扁桃体的动脉供应

<正> 解剖101侧头颈部标本,观测供应扁桃体的各动脉的起始、管径、行程、分支和分布。1.咽升动脉:64.4％起于颈外动脉起点上方12.9±6.6mm,25.7％起干枕动脉远端3.4±3.8mm,6.9％起于颈内动脉分又处,2％起于颈内动脉,1％起于舌动脉。单条咽升动脉93侧,双条7侧,3条1侧。成人该动脉管径1.15±0.21mm,它发出椎前支、鼓室下支和咽支,咽支发小支至扁桃体。2.腭升动脉:71.3％起于面动脉远湍     

咽后瓣修复腭裂的用应解剖

在15例(30侧)正常头颈尸体标本上观察了咽部的肌肉和神经血管。咽部的血供主要为咽升动脉的咽支,由两侧向中间分布;静脉在咽后壁上部呈正中条状,在下部呈网状,汇入翼丛、甲状腺上静脉、舌静脉及颈静脉。咽缩肌神经支配为由咽丛从两侧向中间分布支配。     

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     

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...     

严重扁桃体术后出血的处理

报告3例扁桃体术后出血,均行双氧水棉球,副肾素棉球压迫止血及咽腭弓,舌腭弓缝合无效行颈外动脉结扎。1例动脉结扎后仍出血,最后在人工冬眠下行气管切开咽腔填塞宫纱止血。1例先行气管切开咽腔填塞后仍出血行双侧颈外动脉结扎。另1例动脉结扎后出血立即停止。     

手术切除腭扁桃体、微波治疗舌扁桃体所致咽异感症

我院1997年10月~2009年7月应用手术切除腭扁桃体、微波治疗舌扁桃体肥大引起的咽异感症,取得较好效果,现报告如下: 1资料与方法 1.1 一般资料 427例中,男278例,女149例;其中年龄在20岁以下者87例,21-40岁者296例,41-50岁者32例,50岁以上者12例.病程2周~22a,平均6a.主要临床症状为咽异物感、阻塞感、咽部稍疼痛、干咳,稍有干呕等.经纤维喉镜检查见双侧腭扁桃体1°~2°肿大,表面凹凸不平,部分可见白色络纹,舌根部有较多颗粒状淋巴组织隆起,分布于舌根及两侧.     

基于鼻内带蒂组织瓣蝶腭动脉的解剖研究

目的　研究蝶腭动脉及其分支的解剖特征,为临床获取鼻内黏膜瓣提供解剖学依据。 方法　用10具（20侧）成人尸颅标本在在手术显微镜下对蝶腭动脉及其分支鼻后中隔动脉和鼻后外侧动脉进行观测。 结果　蝶腭动脉是鼻腔的主要供血动脉,在出蝶腭孔前或后分为鼻后中隔动脉和鼻后外侧动脉,鼻后中隔动脉在蝶窦前壁分成两支,主干或上支到蝶窦开口的距离为（3.95±0.74）mm,主干或下支距离后鼻孔的最短距离为（8.96±1.69）mm。鼻后外侧动脉在中鼻甲后端前下约10 mm处分为中鼻甲动脉和下鼻甲动脉。 结论　熟悉掌握蝶腭动脉及其分支的解剖特征对获取鼻内组织瓣有重要意义。鼻中隔粘膜瓣切取时应紧贴蝶窦开口上缘及后鼻孔边缘。在获取下鼻甲、中鼻甲黏膜瓣时,应特别注意靠近下鼻甲的下鼻甲后端10 mm及中鼻甲后端前下约10 mm区域。     

右肾血管伴右卵巢静脉变异1例

正在解剖一具中年女性尸体(身长168 cm)时,发现右肾动脉主干分出2支右肾副动脉,从肾门处分出3支肾静脉汇入下腔静脉,在右肾的上极发出1支肾副静脉汇入下腔静脉,此外有2支右卵巢静脉汇合形成卵巢静脉主干汇入下腔静脉(图1),为了在图片上便于观察,故将下腔静脉置于肾动脉主干后方。为积累国人解剖学资源,且为临床诊断、手术治疗等提供参考资料,现报道如下:     

鼻咽部的淋巴系

1.在70例胎儿及婴儿尸体上用器官内淋巴管注射的方法,观察了鼻咽部的淋巴管及其局部淋巴结。 2.在鼻咽部粘膜层具有一层毛细淋巴管网,于咽鼓管扁桃体及咽扁桃体处最为密集。粘膜层毛细淋巴管注入粘膜下淋巴管,后者汇成数条输出管。 3.从鼻咽部后壁走出的输出管注入咽后内、外侧淋巴结,或是经过颈内动、静脉的后方,注入乳突尖部深处的颈上深淋巴结。 4.从鼻咽部侧壁走出的输出管,注入颈内动、静脉出入颅底处前方的淋巴结,或向下入颈静脉二腹肌淋巴结及在舌动脉起点至颈总动脉分岐处之间的颈上深淋巴结。 5.咽后外侧淋巴结位于寰椎侧块高度,有1～2个;咽后内侧淋巴结紧贴咽腱膜,仅有1个。充色的颈静脉二腹肌淋巴结仅有一个,形体较大。     

口咽淋巴组织群的抗病毒作用

口咽部淋巴组织群的作用长期以来被忽视,近年来研究发现,口咽粘膜相关淋巴组织在机体抗病毒机制中起着重要作用。口咽部有丰富的淋巴组织而且分布集中,腭扁桃体、咽扁桃体,舌扁桃体,和咽鼓管扁桃体等淋巴组织构成“韦氏环”,对外来物质构成一个强大的淋巴关卡,本文就口咽部淋巴组织群的解剖结构,细胞构成,免疫学特性及抗病毒作用等方面进行初步的阐述。     

Yak (Bos grunniens) Tonsils: Morphological Description and Expression of IgA and IgG

This study aimed to describe the morphology, expression of IgA and IgG in adult yak tonsils. The 12 clinically healthy yak tonsils [3- to 6-year old, n = 12] were examined for morphology using light, and transmission electron microscopes. Expression of IgA and IgG was measured by qRT-PCR, ELISA, and immunohistochemistry. The results showed that the palatine tonsil, the tonsil of the soft palate, and the lingual tonsil were oropharyngeal tonsils. The stratified squamous epithelia covering them had a thick underlying layer of connective tissue and their crypts were heavily infiltrated by lymphocytes. The pharyngeal tonsil and the tubal tonsil were nasopharyngeal tonsils. The epithelia of them was predominantly pseudostratified columnar ciliary epithelium, which were loosely arranged with a number of desmosomes or intermediate junctions variably connecting them. The expression levels of IgA and IgG mRNA and protein from high to low was in the pharyngeal tonsil, palatine tonsil, tonsil of the soft palate, lingual tonsil, and tubal tonsil, respectively. Interestingly, the expression of IgG was very significantly higher than that of IgA in yak tonsils (P < 0.01). Both the IgA and IgG ASCs were distributed in the subepithelial areas of the non-reticular crypt epithelium, especially areas of pseudostratified columnar ciliary epithelium, the reticular crypt epithelium, lymphoid follicles, interfollicular areas, and with some of the positive cells aggregating around the glands. The results indicated that the tonsils were not only typical secondary lymphoid organs but also lymphoepithelial structures. IgG could be a significant component of mucosal immune responses in yak tonsils. Anat Rec, 302:999–1009, 2019. © 2018 Wiley Periodicals, Inc.     

An electron and light microscope study of the caecal tonsil: The basic unit of the caecal tonsil

The caecal tonsil (CT) develops in the initial 4–18 mm of each of the chicken's caecal pouches. Utilizing scanning and transmission electron microscopy and light microscopy we identified the basic unit of the CT. The basic unit contains a central crypt with several primary branches, dense lymphoid tissue and germinal centers. The main structural design of the CT appears to correspond to the mammalian palatine and lingual tonsils.     

Ultramicroscopic Examination of the Ovine Tonsillar Epithelia

As solid morphological knowledge of ovine tonsillar epithelia might contribute to a better understanding of the pathogenesis of several diseases including prion diseases, the epithelia of all tonsils of 7 one‐year‐old Texel sheep were examined using scanning and transmission electron microscopy. Major parts of the pharyngeal and tubal tonsils were covered by pseudostratified columnar ciliated epithelia that were interrupted by patches of epithelium containing cells with densely packed microfolds or microvilli, and cells with both microvilli and cilia. Smaller parts were covered by either flattened polygonal cells with densely packed microvilli or microfolds, squamous epithelial cells, or patches of reticular epithelium. The palatine and paraepiglottic tonsils were mainly lined by squamous epithelial cells with apical microplicae or short knobs. Additionally, regions of reticular epithelium containing epithelial cells with apical microvilli were seen. The lingual tonsil was uniformly covered by a keratinized squamous epithelium and devoid of microvillous cells and patches of reticular epithelium. The rostral half of the tonsil of the soft palate was lined by a pseudostratified columnar ciliated epithelium with characteristics of the pharyngeal and tubal tonsils. The epithelium of the caudal part resembled the epithelia of the palatine and paraepiglottic tonsils. Putative M cells, mainly characterized by apical microvilli or microfolds and a close association with lymphoid cells, seem manifestly present on the nasopharyngeal tonsils. The reticular epithelium of the palatine and paraepiglottic tonsils also harbor cells with small apical microvilli. The exact nature of these presumptive M cells should, however, be elucidated in functional studies. Anat Rec, 2010. © 2010 Wiley‐Liss, Inc.     

The posterior inferior cerebellar artery and its branches in relation to the cerebellomedullary fissure

The conventional approach to the fourth ventricle is by splitting the vermis on the suboccipital surface of the cerebellum. By a unilateral transcerebellomedullary fissure approach, it is possible to provide sufficient operative space from cerebral aqueduct to obex without splitting the vermis. This approach needs meticulous dissection of the cerebellomedullary fissure and preservation of the posterior inferior cerebellar artery (PICA) and its branches. The tonsillomedullary and telovelotonsillar segments of the PICA are the most important vessels encountered in the transcerebellomedullary fissure approach. The PICA was examined under a surgical microscope in a total of 40 specimens by perfusing with a mixture of 10% Indian ink and gelatin. The passing of the tonsillomedullary segment of the PICA through the cerebellomedullary fissure was observed superior to the tonsil in 5%, at the level of the upper pole of the tonsil in 17.5%, at the middle of the tonsil in 37.5% and at the level of the lower pole of the tonsil in 37.5% specimens. When the PICA arose from the lateral medullary (LM) segment of the vertebral artery (VA), a caudal loop was present in 90%, when the PICA originated from the premedullary segment of the VA, the loop was present in 87.5% specimens. When the PICA arose from the basilar artery (BA), the loop was absent, and the tonsillomedullary segment of the PICA showed a straight course (100%). A thorough understanding of the relationship of the branches of the PICA to the cerebellar tonsils are prerequisites for surgery in and around the fourth ventricle.     

Innervation of human soft palate muscles

Our objective was to determine the branching and distribution of the motor nerves supplying the human soft palate muscles. Six adult specimens of the soft palate in continuity with the pharynx, larynx, and tongue were processed with Sihler's stain, a technique that can render large specimens transparent while counterstaining their nerves. The cranial nerves were identified and dissection followed their branches as they divided into smaller divisions toward their terminations in individual muscles. The results showed that both the glossopharyngeal (IX) and vagus (X) nerves have three distinct branches, superior, middle, and inferior. Only the middle branches of each nerve contributed to the pharyngeal plexus to which the facial nerve also contributed. The pharyngeal plexus was divided into two parts, a superior innervating the palatal and neighboring muscles and an inferior innervating pharyngeal constrictors. The superior branches of the IX and X nerves contributed innervation to the palatoglossus, whereas their middle branches innervated the palatopharyngeus. The palatoglossus and palatopharyngeus muscles appeared to be composed of at least two neuromuscular compartments. The lesser palatine nerve not only supplied the palatal mucosa and palatine glandular tissue but also innervated the musculus uvulae, palatopharyngeus, and levator veli palatine. The latter muscle also received its innervation from the superior branch of X nerve. The findings would be useful for better understanding the neural control of the soft palate and for developing novel neuromodulation therapies to treat certain upper airway disorders such as obstructive sleep apnea.     

Branching pattern of the external branch of the superior laryngeal nerve and its clinical importance

The external branch of the superior laryngeal nerve gives off many branches above the upper pole of the thyroid gland. Differentiating the branch innervating the cricothyroid muscle from the others may be important during surgery. Therefore, we aimed to demonstrate the branching pattern of this nerve in detail. In 34 human cadavers (59 sides), branches of the nerve were exposed and measurements related to them and neighboring structures were made. A cricothyroidal branch was present on all sides. This branch pierced the inferior pharyngeal constrictor muscle 3.9-17.6 mm above, 3.1-9.9 mm below, or at the level of the upper pole of the thyroid gland. On all sides, the nerve provided one or two thyroidal branches. The thyroidal branch was generally thinner than the cricothyroidal branch. But they were equal in size on three (5%) sides. The external laryngeal nerve provided two or three pharyngeal branches on all sides. These branches arose from the nerve 3.5-12.7 mm from the upper pole of the thyroid gland. Although the branch was generally thinner than the cricothyroidal branch, both branches were equal on four (6.7%) sides. Two cardiac branches were observed on two (3.3%) left sides. In conclusion, the cricothyroidal branch was generally thicker than the other branches. But on seven (11.8%) sides, thyroidal or pharyngeal branches and the cricothyroidal branch were equal in size. These data may be important during surgery as the surgeon may confuse the cricothyroidal branch with other branches of the external laryngeal nerve.     

Dental laminae and teeth of embryonic Ichthyophis glutinosus (L.) (Amphibia: Gymnophiona)

Light microscopic studies of dental lamina anlagen and the form and order of primary teeth were undertaken on embryos of Ichthyophis glutinosus. The palate dental lamina responsible for the dentition of the vomers and the palatine portions of the maxillopalatines develops unpaired on the lingual sides of these bones. Similarly, the upper jaw dental lamina is undivided in the rostro-median; it originates lingual to the premaxillaries. Orally paired and aborally unpaired, the dental laminae of the lower jaw are laid down along the inner sides of their respective bony anlagen. Of these, the orally undivided dental lamina corresponds to the dental portion of the caudally fused lower jaw bones while the aboral pair of dental laminae correspond to the splenial portions. When fully developed, the primary teeth are unbladed-conical and divided. They are labio-marginal, monostichous and pleurally anchored.     

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     

Immunomorphological lymphocytic-tissue associations in the anterior gastrointestinal tract in human fetus

Prevalence of T-cell system of the immunity is found in the pharyngeal, lingual and palatine tonsils and lymph nodes. B-lymphocytes are much less numerous. Adenocytes consolidation in the structure of "pharyngeal hypophysis" is considered as additional part of the anterior hypophysis. The structure of the mucous membrane in the region of pharyngeal hypophysis is described. This membrane is deprived of protective epithelium and mucous glands.     

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,有连续呈葫芦串者.