舌下络脉诊法的组织学基础

为阐明中医舌下络脉的实质，采用连续组织切片结合解剖追踪观察了舌腹面粘膜下静脉及肌层血管，并与犬和大白鼠相对照，结果：舌下络脉在舌腹面外带为舌神经伴行静脉及其属支：内带为舌下神经伴行静脉及其属支；舌边细络为舌神经伴行静脉与舌根静脉的属支，它们均分布在粘膜下层近肌层，犬与大白鼠有相同分布。舌静脉有丰富的静脉瓣和瓣窦，有双瓣，单瓣，静脉隔等类型，舌下神经伴行静脉及舌神经伴行静脉中末段尤多，有连续呈葫芦串     

舌血管构筑及计量学研究

目的：通过对舌血管的观察和计量，为舌下络脉诊，舌瓣提供形态学依据。方法：墨汁灌注，用手术放大镜、显微镜观察人舌血管的构筑，并用Ｑｕａｎｔｉｍｅｔ５２０＋型图像分析仪对舌各种乳头，舌粘膜肌层、舌肌的血管进行计量学研究。结果：单位面积内轮廓乳头的血管密度大于菌状和丝状乳头；舌肌的血管也明显丰富于舌粘膜肌层。结论：舌静脉的回流主要通过舌下神经伴行静脉，该静脉也是舌下络脉诊主要观察的对象。舌粘膜两侧血管吻合丰富，用舌粘膜肌瓣修复扁桃体窝，磨牙后区等特定的解剖部位有其他瓣无法代替的优点。     

舌下络脉诊法的形态学基础

通过血管造影、活检、解剖实践对中医舌下络脉诊法的形态学基础进行了探索,观察到:“舌下络脉”为舌深静脉及属支舌尖静脉,它汇集舌尖、舌两侧、舌腹面的静脉血注入舌下神经伴行静脉。“细络”为毛细血管、微小静脉,扩张瘀血即成“瘀血丝”,多在粘膜固有层,符合瘀证的微循环障碍,“瘀血颗粒”即鱼子酱舌,为腹面粘膜上皮内瘀血扩张的毛细血管。舌腹面粘膜的丰富血运来自舌深动脉斜行向下的细小分支,它不同于舌背的特殊粘膜而为保护性,瘀证时可见角化。另对我国对舌动静脉的认识历史作了论述。     

舌的静脉引流形态学研究

目的：为中医舌诊和外科舌瓣提供舌的静脉引流规律。方法：用３２具成年尸体进行观测，其中有７具为新鲜尸体的静脉腐蚀铸型标本。结果：舌的静脉引流，按管径及引流范围的大小，依次为舌下神经伴行静脉、会厌谷静脉、舌神经伴行静脉、舌根静脉和舌动脉伴行静脉。结论：中医舌诊所见的舌脉基础为舌下神经伴行静脉及舌神经伴行静脉；舌瓣的蒂部必须保留一个较通畅的静脉引流渠道。     

舌下神经舌骨舌肌段的应用解剖

本文用１６具成人尸体，１０％福尔马林固定，红色乳胶股动脉灌注，在手术显微镜下解剖舌下神经舌骨舌肌段的分支及其毗邻结构。该段舌下神经上方有舌神经及其伴行静脉、下颌下腺导管、下颌下腺深部；下缘有舌下神经伴行静脉；舌下神经向上、向前、向下均有分支，分别到达茎突舌肌、舌骨舌肌、颏舌肌、甲状舌骨肌、颏舌骨肌。讨论了这些结构的临床意义。     

舌瓣设计的解剖学基础

目的：为外科舌瓣的设计提供解剖学基础。方法：解剖剥制２５具（５０例）成人舌动、静脉标本，制作７例（１４侧）舌血管铸型标本，观察舌动脉和静脉分布的规律性。结果：舌主要由２条舌动脉供血；舌的静脉每侧有５个流向，多数静脉不与动脉伴行。结论：根据需要舌瓣的蒂部可设在舌体周围的多个部位，多数舌瓣由动脉网供血，但每个舌瓣可获得一个自然的静脉引流渠道。     

11 舌血管构筑的应用解剖学研究

<正>对26例舌的血管构筑用墨汁灌注血管造影碱性磷酸酶及扫描电镜等方法进行较全面系统的观察.本内容系手术显微镜下所见的一部分.舌动脉于舌骨大角处直接起自颈外动脉者多见,其中有25%与面动脉共干起始.起始外径:2.5±0.3mm(2.2～3.2)前行发出舌下动脉后移行于舌深动脉.舌深动脉与舌骨舌肌的局部关系较为恒定,它是舌动脉的直接延续,故其外径变化不明显2.3±0.3mm(2.0～3.1).舌深动脉是看血供的主要血管由后往前至舌尖邻近多以鸦爪状而终,终止处距舌下钱面:2.6±0.6mm(1.8～3.7);其形态特点是行程迂曲明显由后向前与主干几呈直角向上依次分出13.9长支(8～18)至舌背以及不恒定的向下行的小支3支(1～5)至舌底.左右侧舌深动脉分别行于同侧舌肌内未见有跨越正中纤维隔,在舌尖偶可见吻合.舌静脉在解剖观察中就其形成行径和注入个体差异较大,但有二点似较明显:一是舌动脉伴行静脉都较纤细未见有管径大于动脉者;二是舌下神经伴行静脉绝大部分均能见到位于舌下壁的局部位置也相对恒定,从外观可认为是舌引流的主要静脉.从舌位于口腔中特有局部位置有较厚的肌肉和良好的血供舌粘膜下的丰富血管丛,以及舌蒂瓣是口腔内的组织,具有自然的适应性对口腔既有唾液又有细菌的复杂环境将会有较好的抗感染能力等条件.可见口?     

以副神经斜方肌上支为蒂肌瓣转位修复面瘫的应用解剖

在30侧成人尸体标本上,解剖观察了副神经在斜方肌内分布的上支及其与血管的关系。上支可分离长度为6.2cm,横径为0.6mm,与上支神经伴行的血管可游离长为11.3cm,外径(起始处2.5mm,入肌处0.9mm)。根据解剖观察结果,可设计以副神经斜方肌上支及其伴行血管为蒂的斜方肌瓣转位修复面瘫的新术式。     

舌脉诊和舌瓣外科有关的动脉形态学研究

观察了５０侧舌动脉剥制标本和１４侧舌动脉或动静脉铸型腐蚀标本，根据其走行，舌动脉应分为起始段、舌骨舌肌段、舌深动脉升段和舌深动脉水平段，舌根血供来自舌根动脉（平均２．３支）、腭升动脉和扁桃体动脉；舌体血供来自舌深动脉发出的舌体动脉（平均２５．１支）；舌下动脉供应舌下腺、舌腹侧和口底组织；舌系带动脉由舌深动脉末端分支与面动脉颏下支吻合组成，舌两侧的舌根动脉和舌体动脉被舌中隔完全分开，仅有舌背面粘膜下     

股内侧推进肌瓣的应用解剖

在40侧成人下肢标本上,观察了股内侧肌的形态、血供和神经支配。该肌血供分布呈节段性,来自股动脉,膝降动脉、股深动脉和旋股外侧动脉。肌的静脉回流通过与动脉的伴行静脉注入股静脉。肌的运动神经来自股神经的股内侧肌支。本文讨论了股内侧推进肌瓣的应用解剖学要点。     

Distribution pattern of the human lingual nerve

The tongue is an intricate organ with many functions. Despite the knowledge of the presence of muscular and neural connections in the tongue, a detailed neuroanatomical depiction of the nerves' topography in the tongue has not been demonstrated. The topography, branching patterns and neuronal interconnections of the lingual nerve were studied in five postmortem human tongues. They were stained with Sihler's stain, a technique that renders most of the tongue tissue translucent while counterstaining nerves. The lingual nerve reaches the tongue posterolaterally. There are two main branches off of the main trunk: the medial branch sends 2-4 small branches to the medial part of the ventrolateral tongue and the lateral branch runs along the lateral tongue border and sends 3-4 large branches to the anterior tip of tongue. Each subdivision gives off 2-5 distal branches. Both medial and lateral branches have interconnections with the proximal part of the hypoglossal nerve. One of the unexpected discoveries in this study was the high density of nervous fibers in the lateral aspect of the tongue as compared to the midline region. The average diameter of the main trunk of the lingual nerve is 3.5 mm. The medial and lateral branches average 1 mm in diameter, the more distal subdivisions measure 0.5-0.75 mm, and the lingual-hypoglossal interconnections measure 0.125-0.250 mm. In summary, this study provides the first detailed depiction of the topography of the human lingual nerve and its branches in situ, confirmation of lingual-hypoglossal nerve connection, and the first depiction of the high density of lingual nerve innervation in the lateral tongue.     

Morphological Features of the Branching Pattern of the Hypoglossal Nerve

The hypoglossal or twelfth cranial nerve is the motor nerve to the extrinsic and intrinsic muscles of the tongue, and the superior root of the ansa cervicalis and the thyrohyoid and geniohyoid branches are delivered through the nerve. This study investigated the muscular branches of the hypoglossal nerve to clarify their spatial relationships with the muscles of the tongue and the neighboring structures. The muscles and the nerve were gross anatomically examined in 42 cadavers. The superior root and the thyrohyoid branch left the nerve near the occipital and lingual arteries, respectively. The extrinsic muscles consisted of some components, and the geniohyoid branch and the lingual branches arose on the hyoglossus. The ascending lingual branches formed a plexus on the anterior part of the hyoglossus and were divided into the proximal and distal groups. They supplied the two parts of the hyoglossus, the three bundles of the styloglossus and the superior and inferior longitudinal muscles and communicated with the lingual nerve. The descending lingual branches supplied the inferior part of the genioglossus, and the terminal branches gave intramuscular twigs to its main part and the transverse and vertical muscles. The findings indicated that the branching pattern of the hypoglossal nerve is characterized by the positional relationships to the components of the extrinsic muscles. The hyoid bone can be an effective marker to identify the branches and affected position if it was used in combination with the morphology of the extrinsic muscles, and the knowledge of their variations is also beneficial. Anat Rec, 302:558–567, 2019. © 2018 Wiley Periodicals, Inc.     

Anatomy of the lingual nerve: Application to oral surgery

The purpose of this research is to obtain morphological information about the traveling route, branching pattern, and distribution within the tongue of the lingual nerve, all of which are important for oral surgical procedures. Using 20 sides from 10 Japanese cadaveric heads, we followed the lingual nerve from its merging point with the chorda tympani to its peripheral terminal in the tongue. We focused on the collateral branches in the area before reaching the tongue and the communication between the lingual and hypoglossal nerves reaching the tongue. The collateral branches of the lingual nerve were distributed in the oral mucosa between the palatoglossal arch and the mandibular molar region. Two to eight collateral branches arose from the main trunk of the nerve, and the configuration of branching was classified into three types. More distally, the lingual nerve started to communicate with the hypoglossal nerve before passing the anterior border of the hyoglossus muscle. Nerve communications were also found in the main body and near the apex of the tongue. A thorough understanding of the collateral branches near the tongue, and the communication with the hypoglossal nerve inside the tongue, will help to prevent functional disorders from local anesthesia and oral surgical procedures associated with the lingual nerve. Clin. Anat. 32:635–641, 2019. © 2019 Wiley Periodicals, Inc.     

Morphologic studies of the venous drainage of the tongue

Summary The aim of this work was to study the role of the venous drainage of the tongue in tongue inspection in traditional Chinese medicine and tongue-flap surgery. Thirty-two adult cadavers were observed, including 7 venous corrosivecast specimens. The decreasing order of venous drainage of the tongue, based on the diameter of the vein and size of its drainage area, was the accompanying v. of the hypoglossal n., the epiglottic valleculate v., the accompanying v. of lingual n., the lingual root v. and the accompanying v. of the lingual a. The veins constituting the picture of the tongue seen in sublingual collateral inspection were the companion vv. of the hypoglossal and lingual nn. The pedicle of a tongue flap must maintain efficient venous drainage canal.This work was supported by the National Natural Science Fund     

Anatomic bases of tongue flaps

Summary The morphological structure of the lingual a. was studied in 50 dissected and 14 vascular cast specimens. The course of this artery is divided into 4 segments: the original segment, the segment within hyoglossus, the ascending and the horizontal segments of the deep lingual a. The root of the tongue is supplied by 2 to 3 root branches of the lingual a., the ascending palatine a. and the tonsillar a. The body of the tongue is nourished on average by 25 arterial branches from the deep lingual a. The ventral surface of the tongue, as well as the sublingual gland and the floor of the mouth, is supplied by the sublingual a. The termination of the lingual a. anastomoses with the submental branch of the facial a. to form the lingual frenal a. Except for a submucous arterial network on the dorsum of the tongue, all blood vessels are separated completely by the lingual septum, through which arterial anastomoses (2.0 mm in diameter) can be found occasionally.This work was supported by the National Natural Science Fund     

舌粘膜及粘膜下血管网的构筑及其临床意义

本研究应用手术显微镜和扫描电镜观察了人舌粘膜的微血管构筑。舌深动脉长支和舌背动脉终支在舌粘膜下形成一完整的致密动脉网,跨越界沟和舌正中线,成为一整体。由动脉网发出微动脉支进入舌粘膜内,形成粘膜内的毛细血管网和各种乳头毛细血管丛。另外,还讨论了舌粘膜下馓血管构筑和舌瓣设计与临床舌诊的关系。