小儿丘纹动脉的解剖学研究

对60个儿童脑动脉进行了研究,外侧丘纹动脉和返动脉起始角度随年龄增长而逐渐变锐,外侧豆纹动脉始径较粗,多有外径大于0.8mm的干.各丘纹动脉穿前穿质的位置相对恒定.本文讨论了丘纹动脉在大脑中动脉瘤、动静脉畸形和介入神经放射术中的应用.     

断层影像解剖学的现状与未来：首届全国断层影像解剖学论坛总结

断层影像解剖学的现状与未来——首届全国断层影像解剖学论坛总结刘树伟①张绍祥②吴德昌③刘丰春④汪亚晴⑤赵斌⑥本世纪７０年代以来，超声、ＣＴ、ＭＲＩ、ＳＰＥＣＴ、ＰＥＴ、介入放射学及立体定向技术（γ—刀、Ｘ—刀）已成为医学影像学诊治的主流，是当代医学迈入...     

基底动脉的活体解剖学

目的 应用3.0 T磁共振血管成像(MRA)技术对基底动脉进行活体观察和测量.方法 对108例受试者行MRA及常规MRI检查,男58例,女50例,年龄4～63岁.观察颅内段椎基底动脉形态分型,测量基底动脉长度及管腔直径,并进行统计学分析.结果 基底动脉常见类型依次为ⅠⅠ型、ⅡRⅢ型、ⅡRⅠ型或ⅡLⅠ型.基底动脉平均直线...     

胫骨滋养动脉的解剖学研究

用解剖和血管透明方法对32侧成人、5侧婴儿下肢骨滋养动脉的起始、长度、口径、走行及骨内分布进行观测.胫骨滋养动脉一支者占96.88%,起始于胫后动脉者占69.70%, 主干平均长度42.41±9.53mm.起始处外径1.41±0.61mm.人骨处外径0.71±0.14mm.髓腔内,滋养动脉分为升降二支髓动脉,后者向胫骨两端呈树状分支.在骨皮质内,髓动脉与骨膜动脉的分支吻合.     

腋动脉及其分支的应用解剖学研究

目的探索国人腋动脉(AA)及其分支的类型、量化数据以及他们之间的比例关系。方法解剖观察32具成人尸体标本(男25具、女7具)的腋动脉分支类型、外径及腋动脉起始段的外径与其自身比例,腋动脉3段的长度、外径,计算三者间的自身比例。结果腋动脉分支分为7型及1个变异型。每型又分为若干亚型,以6支型(出现率30.16%)和5支型(出现率26.98%)多见;腋动脉3段长度差异较大,三者之比为1∶1.18∶1.25,外径由第一段至第三段渐细,三者之比为1∶0.89∶0.75,腋动脉的各分支依据其支数及起始位置的不同,分为若干型及亚型。腋动脉起始端与各分支起始端外径之比分别为胸上动脉(TS)1∶0.28,胸肩峰动脉(TA)1∶0.42,胸外侧动脉(TL)1∶0.31,肩胛下动脉(SS)1∶0.63,旋肱前动脉(CHA)1∶0.25,旋肱后动脉(CHP)1∶0.46。结论腋动脉及其分支的变异较大,临床介入放射学及血管外科学对血管处理或选择时,应以出现率高、类型恒定、管径允许者作为应用对象。     

蝶窦的影像解剖学研究

目的 :为开展经鼻蝶窦鞍区手术及功能性鼻窦内窥镜手术提供蝶窦的影像解剖学基础。方法 :取 5 0具成人头颅标本 ,行冠状位、矢状位及水平位薄层CT扫描。观测蝶窦气化发育的情况 ,根据蝶窦向蝶骨体、蝶骨小翼及鞍背气化的程度进行分型分度。结果 :10 0侧蝶窦中属甲介型为 4% ,鞍前型为18% ,半鞍型为 18% ,全鞍型为 14 % ,鞍枕型为 46 % ;另外测得蝶窦的最大左右径的平均值 :左 18.5mm ,右17.6mm ;最大前后径的平均值 :左 2 2 .2mm ,右 2 0 .8mm ;最大上下径的平均值 :左 2 1.0mm ,右 2 0 .4mm。从正中线至蝶窦外侧壁的平均距离左 14 .8mm ,右 15 .2mm。结论 :冠状位以及水平位CT扫描能清晰显示两侧蝶窦腔气化发育的情况 ,气化程度不同的蝶窦在选择手术进路时有着极其重要的指导意义     

上颌动脉的临床应用解剖学研究概况

上颌动脉的体质调查研究结果与日本人没有明显差异 ,91%从翼外肌浅面经过 ,9%从翼外肌深面经过。可经上颌窦径路 ,口腔径路和鼻腔径路结扎上颌动脉治疗顽固性鼻腔出血 ,效果良好。上颌动脉的分支颞深动脉营养颞肌的前份和中份 ,是颞肌瓣的主要血管蒂 ,作颞肌瓣移植时 ,根据受区特点 ,可切取颞肌前、中份。颊动脉是颊脂肪垫主要血管之一 ,90 %起于上颌动脉翼肌段 ,10 %起于颞深动脉或下牙槽动脉 ,带蒂的颊脂肪垫可用于封闭颌面部瘘管和修复颌面部缺损。上颌动脉及其分支的应用解剖学研究有待深入 ,如紧密结合颌面整形术式的开展 ,可进行上颌骨移位有关的应用解剖学研究和关于上颌部位血管瘤在病理状态下的血管形态学特点的研究     

肝门区动脉的应用解剖学

本对西安地区30例成人尸体肝门区动脉的分支类型及其长度、口径、夹角等应用解剖学数据，进行了观测和统计学处理。提供了超选择性动脉导管的合理参数。为肝门区动脉插管提供了参考依据。     

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.     

Age changes in the human laryngeal cartilages

Various changes in the human laryngeal cartilages have been studied by the naked eye, radiology, and histology in 28 dissecting room and 20 autopsy specimens (21 male and 27 female) ranging from 14 to 101 years. Except for one 14- and one 20-year-old specimen, radiographic signs of calcification occurred in all and were found in hyaline cartilaginous tissue of the thyroid, cricoid, arytenoid, and the variably occurring triticiate cartilages. A series of stages has been established indicating the pattern of spread of the process in the thyroid cricoid and arytenoid cartilages. Minor differences between the sexes were found in the thyroid and the cricoid, and some correlation was noted between sites of calcification with sites of muscle attachment and sites of greatest mass. The degree of involvement was not, however, found to be a reliable index of age, with wide variations occurring between individuals. Histology showed various degenerative processes, including calcification, but also revealed the occurrence of actual ossification even in some younger specimens. However, some foci of cartilage always persisted even when ossification was well advanced. Naked eye examination detected regions within the cartilages where ossification was well established, dark areas being produced by the presence of marrow. The remaining tissue was found histologically to be composed of cartilage, which might be calcified or might even contain small foci of bone. Radiology was an accurate method for detection of calcification and ossification, which were sometimes distinguishable, larger masses of calcified cartilage having a dense uniform radiographic appearance unlike the trabecular pattern of bone. © 1993 Wiley-Liss, Inc.     

Aberrant branch of the superior laryngeal artery passing through the thyroid foramen

This study examines the microsurgical anatomy of the aberrant superior laryngeal artery (ASLA) which passes through the thyroid foramen. It defines the location of the ASLA and its main branches. The aberrant superior thyroid artery was looked for in 20 randomly selected Chinese adult cadavers, and when found, was dissected and measured under an operating microscope (7-30x magnification). The ASLA passed through the thyroid foramen, which only occurred in the presence of the artery. The foramen was observed in six of the 20 cadavers: one on the right, three on the left, and two on both sides. The study provides detailed information concerning the ASLA, which we hope will help explain the arterial bleeding that may occur during laryngeal surgery. The results might be helpful in improving surgery to the larynx and other neck operations. Incidental intraoperative injury of the aberrant artery could be avoided by understanding details of its course in relation to surrounding anatomic landmarks.     

Distribution of internal thoracic artery perforators: A clincal anatomy study

There are various modifications of the transverse rectus abdominis musculocutaneous flap and deep inferior epigastric perforator flap to reduce the morbidity of the donor site or to augment the vascularity of the flap. For microanastomosis of multiple pedicles, multiple recipient vessels or an intervening vein graft should be provided. In addition, alternative perforator‐based flaps used in breast reconstruction have small caliber pedicles. Therefore, small recipient vessels such as internal thoracic artery perforators are more suitable for appropriate microanastomosis. Therefore, it is important to acquaint the distribution and anatomical characteristics of internal thoracic artery perforators. We researched the perforators running in the intercostal spaces under the pectoralis major muscle to provide an overview of the anatomical distribution and characteristics of the perforators in patients who underwent immediate subpectoral implant‐based breast reconstructions. In our study, the major perforators (diameter > 1.5 mm) were easily found 2–7 cm medially between the third and fourth intercostal space and were sparse in the lateral area from the midline of the breast (usually 8–9 cm lateral to the midsternal line) and above the third rib. In each side of the breast, the average number of perforators greater than 1.5 mm was 1.6, and the average number of perforators between 1 mm and 1.5 mm in diameter was 3.2. Our results provide information about perforators in the anterior chest wall related to the breast area. Clin. Anat. 32:471–475, 2019. © 2018 Wiley Periodicals, Inc.     

经桡动脉至冠状动脉插管的应用解剖

目的:为经桡动脉至冠状动脉插管提供应用解剖学基础。方法:在40侧成人上肢标本及50例成人心标本上观测与冠状动脉造影术有关的解剖结构。结果:桡动脉干长(210.8±23.4)mm,体表投影位于肱骨髁间连线中点远侧(22.4±2.6)mm与桡、尺骨茎突连线外侧1/4处的连线,远侧端内径为(1.9±0.5)mm。左、右冠状动脉干长分别为(9.9±3.5)mm和(5.7±3.1)mm,内径分别为(4.1±0.9)mm和(3.1±0.8)mm。冠状动脉向上方开口者与升主动脉侧壁远侧端的夹角左侧(76%)为(123.00±8.20)°,右侧(58%)为(109.30±11.10)°;向下方开口者其夹角左侧为(72.00±12.20)°,右侧为(65.00±13.50)°。结论:桡动脉穿刺针的方向应与其体表投影方向一致,导管的大小以5 F为宜;导管进入冠状动脉干的长度不宜过深;还应根据冠状动脉的开口方向调整导管的角度,并注意桡动脉和冠状动脉口的变异。     

眼动脉眶内段的应用解剖研究

目的 :为眶内手术中寻找和处理眼动脉及其分支提供解剖学依据。方法 :手术显微镜下解剖、观察、测量4 0侧成人眶内眼动脉的分段、各段的长度、外径、重要毗邻、主要分支、各分支起点与各段分界点之间的相互位置关系。结果 :(1)眶内眼动脉依其行程分为 4段。O3 段与O4段的分界点 (O4段起点 )坐标在左眼约位于时钟 5 4分钟位置 ,在右眼约位于时钟 10分钟位置。 (2 )视网膜中央动脉的起点多集中在眼动脉角后约 7.4 0mm至角前约 3.90mm的范围内 ,视网膜中央动脉穿视神经鞘处至眼球后极的距离平均为 (8.4 6± 1.91)mm。 (3)眼动脉角至眼球后极的距离平均为 (19.32± 4 .2 2 )mm ;眼动脉弯至眼球后极距离平均为 (14 .2 0± 3.92 )mm。 (4 )眶内眼动脉各段中 ,以O2段发出的至眼球、眼外肌和泪腺的分支最多。结论 :(1)眶内眼动脉以四分段法对眶内手术更有实用意义。 (2 )眼动脉各分支的起点变化较大 ,可用眼动脉四段的分界点作为识辨眼动脉及其重要分支的标志     

中外结扎舌动脉的应用解剖

目的为口外舌动脉结扎提供解剖学资料。方法在30例经动脉灌注红色乳胶的成人尸体标本上,对舌动脉的起源、走行、分段和各段的重要毗邻等进行解剖观测。结果舌动脉单独起于颈外动脉者占66.7%,与面动脉共干者占23.3%,与甲状腺上动脉共干者占10.1%。舌动脉起始处的外径为(3.4±0.6)mm。起点至颈总动脉分叉处的距离为(1.1±0.5)cm。舌动脉全程可分为4段,即起始段、舌骨舌肌段、升段和水平段。舌骨舌肌段位置恒定,部位表浅,体表标志明确,血管周围无重要结构。结论舌动脉舌骨舌肌段是行口外舌动脉结扎最理想的部位。     

尺动脉穿支皮瓣的应用解剖学研究

目的　为尺动脉穿支皮瓣的临床应用提供解剖学依据。 方法　观察10具动脉铸型标本。取新鲜成人尸体25具(50侧),行一次性全身动脉造影。通过直接层次解剖,应用图像分析和测量系统Scion image,对前臂内侧区穿支进行定性、定量分析;螺旋CT扫描数据以Dicom 格式输入Mimics 图像工作站,对尺动脉穿支皮瓣进行三维重建。 结果　该区共有外径≥0.5mm 的穿支(7.0±2.0)支,外径(0.6±　0.2) mm,蒂长(2.7±1.4)cm,单穿支的供血面积(26.0±7.0)cm2。尺动脉除在远端发出粗大的尺动脉腕上皮支,在肱骨内上髁以下8～10cm处也有较粗、恒定的穿支,尺动脉多个穿支相互吻合形成前臂内侧血管链。 结论　可以尺动脉近端穿支为基础设计游离皮瓣,以内侧血管链为基础设计长而窄的增压穿支皮瓣也是切实可行的。     

垂体上动脉的显微外科解剖及其临床意义

目的：为探讨垂体上动脉在鞍区显微外科手术时的意义,以及与颈内动脉眼动脉段动脉瘤发生的关系。方法：研究了２４例颅脑４８侧颈内动脉发出的垂体上动脉的显微外科解剖。结果：垂体上动脉起自颈内动脉眼动脉段,有１～４支,可分为单支型（３７．５％）和多支型（６２．５％）。平均支数为２．２±１．０支,直径为０．２６±０．１（０．１６～０．４８）ｍｍ。起点在颈内动脉起点远侧５．８±２．０（３．６～１８．６）ｍｍ。该动脉起始后向内、后、上行至视交叉下前面,发出分支与对侧垂体上动脉和后交通动脉分支相互吻合,构成漏斗周围吻合网,分布至漏斗、垂体、视交叉。且有一恒定分支折返前行至视神经,它对视神经的血液供应起着非常重要的作用。结论：该动脉的显微解剖,对理解颈内动脉瘤的发生以及鞍区肿瘤的外科手术有重要的临床意义。     

喉返神经在颈部的应用解剖研究

目的　为在甲状腺手术中避免误伤喉返神经提供解剖学基础。方法　对 5 0具 (男 3 0具 ,女 2 0具 )成人尸体解剖喉返神经和甲状腺下动脉之间的关系进行解剖观测。结果　喉返神经平均横径为 ( 1.93± 0 .3 5 )mm。喉返神经入喉支以 2～ 5干型为多见 ,占 70 .0 0 %。甲状腺下动脉的直径为 ( 2 .61± 0 .2 3 )mm。喉返神经和甲状腺下动脉之间的关系 ,左右均有明显差异。结论　喉返神经横径平均在 ( 1.93± 0 .3 5 )mm之间 ;喉返神经在甲状腺峡平面分支的最为常见 ;神经位于动脉主干之后的为多见 ,占 5 4.0 0 % ;神经位于动脉前及动脉分支之间的例数相近 ,左侧神经位于动脉之后的多见 ,而右侧神经位于动脉之前的多见 ,左右有明显差异 ,为临床颈部外科手术时参考。     

肺移植中支气管动脉的应用解剖

目的：提供肺移植支气管动脉吻合术有关的参考资料。方法：于肺根处逆向解剖了２２具成人尸体的支气管动脉，观察其外径和行程规律。结果：左支气管动脉起于主动脉弓下缘→左支气管上缘，和／或起于胸主动脉前壁→左支气管下缘，外径均为１．７ｍｍ。右支气管动脉主要起于右侧肋间动脉→右支气管后壁，外径２．０ｍｍ，是右肺、支气管的主要营养动脉；其次起于主动脉弓下缘、胸主动脉前壁→右支气管下缘，也可以是合干支气管动脉（出现率约１／３）的右支。结论：支气管动脉与胸廓内动脉吻合是肺移植血供重建的术式，但对于“后壁”右支气管动脉，宜将其肋间后动脉主干与受体的相应动脉吻合