甲状腺形态的调查

作者调查甲状腺形态共321例,可分7型。以甲状腺由左、右二叶、峡部及锥状叶组成者最多,占63.24%。左、右叶的位置,上端平甲状软骨板中、下1/3,下端平第4气管环者为多。有峡者占91.28%,它多覆盖第1～3气管环,占36.86%。具有锥状叶者占72.59%,以其下端与左叶相连;上端平甲状软骨板下1/3和环状软骨者较多。测量了50例甲状腺,两叶宽度相近,而长度和厚度则右叶大于左叶。为积累国人体质资料及临床放射性同位素扫描的需用,作者于1978～1984年间,利用学生解剖的川西地区成年男性尸体321例,进行了甲状腺的形态调查、绘图和照相(少数)。测量了50例甲状腺的长度、宽度和厚度。凡肉眼观察有肿大等病变者未计入。     

肩峰及喙肩韧带的测量及其临床意义

目的 　通过测量成人肩峰的长度、宽度和厚度以及喙肩韧带在肩峰止点处的宽度和厚度,为临床应用提供形态学基础。 方法　选取36个新鲜成人冷冻肩关节标本,分别进行CT扫描,并将扫描数据导入Mimics15.0软件中,重建肩胛骨,使用软件自带工具测量肩峰的长度、宽度和厚度。然后解剖喙肩韧带,用游标卡尺测量其在肩峰止点处的宽度和厚度。 结果　肩峰的长度为(46.27±2.88)mm,宽度为(25.71±1.52)mm,厚度为(8.10±1.14 )mm ;喙肩韧带在肩峰止点处的宽度为(14.27±1.19)mm,厚度为(4.05±0.38)mm。 结论　喙肩韧带和肩峰的解剖学数据,可以为肩关节疾病的临床诊疗提供帮助。     

喉、甲状腺手术的应用解剖

目的:为颈前部手术提供相关血管、神经的形态学依据.方法:在16具32侧成人头颈部标本上解剖观测喉和甲状腺的血管和神经的走行及分布.结果:甲状腺左、右叶平均长度分别为(49.5±8.2)、 (50.1±7.8) mm,有锥形叶者7例,占43.7%;16例中有1例甲状腺最下动脉(出现率为6.3%);甲状腺上动脉与喉上神经伴行,甲状腺下动脉与喉返神经相交叉.喉上动脉入喉处在甲状软骨上角的前下方左侧为(13.91±2.83) mm,右侧为(14.96±2.56) mm,两侧差异有统计学意义;喉上神经喉内支入喉处在甲状软骨上角前下方左侧为(11.80±3.42) mm,右侧为(12.24±2.68) mm;喉下神经在甲状软骨下角后下方入喉,距离甲状软骨下角左侧(5.38±1.56) mm,右侧(5.69±1.77) mm,两侧差异有统计学意义.结论:熟悉喉、甲状腺血管、神经的应用解剖学是有效预防甲状腺手术并发症的基础     

中国人三叉神经根的形态学研究及其外科应用

在手术显微镜下,对三叉神经感觉根和运动根的长度、宽度,根丝的宽度和数目,半月节的长度、宽度和厚度,半月节三个分支(颅内段)的长度和宽度,以及与手术需要有关的数据进行了一一测量。同时也记述了感觉根各部根丝与半月节三个分支相对应的局部定位关系,以及运动根与感觉根的位置关系。讨论了感觉根次全切断后,颜面部感觉有时依然残存和颜面部有时出现感觉异常的原因。进而为神经外科手术治疗三叉神经痛,提出了几项可供参考的具体建议。     

甲状腺形态的初步观察

地方性甲状腺肿为我国常见地方病之一,但对国人甲状腺正常形态的调查,国内尚未见资料发表。本文收集了国人尸体85具(成人77具,童尸8具),通过解剖、观察、繪图、登记及测量,对国人甲状腺形状、位置及大小进行了观察,为体质解剖学及临床提供资料。观察结果如下: (一)甲状腺形态一般教科书记载,甲状腺由左、右侧叶及峡部组成,有时可见锥状叶。根据我们的调查,将甲状腺分为四种类型(图1)。     

国人气管、支气管、肺段支气管长度、矢径、横径、直径的测量及典型相关和回归分析

本文测量了50例成人(男25例、女25例)和20例幼儿的气管、支气管和肺段支气管的长度和直径。结果表明,左肺下叶各段支气管的长度大干上叶各段支气管,右肺各段支气管的长度为下叶各段支大于中叶各段支,中叶各段支大于上叶各段支,而直径无一定规律。同时用成人50例的气管、支气管、部分肺段支气管的长度、横径共20个指标,以及身长、胸围、胸廓矢径、胸廓横径、胸廓长5个外部指标,以了解内部指标与外部指标的相关程度,建立了由外部指标推算内部指标的回归方程,其中有13个具有显著意义,可用来推算预测人体气管、支气管树的形态。     

肩胛骨解剖学研究及其临床意义

目的测量肩胛骨相关解剖学参数,为临床上肩胛上神经卡压提供解剖学依据,同时为国人解剖学数据提供资料。方法选择国人成人肩胛骨标本72例,测量其肩胛切迹上横直径、最大深度,及其肩胛骨形态长度和形态宽度,并研究它们之间的关系。结果肩胛骨的形态长度为(13.110±2.191)cm,形态宽度为(10.081±1.430)cm;肩胛切迹上横直径为(1.172±0.763)cm,最大深度为(0.783±0.582)cm。回归分析显示,肩胛切迹上横直径与肩胛骨形态宽度成正相关,肩胛切迹最大深度与肩胛骨形态长度成正相关。结论肩胛骨的形态长度、宽度与肩胛切迹最大深度、上横直径存在线性关系,而肩胛切迹狭窄时易造成肩胛上神经卡压,因此为神经卡压提供解剖学依据。     

健康成人海马结构体积的磁共振测量

目的:探讨正常成人海马结构体积的平均值范围,为与海马结构形态改变相关的疾病提供线性测量指标。方法:使用GE3.0T核磁共振仪采集海马结构图像,观测海马结构体积、纵轴长度、宽度、高度等指标,分析各线性指标与海马结构体积的相关性及海马结构体积随年龄变化的规律。结果:健康成人海马结构的体积随着年龄的增长而减小。海马结构体积左、右侧差异有统计学意义(左侧右侧),性别差异亦有统计学意义(男性女性)。Pearson分析显示,海马结构纵轴长度、海马结构宽度、海马结构高度、侧脑室颞角间距与海马结构体积呈正相关,侧脑室颞角宽度与海马结构体积呈负相关。结论:海马结构体积随着年龄增长而减小,且存在侧别及性别上的差异。海马结构纵轴长度、海马结构宽度、海马结构高度、侧脑室颞角间距、侧脑室颞角宽度可作为海马结构形态变化的初筛指标。     

肱肌止点的解剖学研究及其在钢板固定尺骨冠突骨折中的应用

目的测量肱肌止点的相关数据,为临床准确、安全地放置冠突钢板提供解剖学依据。方法 8例正常新鲜成人肘关节标本,解剖观察肱肌止点的位置,并测量肱肌止点的长度、宽度、与内侧副韧带前束附着的间隙宽度及近端距离冠突尖的长度。结果肱肌止点大部分位于尺骨鹰嘴尖与冠突尖连线的内侧,长度为(21.79±2.70)mm,分深浅两头:浅头止点为腱膜组织,宽度(4.11±1.12)mm;而深头止点由两侧的腱膜和中间的肌肉构成,宽度(11.25±3.07)mm。其中,桡侧腱膜宽度(1.77±0.46)mm,尺侧腱膜宽度(2.75±0.57)mm,两者夹持的肌肉宽度(6.82±2.08)mm。肱肌止点与内侧副韧带前束附着的间隙宽度(4.14±0.49)mm,近端距离冠突尖的长度(9.30±1.51)mm。结论 (1)肱肌止点与内侧副韧带前束附着的间隙可用于放置尺骨冠突钢板。(2)松解肱肌深头止点的尺侧腱膜可使该间隙的宽度达到6.89mm,继续松解中间的肌肉可达到13.71mm,足以安放冠突钢板。     

甲状腺异常及甲状腺下动脉缺如1例

在教学中发现一中年女尸甲状腺异常及甲状腺下动脉缺如.报道如下:甲状腺分裂为左右两部分,其左侧部为窄长条状,上端位于甲状软骨中下部,下端近胸骨上端;右侧部为四边形,其上边由外上向内下斜行,此叶在中间部分出现一外上向内下走行的斜裂,将其分为上下两部分.左叶与右叶宽度比约为1∶2,长度大致相同.左右两叶相距最窄处约1 cm,上端相距约2.5 cm,下端相距约1.5 cm.     

国人儿童甲状腺的应用解剖

目的 探讨国人儿童甲状腺的形态、位置。方法 对34例0-9岁儿童尸体进行解剖,完整暴露甲状腺,观察其形态,用游标卡尺测量其高、宽、厚度。结果 ①甲状腺前面宽平均为3.33 cm。左侧叶高(2.69±0.67)cm;宽(1.05±0.34)cm;厚(0.62±0.22)cm;右侧叶高(2.78±0.68)cm;宽(0.99±0.33)cm;厚(0.62±0.21)cm。②Ⅰ型两个侧叶和峡部,有17例(50％);Ⅱ型两个侧叶、峡部和锥叶,有16例(47.1％);Ⅲ型两个侧叶(无峡部及锥叶)1例(2.9％)。③甲状腺的位置:左侧上极平甲状软骨中部23例(68％),右侧上极平对甲状软骨中部25例(74％),峡部上缘平对环状软骨25例(74％),34例中有锥状叶的16例(47％)。结论 探明了国人儿童甲状腺形态、位置、大小,为临床应用提供了局部解剖学资料,为小儿缺碘甲状腺肿的普查提供了参考资料。     

Shape,measurements and weight of the thyroid gland in northwest Indians

The shape of the thyroid gland, its extension as the pyramidal lobe (PL) and attachments of the levator glandulae thyroideae (LGT) were studied in 410 male and 160 female adults from the Chandigarh zone in northwest India during medicolegal autopsies performed in the department. Whereas the measurements of the gland were recorded in 210 subjects, the weights were taken only in 160 instances. The shapes of the glands were: lateral lobes (LL) with isthmus (50.2%), horseshoe-shaped gland (36.8%), gland with separate lobes (7.9%) and irregularly shaped gland (5.1%). No sexual dimorphism was seen in the incidence of various shapes of the gland. The incidence of the PL and LGT was 28.9% and 19.5%, respectively. Neither a PL nor LGT was present in irregularly shaped glands. The mean weight of the gland was 15.01±7.69 g in males and 13.16±5.64 g in females. Sexual and age-wise differences in weights were found to be statistically insignificant. A survey involving 152 subjects in 2 villages in Chandigarh showed that it is an iodine sufficient zone. The size and weight of thyroid glands in adults of the two genders were found to be smaller than in western Caucasian and Japanese subjects.     

Ultrasonographic study on the growth and dimensions of healthy children and adults organs

We measured by ultrasound the spleen, the kidneys, the pancreas in 323 children (age 0-12), the thyroid in 60 children of same age range, and all these organs in 180 adults (in adults we measured additionally the testis, the gallbladder and the choledochus). Children and adults were all healthy, without evidence of pathologies potentially involving these organs. The children have been selected looking at clinical and hematological parameters, while the adults have been selected among a military population, that is the most significant sample of healthy young adults. We measured the length, the transversal diameter and the thickness of the spleen, kidneys, pancreas, testis and thyroid, the diameter of the choledochus and the maximum length of the gallbladder (pre and post stimulus). We found a good correlation between age and dimensions for pancreas, kidneys and spleen in children, representing the progressive growth of these organs. Our data represent an assessment of the normal dimensions of these organs in vivo by means of ultrasound, and therefore they are an useful tool to discriminate pathologically enlarged or reduced organs, both in children and in adults.     

Size and location of thyroid gland in the fetal period

Purpose

The present study’s purpose was to examine the size and location of the thyroid gland using anatomic dissection methods on fetal cadavers.

Methods

This study was performed on 200 spontaneously aborted human fetuses (100 males and 100 females) aged between 9 and 40 weeks of gestation. Fetuses without any external and internal pathology or anomaly were included in this study. Fetuses were divided into four groups based on gestational ages as follows: first group 9–12 weeks (first trimester), second group 13–25 weeks (second trimester), third group 26–37 weeks (third trimester) and fourth group 38–40 weeks (full term). The fetuses were also grouped into monthly cohorts as follows: 9–12 weeks, 3rd month; 13–16 weeks, 4th month; 17–20 weeks, 5th month; 21–24 weeks, 6th month; 25–28 weeks, 7th month; 29–32 weeks, 8th month; 33–36 weeks, 9th month; and 37–40 weeks, 10th month. The anterior necks of fetuses were dissected and the thyroid glands exposed. Vertebral and laryngeal levels and the dimensions (width, length, thickness and weight) of the fetal thyroid glands were determined by anatomical dissection methods. The dimensions and ratios of the fetal thyroid gland (weight/fetal body weight) were evaluated.

Results

The mean values and standard deviations of all parameters by gestational weeks, months, and trimesters were calculated. It was found that all parameters increased with gestational age. No significant differences were observed between genders in all parameters (P > 0.05). There were no significant differences between the right and the left sides for parameters of the thyroid glands. The levels of the superior poles of the thyroid lobes were located at the cervical (C) C1–C3 vertebral bodies. The levels of the inferior poles of the thyroid lobes were located at C4–C5 vertebral bodies. The levels of the superior poles of thyroid lobes were located between the upper ½ and lower ½ of the thyroid cartilage or cricoid cartilage. The levels of the inferior poles of the thyroid lobes were located between the second and sixth tracheal rings. The distance between the superior poles of the thyroid gland and the hyoid bone increased throughout the fetal period. The dimensions of fetal thyroid glands increased with gestational age. The ratio between thyroid gland weights and fetal body weights was unchanged during the fetal period.

Conclusions

We believe that the results obtained from this study will be useful in monitoring thyroid glands in the intrauterine period as well as recognizing early diagnosis and treatment of thyroid anomalies. It will also contribute to future studies in obstetrics, perinatology, and fetopathology.     

Sonographic studies of human soleus and gastrocnemius muscle architecture: gender variability

The purpose of this study was to establish if there are gender differences in muscle architecture in relaxed human soleus and gastrocnemius muscles of normal, live subjects. Ultrasonography was used to measure fiber bundle length, muscle thickness, and angles of pennation in a total of ten predetermined sites in the medial and lateral heads of gastrocnemius and the anterior and posterior soleus in 19 males and 16 females. Percentage differences between males and females for each parameter were recorded. Gender differences were statistically analyzed using multivariate analysis of variance. In the gastrocnemius and soleus muscles of males and females the differences between the overall fiber bundle length, angle of pennation and muscle thickness were statistically significant (P < 0.05). Overall, females were found to have longer average muscle fiber bundle length and males thicker muscles and larger angles of pennation. The greatest percentage differences of the architectural parameters between males and females were in the posterior soleus: 13% difference in fiber length and 26% difference in angle of pennation in the midline of posterior soleus and 26% difference in muscle thickness of the lateral part of posterior soleus. No correlation was found between leg length and fiber length, angle of pennation or muscle thickness. Fiber length (decreased), angle of pennation (greater) and muscle thickness (greater) of most parts of the gastrocnemius and soleus muscles were significantly different in males and females. Leg length of males and females did not correlate to these architectural parameters. Accepted: 18 February 2000     

Thyroid dimensions of Korean adults on routine neck computed tomography and its relationship to age, sex, and body size

The purpose of this study was to establish a “normal” range of dimensions of the thyroid gland on routine neck computed tomography in the Korean population and to investigate the possible influence of some physiological factors on the thyroid dimension. Neck computed tomography scans of 100 adults (57 males, 43 females; mean age=55.2 years) were reviewed retrospectively to measure the size of the thyroid gland and to evaluate its relationship to the trachea and cervical vertebra. For right and left lobes, the mean width was 15.7±2.6 mm and 15.2±3.1 mm, the mean thickness was 20.9±3.4 mm and 18.9±3.4 mm, the mean length was 61.8±8.6 mm and 58.5±8.3 mm, the mean estimated volume of each lobe was 8.8±3.1 cm³ and 7.6±3.0 cm³, respectively. The mean volume of total thyroid glands (including isthmus) was 17.5±6.6 cm³. There was no significant difference between the total study group and the normal thyroid function group. The dimensions of the right lobe were significantly larger that those of the left. There was no significant difference between males and females. In multiple regression analysis, it was likely that the influence of body weight on the thyroid dimension was most pronounced. Our study presents initial data for assessing the thyroid gland on neck computed tomography scans in Koreans, and thereby provides suitable limit values of normal thyroid glands.     

Solid Cell Nests Within a Parathyroid Gland—Report of an Exceptional Case

The ultimobranchial body (UBB) denotes the cellular mass originating from the fourth branchial pouch, which migrates from the neural crest and infolds within the middle and upper poles of the thyroid lobes, thereby establishing the presence of calcitonin-secreting parafollicular C cells. In various numbers, UBB remnants (entitled “solid cell nests”, or SCNs) are found in thyroid glands examined histologically. However, despite the close embryological relation between the UBB and the superior parathyroid glands, intraparathyroidal SCNs have to our knowledge not been previously reported. Here, we describe a patient presenting with a papillary thyroid carcinoma with central and lateral lymph node metastases. Upon postoperative analysis, an unintentionally removed parathyroid gland was observed adjacent to the superior aspect of the right thyroid lobe. Within a 0.6?×?0.5-mm area of the parathyroid gland, solid nests composed of epithelial cells with oval and slightly elongated nuclei were seen. The cells were positive for p40, p63, and GATA3, but negative for PTH. The final diagnosis was a SCN entrapped within the parathyroid gland. Empirically, we have not previously observed SCNs within the parathyroid glands. To our knowledge, our finding thus constitutes a very unusual histological manifestation, and could indicate an underlying aberrancy during embryogenesis given the close anatomical relationship between the UBB and the superior parathyroid glands.     

腭咽括约肌的解剖学研究

本文应用60侧婴幼儿、14侧成人的头部标本,研究了围绕鼻咽腔的腭咽括约肌来源和行走方向,测量该肌前部纤维的长度、宽度和厚度,分析腭咽括约肌的功能,并针对临床应用的有关问题进行了讨论。     

Age-associated C-cell hyperplasia in the human thyroid.

C cells in 26 normal human thyroids from forensic autopsies were identified by immunoperoxidase staining for calcitonin. C-cell concentrations and total C-cell numbers were determined with the use of morphometric techniques. There was great variation in C-cell density within a given gland and among individuals, although C cells tended to concentrate about one third of the way down the vertical axis of the lateral lobes. Densities of 1-2000 cells/cu mm were found in the third and later decades. In addition there was a statistically significant (P less than 0.01) positive Spearman correlation between total C-cell numbers and age in males. C-cell hyperplasia appears to be an age-related phenomenon that may have physiologic significance and must be taken into consideration in evaluation of thyroid glands for the diagnosis of premalignant lesions of C cells.     

One gland, two lobes: organogenesis of the "Harderian" and "nictitans" glands of the Chinese muntjac (Muntiacus reevesi) and fallow deer (Dama dama).

The nictitans and Harderian glands are enigmatic glands situated in the anterior aspect of the orbit. Traditionally, the nictitans and Harderian glands of mammals have been considered to be two fundamentally distinct glands. However, a consistent, unambiguous distinction between these two glands has remained elusive due to conflicting anatomical and histochemical definitions. The Harderian gland was originally described, and first distinguished from the nictitans gland, in adult deer. We examined the organogenesis and histochemistry of the anterior orbital glandular mass in two species of deer (Muntiacus reevesi and Dama dama) to determine whether it comprises two distinct glands or one bilobed gland. The anterior orbital regions of 30 fetal specimens of both species, along with some adult material, were examined histologically. Four stages of glandular organogenesis were observed. Most notably, both glandular portions developed from the same inception point, but the deep lobe developed faster than the superficial lobe. The common inception point and the relationship of the collecting ducts clearly shows that this is a single glandular mass that differentiates into two lobes rather than two distinct glands. Moreover, although the histochemical profiles of the two lobes differ slightly, both lobes produce lipids, which is further indication that these are not profoundly different glands but part of a single, heterogeneously developed gland. Thus, it is proposed that the terms nictitans and Harderian glands, as separate entities, be discontinued and that the entire gland be referred to as the anterior orbital gland (glandula orbitalis anterior), with superficial and deep lobes (pars superficialis and pars profundus, respectively).