别为１．３ｍｍ和１．８ｍｍ,入肌点至起点长分别为５．１ｃｍ和８．６ｃｍ。结论：吻合多血管神经腹内斜肌瓣移植可全面修复晚期面瘫     

Anatomic basis of vascularised nerve grafts: the blood supply of peripheral nerves

The present study was carried out on 30 cadavers (5 fresh, 20 preserved adult and 5 fresh stillborn) following injection of red latex through the subclavian and common iliac arteries. The blood supply to the peripheral nerves was studied in general, together with the vascular pedicles to the ulnar, saphenous, sural, deep and superficial peroneal nerves, and the superficial branch of the radial nerve. The nutrient arteries supplying the peripheral nerves came from either the adjacent axial artery or the fasciocutaneous or muscular arteries. They formed anastomotic channels in the epineurium and penetrated it to form a continuous longitudinal artery. Based on the presence of absence of dominant arterial pedicles, five patterns of blood-supply to the nerves could be identified. I: no dominant arterial pedicle; II: only one dominant artery (e.g. artery with a diameter more than 0.8 mm and accompanying the nerve for most of its length); III: only one dominant vessel that divided into ascending and descending branches to supply the nerve; IV: multiple dominant pedicles; V: multiple dominant arterial pedicles forming a continuous artery that accompanied the nerve. The arterial pedicles to the ulnar, saphenous and deep peroneal nerves and the superficial branch of the radial n. had mean diameters of over 0.8 mm, thus being suitable for microvascular anastomosis. Those to the sural nerve were not present in two thirds of the dissected cadavers. In 10% of the cadavers the superficial peroneal nerve had an arterial pedicle that accompanied the nerve for less than two cm with a mean diameter less than 0.8 mm. The ulnar nerve could be very suitable as a donor vascularized nerve graft as it had a dominant vascular pedicle in all the cases studied; however, its use should be restricted to C8 and T1 root damage of the brachial plexus. The superficial branch of the radial n. might be suitable for vascularized nerve grafting, but this is difficult in practice since the radial artery is a major limb artery. The saphenous nerve had a dominant arterial pedicles in all the cadavers dissected and could be the most suitable as a donor vascularized nerve graft, unlike the sural nerve which did not have a dominant arterial pedicle in two-thirds of the specimens. The deep and superficial peroneal nerves may also be unsuitable since the former is accompanied by a major limb vessel while the latter had a dominant vascular pedicle that accompanied the nerve for only a short distance in 10% of the dissected cadavers.     

成年男性脐动脉的应用解剖

目的 研究男性标本脐动脉的解剖学特点,为临床膀胱癌切除术中结扎脐动脉提供理论依据。 方法 随机选用福尔马林液固定的成年男性尸体19具（38侧）,解剖观测脐动脉的起点、走行、起始端外径及分支,结果进行统计学分析。 结果 脐动脉均起自髂内动脉。脐动脉起始端外径为（3.02±0.30）mm。脐动脉均发出膀胱上动脉,其分支有5种类型：数支膀胱上动脉型,占总标本量的52.6%（20侧）;数支膀胱上动脉和1支膀胱下动脉型,占28.9%（11侧）;2支膀胱上动脉、1支膀胱下动脉与闭孔动脉的共干动脉型,占5.3%（2侧）;数支膀胱上动脉和1支闭孔动脉型,占7.9%（3侧）;2支膀胱上动脉和1支精囊动脉型,占5.3%（2侧）。 结论 脐动脉起始位置固定,起始端外径狭小,分支数目变异较多,对膀胱手术有重要意义。     

Variability in the Origin of the Obturator Artery

INTRODUCTION

General surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper’s ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported.

MATERIALS AND METHODS

The present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted.

RESULTS

In 79% of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19% of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2% of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity.

CONCLUSION

The data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.