右颈内静脉变异伴同侧颈总动脉和股动脉弯曲一例

正颈内静脉为颅内乙状窦的直接延续,负责颅内静脉血液的回流,在颅外还接受面静脉、舌静脉、甲状腺上、中静脉等处的静脉血液,为颈部最粗大的静脉。颈内静脉一般与颈总动脉伴行,位于颈总动脉的外侧,变异较少,很少报道。我们在局部解剖学课堂教学过程中发现一侧颈内静脉异常细小,同时伴同侧颈总     

双侧腋动脉分支变异一例

正笔者在局部解剖的过程中发现1例颈部血管变异。该标本为一老年女性,身高161 cm,年龄70岁。解剖中发现其左下肢曾完成股骨头置换手术,其余部位无异常。该例左侧颈总动脉于甲状软骨上缘处发出颈内动脉和颈外动脉,颈外动脉直径0.52 cm,相对较细;颈内动脉直径0.83 cm,相对较粗。颈外动脉发出面动脉、舌动脉、上颌动脉、枕动脉和颞浅动脉等分支,而甲状腺上动脉来源异常,于距离颈内、外动脉分杈处下方0.22 cm处由颈总动脉     

舌下神经与迷走神经交通一例

作者在解剖一具老年男性尸体时 ,发现其右侧舌下神经与迷走神经之间存在交通支 ,现报道如下 :该例标本的右侧舌下神经自舌下神经管出颅后 ,位于迷走神经、副神经与颈内静脉的内侧 ,当其下降到颈部时 ,绕过迷走神经的后侧和外侧 ,继而经颈内动脉和颈内静脉之间下降 ,在下颌角水平呈弓形越过颈内动脉和颈外动脉的外侧向前入舌 ,同时发出一交通支 ,该交通支起始处横径 0 .0 7cm ,长 4.85cm ,伴迷走神经的外侧走行 ,在甲状软骨上缘水平下方 3 .3 1cm外汇入迷走神经 ,迷走神经的行程与分支均正常。舌下神经与迷走神经交通一例@曲永松$山东省莱阳…     

右食管后锁骨下动脉与左头臂静脉位置异常1例

在教学中解剖一成人男尸,发现头臂干缺如,正常走行的主动脉弓由右向左发右、左颈总动脉与左锁骨下动脉,右锁骨下动脉自主动脉弓末段后方发出,且左头臂静脉行于右颈总动脉的后方(图1),现报道如下.     

异常右甲状腺上动脉伴右喉上动脉缺如一例

<正>在解剖1老年男性尸体时,发现其右侧甲状腺上动脉与舌动脉共干从颈外动脉发出,此种变异罕见,现报道如下。在右颈总动脉分叉上方0.7cm处,右甲状腺上动脉与舌动脉共干从颈外动脉发出,形成甲状舌干,该干长度为0.3cm。其中甲状腺上动脉起始处直径2.8 mm,先斜行向内下方走行1.7cm后,在甲状腺侧叶上极上方从动脉前壁先发出2个分支,1支为后腺支,直径为1.4mm,该支再分为3个小支经侧叶上极     

咽升动脉分支的解剖分组及其临床意义

目的探讨咽升动脉及其主要分支在颈部颅底区域走行规律及其在血管内外治疗中的临床意义。方法选择以10%甲醛固定并用乳胶灌注的8具(16侧)成人颅颈部标本, 自颈总动脉分叉水平向上解剖至颅底骨质, 分离显露咽升动脉及周围相关结构, 观察咽升动脉的起源部位及主要分支, 测量相关解剖学参数。依据咽升动脉主要分支与颈动脉鞘的位置关系分为颈动脉鞘内、外2组, 观察2组分支血管的走行规律及解剖分布特点。结果 8具16侧标本中:咽升动脉13侧自面动脉起始点平面以下的颈外动脉发出, 2侧起源于枕动脉, 1侧与枕动脉共干起源于颈外动脉;14侧咽升动脉沿颈内动脉腹侧上行(15.39 ± 3.20)mm后发出主要分支咽干和脑膜干, 2侧变异。脑膜干自咽升动脉主干发出(9.32 ± 3.20)mm后均穿入颈动脉鞘, 上行分叉后经舌下神经管或颈静脉孔或鼓室小管下口或枕大孔入颅;咽干则在颈动脉鞘外走行并分布于咽旁、椎旁等区域。颈动脉鞘内组包括脑膜干和鼓室下动脉, 均穿入颈动脉鞘后沿颈内动脉内侧上行;颈动脉鞘外组包括咽干和肌支, 于鞘外走行。结论咽升动脉及其分支变异显著、走行复杂, 可按照咽升动脉各主要分支与颈动脉鞘的...     

迷走神经颈段走行变异一例

迷走神经在颈部的走行比较恒定,变异较少。笔者在行颈部扩清术中,发现迷走神经在颈部走行变异一例。为积累资料,供临床参考,报道如下。 患者男性53岁,因患腭部粘液表皮样癌并颈淋巴结转移住院治疗,在行颈部扩清术中发现:左侧迷走神经在颈动脉分叉处上方约3cm处,从颈内动脉的前外侧下行,经颈动脉窦的外侧逐渐移向颈总动脉的前方,于颈动脉窦与锁骨之间中点处,跨过颈总动脉前面中线,逐渐偏行于颈总动脉的前内侧进入胸腔(见附图)。在手术过程中,颈内静脉及舌下神经降     

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.     

肝动脉来源伴腹腔干多分支变异一例

正作者在解剖1具成年男性尸体标本时,发现肝右动脉来源于肠系膜上动脉变异,以及腹腔干分出膈下动脉和胰背动脉变异,现报道如下。本例中,肝右动脉(图中箭头标注走形),外径0.3cm,在胰体后方、于肠系膜上动脉起始处下方约3cm自右壁处发出,与肠系膜上动脉成45°向右上走行,经过肠系膜上静脉末端后方,     

颈内动静脉与颅底骨三维空间关系

目的 :显示对比正常侧和病变侧颈内动静脉与周围骨结构的解剖关系 ,以完善术前准备。方法 :10例颌颈部肿瘤患者 ,术前行颈动脉三维CT血管成像 (CTA) ,同步注射造影剂 ,螺旋CT对病变区血管段进行重点薄层螺旋扫描 ,由EasyVision工作站三维重建。结果 :5例颈外动脉和颈内静脉受压狭窄 ,其中 3例出现颈总动脉、颈内动脉向内侧移位 ,另 1例左侧颈内动脉动脉瘤清晰定位。CTA能够显示病变区血管段 (包括颈总动脉、颈内动脉、颈外动脉、颈内静脉 )与下颌骨、舌骨、颈椎、颅底骨结构的三维解剖关系 ,进行旋转、放大 ,三维测量 ,多视角观察 ,无重叠干扰。结论 :对颌颈、口咽部肿瘤患者术前CTA检查 ,能够判断颈部大血管的情况及颈部巨大肿瘤造成颈内动脉移位 ,CTA可显示血管性肿瘤的三维形状和与颅底骨空间关系 ,为手术入路及术式提供参考 ,有助于降低手术风险     

Continuation of the ascending cervical artery as the occipital artery in man

We report an elderly male cadaver with unilateral anomalous continuation of the ascending cervical artery as the occipital artery. The ascending cervical artery was enlarged from its origin and supplied segmental branches through the intervertebral foramina. At the upper cervical spine, the ascending cervical artery continued as the occipital artery providing the branches normally seen stemming from this artery. No other vascular anomalies were noted in this specimen. This anatomical curiosity should be kept in mind by the clinician or academic who may manipulate this anatomical area.     

Correspondence. Superficial brachial artery continuing as the common interosseous artery

The superficial artery of the arm with a course anterior to the median nerve is found at an incidence of ≈13%, and it continues as the radial artery twice as frequently than as the ulnar artery; less frequently it continues as both arteries (Bergman et al. 1988). We report a rare case in which the superficial brachial artery continued as the common interosseous artery only and the deep brachial artery continued as the radial and superficial ulnar arteries in the cubital fossa.     

肝动脉和肾动脉变异及不完全输尿管重复畸形1例

<正>作者在解剖一具中年男性尸体标本的肝门结构和腹后壁结构时,发现其存在肝动脉、右肾动脉变异及右侧输尿管畸形,现报道如下:(1)肝动脉变异肝总动脉由腹腔干发出,在肝胃韧带内右行至肝门下方分为胃十二指肠动脉和肝固有动脉。肝固有动脉发出     

Coronary artery aneurysms and coronary artery fistula as a cause of angina pectoris

Coronary artery aneurysm is an uncommon disease. Coronary artery fistulae are infrequent congenital anomalies. A extremely rare case report of combination of coronary artery aneurysms and coronary artery fistula is presented with a brief literature review.     

Heavy snoring as a cause of carotid artery atherosclerosis

STUDY OBJECTIVES: Previous studies have suggested that snoring and obstructive sleep apnea hypopnea syndrome may be important risk factors for the development of carotid atherosclerosis and stroke. However, it is not clear if snoring per se is independently related to the risk of developing carotid atherosclerotic plaque. DESIGN: Observational cohort study. SETTING: Volunteer sample examined in a sleep laboratory. PARTICIPANTS: One hundred ten volunteers (snorers and nonsnorers with only mild, nonhypoxic obstructive sleep apnea hypopnea syndrome) underwent polysomnography with quantification of snoring, bilateral carotid and femoral artery ultrasound with quantification of atherosclerosis, and cardiovascular risk factor assessment. Subjects were categorized into 3 snoring groups: mild (0%-25% night snoring), moderate (> 25%-50% night snoring), and heavy (> 50% night snoring). INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The prevalence of carotid atherosclerosis was 20% with mild snoring, 32% with moderate snoring, and 64% with heavy snoring (P < 0.04, X2). Logistic regression analysis was used to determine the independent effect of snoring on the prevalence of carotid and femoral atherosclerosis. After adjustment for age, sex, smoking history, and hypertension, heavy snoring was significantly associated with carotid atherosclerosis (odds ratio 10.5; 95% confidence interval 2.1-51.8; P = 0.004) but not with femoral atherosclerosis. CONCLUSIONS: Heavy snoring significantly increases the risk of carotid atherosclerosis, and the increase is independent of other risk factors, including measures of nocturnal hypoxia and obstructive sleep apnea severity. Considering the high prevalence of snoring in the community, these findings have substantial public health implications for the management of carotid atherosclerosis and the prevention of stroke.     

膝降动脉作为游离股前外侧皮瓣受区血管的临床应用

目的　探讨胫前或胫后血管均无法利用的情况下将膝降动脉作为游离股前外侧皮瓣移植修复膝关节周围创面受区血管的临床可行性应用。 方法　2015年1月至2017年5月,应用于膝降动脉和大隐静脉吻合的游离股前外侧皮瓣移植修复7例膝关节周围大面积皮肤软组织缺损合并肌腱、骨外露的患者,其中男4例,女3例,皮瓣面积为38 cm×8 cm~18 cm×8 cm。 结果　随访6~14个月,平均8.9个月,2例面积较大皮瓣远端分别坏死约6 cm、4 cm,经切除后与残留创面二期植皮愈合,剩余5例皮瓣完全成活,受区残留创面二期植皮愈合。 结论　术前经彩色多普勒超声精确定位并测量膝降动脉口径、血流,术中采用显微外科技术扩大膝降动脉口径,可将膝降动脉作为游离股前外侧皮瓣受区血管修复膝关节周围软组织缺损创面,并取得满意的临床疗效。     

Late onset of Aspergillus aortitis presenting as femoral artery embolism following coronary artery bypass graft surgery

Aspergillus sp. are ubiquitous mould infections and in most patients, the source is presumed to be air-borne infections during surgical procedures. Prevention of these infections requires special attention of ventilation systems in operating rooms. Post-operative aspergillosis occurs mainly in immunocompromised patients as well as those who receive corticosteroids temporarily. We report a case of a 71-year-old immunocompromised patient who developed multiple lower limb embolisms due to Aspergillus niger originating from an aortitis of the ascending aorta nine months following coronary artery bypass graft (CABG) surgery.     

睾丸动脉与肾上腺下动脉共干1例

作者上局部解剖学解剖一具成年男性尸体标本时,见其左侧睾丸动脉与肾上腺下动脉共干起始(如图1),现报道如下: 左侧睾丸动脉与肾上腺下动脉于距肾动脉起端平面下方1.5cm处共干起始于腹主动脉左外侧壁,起点外径约0.3cm.