咀嚼肌的应用解剖学研究——I.咬肌的动脉与神经

在30具(男23.女7)共60例成人尸体上观察与测量了咬肌的动脉与神经来源、咬肌神经的分支以及肌内构筑、咬肌由上颌动脉咬肌支和邻近动脉肌支供血,面动脉与面横动脉的咬肌支为其主要营养动脉.咬肌神经在肌内可分成单干和双干两型,前者居多,两型中其肌内分支间均有吻合.就结果对有关颌面外科应用问题进行了探讨.     

Correlation between the course of the medial plantar artery and the morphology of the abductor hallucis muscle

The abductor hallucis muscle flap is commonly used as a proximally-based flap in the management of ankle, heel, and midfoot lesions, where it is ideally suited for closing defects. This study investigates the anatomical details of this muscle in 13 fresh male cadavers. The medial plantar artery (MPA) was studied by dissection and macroscopic analyses to document the relationship of its superficial and deep branches with respect to the abductor hallucis muscle (AHM). Three main patterns could be described. In Pattern A (54%) the MPA divides into two branches. The deep branch reaches the deep surface of the AHM, supplying its proximal part, and the superficial branch courses between the AHM and the flexor digitorum brevis, to end as the first plantar metatarsal artery. The latter supplies two to three small branches to the distal part of the AHM. The fibers of the AHM end symmetrically on the two sides of the tendon and the muscle presents an arciform shape. The MPA, in Pattern B (38%), lacks a deep branch and continues along the lateral border of the AHM as a superficial branch that supplies proximal and distal collaterals to the muscle. The muscle fibers of the AHM end mainly on the medial side of the tendon. The muscle belly presents an arciform shape and is located on the medial margin of the foot superomedially with respect to Pattern A. In Pattern C (8%) the MPA continues as a large deep branch on the deep surface of the AHM and ends as the medial collateral artery of the big toe. A smaller superficial branch of the MPA provides a few collaterals to the AHM from its proximal part and to the flexor digitorum brevis in its distal part. The AHM fibers end mainly on the lateral side of the tendon and morphologically the muscle presents a straight line on the sole of the foot compared to Pattern A. Although Patterns B and C, from a surgical point of view, necessitate interruption of the main trunk of the MPA, Pattern A may permit the vascularization of the muscles of the medial side of the sole of the foot by the superficial trunk of the MPA. Because preoperative radiological study of the plantar vessels correlate with the morphological characteristics of the AHM observed during surgery, such imaging may be useful in determining the appropriate flap design based on the patient's unique pattern of MPA branching.     

尺动脉腕背支升支皮瓣的应用解剖学研究

目的　为临床应用尺动脉腕背支升支皮瓣修复手部创面 ,提高治疗效果提供解剖学基础。方法　用新鲜成人男性上肢标本 1 6侧 ,采用显微解剖学技术 ,对尺动脉腕背支升支的起始、走行、分支及分布进行解剖学观察和测量。结果　尺动脉腕背支起始于尺动脉的尺侧 ,距豌豆骨上方 4 2 .6 0± 8.2 0mm ,起始处外径1 .4 6± 0 .32mm ,长 1 1 .4 6± 8.2 0mm。尺动脉腕背支与尺神经手背支伴行 ,穿过尺侧腕屈肌腱的深面 ,从掌侧向后内侧斜行 ,两者成锐角 ,平均 38.6 0± 8.2 0°,行至 1 1 .4 6mm处分为升支与降支。升支穿深筋膜进入皮下组织 ,沿前臂内侧缘上行 1 2 2 .4 0± 1 3.80mm处再分为细小分支 ,升支起始部的外径为 0 .6 2± 0 .2 8mm。结论　尺动脉腕背支升支皮瓣是以尺动脉腕背支升支为蒂 ,可在前臂尺侧设计大面积岛状皮瓣 ,通过转位修复腕部和手部创伤及挛缩瘢痕切除术后的创面 ,不牺牲前臂主要血管 ,手术操作易于掌握     

足背内侧皮神经营养血管皮瓣修复足远端创面应用解剖

目的：为远端蒂足背内侧皮伸经浅静脉营养血管皮瓣修复足远端皮肤缺损提供解剖学基础。方法：在31侧成人下肢标本f：解削观察足背内侧皮神经分支分布特点，6侧新鲜足标本观测皮神经血供分规律。结果：足背内侧皮神经及其分支恒定的血供来源，近端主要来自胫前动脉末端或足背动脉发m的皮支，外径0．8～1．0mm，内、外侧支远端来自南足底内侧动脉的皮支和第2跖背动脉末端的皮支，皮动脉外径在0.5—0．8mm。皮动脉分支营养神经及神经及浅静脉，在神经和静脉旁分支间形成链式吻合，与筋膜皮肤的血管互相吻合。结论：足背内侧皮神经浅静脉营养血管足背皮瓣可设计两种远端蒂修复足远端创面，(1)以第1跖趾关节内侧近端1．3～1．5cm为旋转轴点。(2)以距第2趾蹼游离缘1．5cm为旋转轴点。     

肠系膜上静脉外科干及下腔静脉下段的应用解剖观察

本文解剖了30具成人尸体,对肠系膜上静脉外科干、下腔静脉下段的位置、长度、外径、两者的相互关系以及前者与肠系膜上动脉分支后者与腹主动脉分支的关系等进行了观察测量。认为国人的外科干至少80％能满足手术中行肠腔静脉吻合术应具备的四点要求。     

腕关节关节囊内韧带的解剖观察及其创伤学意义

本文描绘了腕关节关节囊内韧带的解剖,其中首次描述了中腕关节的韧带连结,即大、小多角骨,头状骨至舟状骨的韧带和钩骨至三角骨的韧带.本文还论述了与这些韧带连结方式密切相关的腕骨生理运动特点及维持腕关节稳定性的因素.文章还讨论了与腕关节关节囊内韧带有关的腕部创伤学特点.     

The juxtaglomerular apparatus in malignant hypertension of man

Summary Investigation of the behaviour of the renal Juxtaglomerular apparatus in 19 patients with malignant hypertension has shown that in kidneys fixed immediately after operation the Juxtaglomerular granulation index is twice as high as in autopsy kidneys. The formation of renin by the epitheloid cells begins with the appearance of osmiophilic substances in the region of the endoplasmic reticulum. The first stages of granule formation are small rhomboid particles in the Golgi cisternes, which aggregate to form bigger round or polymorphic granules in the Golgi area.In pathological conditions the substances synthesized may be set free and become active locally as a result of fibrinoid necrosis of the vascular wall. The rate of production is increased firstly by forcing rhe production of active agents in the preexistent epitheloid cells, secondly by transformation of the so-called bivalent cells and finally, by cell division.In accelerated hypertension the production of renin also takes place in nephrons whose glomeruli, tubules and macula densa, are damaged. There is a correlation between blood pressure elevation and the Juxtaglomerular granulation index.

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Zusammenfassung Untersuchungen über das Verhalten des juxtaglomerulären Zellkomplexes der Niere bei 19 Patienten mit maligner Hypertonie haben folgendes ergeben: In operativ gewonnenen und sofort fixierten Nieren ist der juxtaglomeruläre Granulationsindex doppelt so hoch wie in Nieren aus dem Sektionsgut. Die Reninbildung der epitheloiden Zellen beginnt mit dem Auftreten osmiophiler Substanzen im Bereich des endoplasmatischen Reticulums. Kleine rhomboide Gebilde in Golgizisternen sind Vorstufen von reifen Sekretgranula, die sich im Golgifeld zu größeren runden oder vielgestaltigen Sekrettropfen zusammenlagern.Unter pathologischen Bedingungen können infolge fibrinoider Gefäß- wandnekrosen Sekretsubstanzen lokal frei und lokal wirksam werden. Vermehrte Arbeitsleistung erfolgt zunächst durch Forcierung der Sekretproduktion in den präexistenten epitheloiden Zellen, sodann durch Transformierung sogenannter bivalenter Zellen und schließlich durch Zellneubildungen.Reninproduktion findet bei akzelerierter Hypertonie auch in solchen Nephronen statt, deren Glomerula und Tubuli samt Macula densa strukturell geschädigt sind. Es besteht eine Korrelation zwischen Höhe des Blutdruckes und Höhe des Granulationsindex.

     

Morphological changes in the internal organs in chronic streptococcal infection

A histological and histochemical study was made of the internal organs of albino mice at various times (from 24 h to 27 weeks) after a single intraperitoneal injection of L-forms of -hemolytic group A streptococci. A progressive pathological process (myocarditis, hepatitis, glomerulonephritis) against a marked allergic bacground and leading to systemic lesions of the tissues was discovered.Institute of Human Morphology, Academy of Medical Sciences of the USSR. N. F. Gamaleya Institute of Epidemiology and Microbiology, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR A. P. Avtsyn.) Translated from Byullten' Éksperimental'noi Biologii i Meditsiny, Vol. 80, No. 9, pp. 111–115, September, 1975.     

女性盆底可视化研究

目的：建立中国人体女性盆底部局部可视化数字模型。方法：应用中国女性数字化可视人体数据集，采用体绘制及面绘制重建方法，分别在P4微机和SGI工作站上对盆底部结构进行计算机三维重建及立体显示。结果：在P4微机上实现女性盆底部交互式三维可视化，在SGI工作站上重建了女性盆底部三维数字模型，三维重建图像能够清晰显示盆底部肌肉与骨性结构、膀胱、子宫及直肠等的三维解剖关系。结论：中国女性数字化可视人体数据集能够提供完整精确的断面数据，女性盆底三维交互可视化及数字模型准确反映该区域复杂的解剖结构及其空间毗邻关系，可为该区疾病的影像诊断及外科手术治疗提供形态学依据。     

Fossa navicularis: anatomic variation at the skull base

The fossa navicularis is a relatively rare anatomic variation of the skull base. Awareness of its existence will avoid misinterpretations of radiological images and unnecessary investigations. This study describes the appearance of the fossa navicularis, and investigates its incidence and whether it is related to pathology at the basiocciput. We studied 492 dry human skulls and 525 computer tomography (CT) images of patients. Dry skulls showing a fossa navicularis were investigated by CT scan, whereas patients identified as having a fossa navicularis were further examined with magnetic resonance imaging (MRI). To document the position of the fossa more precisely, measurements were made between the fossa navicularis and certain anatomic landmarks such as the foramen ovale, the pharyngeal tubercle, the posterior border of the vomer, the foramen lacerum, the carotid canal, and the occipital condyle. Upon examination, 26 of 492 skulls (5.3%) were found to have a fossa navicularis. Twelve were <2 mm in depth and the other 14 had a depth of >/=2 mm. Of the 525 patients, 16 (3.0%) were identified as having a fossa navicularis in CT images. Evaluation of MRIs showed no soft tissue lesions in any of these patients. Comprehensive anatomic details of the fossa navicularis have not been reported in the literature. The results of this study may be useful to radiologists, anatomists, and surgeons interested in the skull base.