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Morphological classification, anatomical variations, innervation patterns, musculocutaneous nerve relation of the coracobrachialis muscle: anatomical study and clinical significance. 腕角肌的形态分类、解剖变异、支配模式、肌皮神经关系:解剖学研究和临床意义。
IF 1.1 Q3 Medicine Pub Date : 2024-06-30 Epub Date: 2024-05-13 DOI: 10.5115/acb.24.032
Ashraf Youssef Nasr, Rawan Ashraf Youssef

The anatomical variations of coracobrachialis muscle (CBM) are of great clinical importance. This study aimed to elucidate the morphological variations, innervation patterns and musculocutaneous nerve (MCN) relation to CBM. Upper limbs of fifty cadavers (30 males and 20 females) were examined for proximal and distal attachments, innervation pattern of CBM and its relation to MCN. Four morphological types of CBM were identified according to number of its heads. The commonest type was the two-headed (63.0%) followed by the single belly (22.0%), three-headed (12.0%) and lastly fourheaded (3.0%) type. Moreover, an abnormal insertion of CBM was observed in four left limbs (4.0%); one inserting into the medial humeral epicondyle, the second into the upper third of humeral shaft, the third one in the common tendon of biceps, and the fourth one showing a bifurcated insertion. Also, four different innervation patterns of CBM were identified including MCN (80.0%), lateral cord (14.0%), lateral root of median nerve (4.0%), and median nerve itself (2.0%). The course of MCN was superficial to the single belly CBM (19.0%) and in-between the heads in the other types (71.0%). Measurements of the length and original distance of CBM muscular branches originating from MCN revealed no sex or side significant difference. Awareness of the anatomic variations, innervation patterns, and MCN relation of CBM is imperative in recent diagnostic and surgical procedures to obtain definite diagnosis, effective management and good outcome.

冠状肱肌(CBM)的解剖变异具有重要的临床意义。本研究旨在阐明CBM的形态变化、神经支配模式和肌皮神经(MCN)的关系。研究人员对 50 具尸体(30 名男性和 20 名女性)的上肢进行了检查,以了解 CBM 的近端和远端附着情况、支配模式及其与 MCN 的关系。根据CBM的头数,确定了四种形态类型。最常见的是双头型(63.0%),其次是单头型(22.0%)、三头型(12.0%)和四头型(3.0%)。此外,有 4 个左侧肢体(4.0%)的 CBM 插入异常,其中一个插入肱骨内上髁,第二个插入肱骨轴的上三分之一处,第三个插入肱二头肌的共同肌腱,第四个显示分叉插入。此外,还发现了四种不同的 CBM 神经支配模式,包括正中神经网(80.0%)、侧索(14.0%)、正中神经外侧根(4.0%)和正中神经本身(2.0%)。正中神经的走向在单腹CBM的表层(19.0%),而在其他类型中则在两头之间(71.0%)。对源自 MCN 的 CBM 肌肉分支的长度和原始距离进行测量后发现,没有性别或侧显着差异。对CBM的解剖变异、神经支配模式和与MCN的关系的认识在近期的诊断和外科手术中是非常必要的,这样才能获得明确的诊断、有效的治疗和良好的疗效。
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引用次数: 0
Insertions of the striated muscles in the skin and mucosa: a histological study of fetuses and cadavers. 横纹肌在皮肤和粘膜中的插入:对胎儿和尸体的组织学研究。
IF 1.1 Q3 Medicine Pub Date : 2024-06-30 Epub Date: 2024-05-09 DOI: 10.5115/acb.24.048
Ji Hyun Kim, Gen Murakami, José Francisco Rodríguez-Vázquez, Ryo Sekiya, Tianyi Yang, Sin-Ichi Abe

Striated muscle insertions into the skin and mucosa are present in the head, neck, and pelvic floor. We reexamined the histology of these tissues to elucidate their role in transmission of the force. We examined histological sections of 25 human fetuses (gestational ages of ~11-19 weeks and ~26-40 weeks) and 6 cadavers of elderly individuals. Facial muscle insertion or terminal almost always formed as an interdigitation with another muscle or as a circular arrangement in which muscle fiber insertions were sandwiched and mechanically supported by other muscle fibers (like an in-series muscle). Our examination of the face revealed some limited exceptions in which muscle fibers that approached the dermis were always in the nasalis and mentalis muscles, and often in the levator labii superioris alaeque nasi muscle. The buccinator muscle was consistently inserted into the basement membrane of the oral mucosa. Parts of the uvulae muscle in the soft palate and of the intrinsic vertical muscle of the tongue were likely to direct toward the mucosa. In contrast, the pelvic floor did not contain striated muscle fibers that were directed toward the skin or mucosa. Although 'cutaneous muscle' is a common term, the actual insertion of a muscle into the skin or mucosa seemed to be very rare. Instead, superficial muscle insertion often consisted of interdigitated muscle bundles that had different functional vectors. In this case, the terminal of one muscle bundle was sandwiched and fixed mechanically by other bundles.

在头部、颈部和骨盆底,有条纹肌插入皮肤和粘膜。我们重新研究了这些组织的组织学,以阐明它们在力量传递中的作用。我们研究了 25 个人类胎儿(胎龄约为 11-19 周和约 26-40 周)和 6 具老年尸体的组织切片。面部肌肉的插入点或末端几乎总是与另一块肌肉相互咬合,或者呈环形排列,其中肌纤维插入点被其他肌纤维夹住,并由其他肌纤维提供机械支持(就像序列内肌肉)。我们对面部的检查发现了一些有限的例外情况,即接近真皮层的肌肉纤维总是位于鼻肌和心肌中,而且经常位于唇上提肌alaeque nasi中。颊粘膜肌始终插入口腔粘膜基底膜。软腭的部分悬雍垂肌和舌头的固有垂直肌很可能指向粘膜。相比之下,骨盆底不包含指向皮肤或粘膜的横纹肌纤维。虽然 "皮肤肌肉 "是一个常用术语,但肌肉实际插入皮肤或粘膜的情况似乎非常罕见。相反,表层肌肉的插入通常由具有不同功能矢量的相互交错的肌束组成。在这种情况下,一个肌束的末端被其他肌束夹住并进行机械固定。
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引用次数: 0
Challenging arterial pattern of foregut and its potential impact on surgery. 具有挑战性的前肠动脉模式及其对手术的潜在影响。
IF 1.4 Q3 ANATOMY & MORPHOLOGY Pub Date : 2024-06-27 DOI: 10.5115/acb.24.078
Phalguni Srimani, Anubha Saha

Anticipating a wide range of morphological variations of arterial anatomy of foregut derivatives beyond the classical pattern, a precise understanding is pertinent to preoperative diagnosis, operative procedure and to avoid potentially devastating post-operative outcome during various traumatic and non-traumatic vascular insult of foregut. The study aimed to revisit the morphological details and update unusual configurations of arteries of foregut to establish clinico-anatomical correlations. This study described the detailed branching pattern of coeliac trunk (CT) as principal artery of foregut with source & course of hepatic, gastric, duodenal and pancreatic branches in 58 cadaveric dissections. Based on morphology, different types and subtypes were made. The descriptions were explained using figures and pertinent tables. Among classical branches of CT, splenic artery was found as most stable whereas other two branches were found to be most variable with missing common hepatic artery in 11 cases. In addition to classical trifurcation (65.52%), different types of bifurcation (12.07%) and tetrafurcations (22.41%) of CT were observed. Regarding variations of hepatic arteries (27.59%), both non-classical origin and accessory hepatic branches were found. In case of gastric branches, more variant origins were seen with right gastric (50%) as compared to left gastric artery (34.48%). Other morphological variations included non-classical origin of gastro-duodenal artery (18.96%) along with presence of accessory pancreatic (17.13%) and duodenal arteries (6.38%). Awareness of anatomical variations regarding circulatory dynamics of foregut is worth knowing in order to facilitate successful planning of surgery involving upper abdominal organs with least complications.

前肠衍生物的动脉解剖形态变化范围广泛,超出了传统模式的范畴,因此准确了解这些形态变化对于术前诊断、手术过程以及避免前肠遭受各种创伤和非创伤性血管损伤时可能出现的破坏性术后结果至关重要。本研究旨在重新审视前肠动脉的形态细节并更新其不寻常的构型,以建立临床解剖学相关性。这项研究描述了 58 例尸体解剖中作为前肠主要动脉的腹腔干(CT)的详细分支模式,以及肝、胃、十二指肠和胰腺分支的来源和走向。根据形态,划分出不同的类型和亚型。并用数字和相关表格进行了说明。在 CT 的经典分支中,脾动脉最为稳定,而其他两个分支的变化最大,其中有 11 例缺少肝总动脉。除了经典的三叉(65.52%)外,还观察到不同类型的 CT 分叉(12.07%)和四叉(22.41%)。关于肝动脉的变异(27.59%),发现了非经典起源和附属肝分支。在胃动脉分支方面,与胃左动脉(34.48%)相比,胃右动脉(50%)的变异起源更多。其他形态变异包括胃十二指肠动脉(18.96%)的非经典起源,以及胰腺(17.13%)和十二指肠动脉(6.38%)的分支。对前肠循环动力学解剖变异的认识值得了解,以便成功规划涉及上腹部器官的手术,减少并发症。
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引用次数: 0
Variability in the projection level of the vertebra prominens: a cadaveric study. 椎体突出水平的变化:尸体研究。
IF 1.4 Q3 Medicine Pub Date : 2024-06-25 DOI: 10.5115/acb.24.061
Trifon Totlis, Andreas Sammer, Maria Piagkou, Konstantinos Natsis, Panagiotis-Konstantinos Emfietzis, Filippos Karageorgos, George Tsakotos, George Triantafyllou, Georg Feigl

The 7th cervical vertebra (C7) is described as having the most prominent spinous process (SP) and is characterized as the "vertebra prominens" (VP) of the cervical spine in anatomy textbooks. The VP is an important anatomical landmark of the neck for clinical examination and therapeutic intervention. The present study identifies the level of the most prominent SP of the cervical and uppermost thoracic vertebrae in a cadaveric cohort. Thirty-nine (23 female and 16 male) cadavers of a mean age of 77.5 years were investigated in a prone position and a certain cervical kyphotic bending. The most prominent SP, at the base of the neck, was palpated and marked with a wedging nail into the SP of the vertebra. The cervical region was dissected, and a blind investigator examined whether the nail was placed into the SP of C7 or the SP of another upper or lower vertebra. In 19 out of 39 cadavers (48.7%), the C7 was identified as the VP (typical anatomy), followed by the C6 (in 14 cadavers, 35.9%), C5 (in 4 cadavers, 10.3%). In 2 cadavers (5.1%) the first thoracic vertebra was identified as having the most prominent SP. Although C7 is described as the VP, in the present study the SP of C7 was the most prominent in less than 50%. The high variable projection level of the most prominent SP of the cervical vertebra holds great clinical significance for spine examination, neck surgery, and spinal anesthesia.

第 7 颈椎(C7)被描述为具有最突出的棘突(SP),在解剖教科书中被称为颈椎的 "突出椎体"(VP)。VP 是临床检查和治疗干预的重要颈部解剖标志。本研究确定了尸体群中颈椎和最上胸椎最突出 SP 的水平。研究人员对 39 具(23 女 16 男)平均年龄为 77.5 岁的尸体进行了俯卧位和一定的颈椎弯曲度调查。触诊颈部底部最突出的 SP,并用楔入椎体 SP 的钉子做标记。解剖颈椎区域,由一名盲人调查员检查钉子是钉在 C7 椎体的 SP 上,还是钉在其他上部或下部椎体的 SP 上。39 具尸体中有 19 具(48.7%)的 C7 被确定为 VP(典型解剖),其次是 C6(14 具尸体,35.9%)、C5(4 具尸体,10.3%)。在 2 具尸体(5.1%)中,第一胸椎被确认为具有最突出的 SP。虽然 C7 被描述为 VP,但在本研究中,C7 的 SP 最突出的比例不到 50%。颈椎最突出 SP 的投影水平变化较大,这对脊柱检查、颈部手术和脊髓麻醉具有重要的临床意义。
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引用次数: 0
Prevalence of anatomical variants in the branches of celiac and superior mesenteric arteries among Egyptians. 腹腔动脉和肠系膜上动脉分支解剖变异在埃及人中的流行情况。
IF 1.4 Q3 Medicine Pub Date : 2024-06-25 DOI: 10.5115/acb.23.316
Abdelrazek Abdelhady Sheta

Celiac trunk and superior mesenteric artery (SMA) are the main blood supply to the liver and pancreas. The data of anatomical variations in these arteries or their branches are very important clinically and surgically. The aim of this study was to describe the different variants in these arteries through the examination of the angiographs of a large series of Egyptian individuals. This research involved 389 selective angiographies to celiac artery, its branches, and the SMA. Anatomy of the target arteries of people who experienced visceral angiograph was reviewed and the data were recorded. From the total available angiograms in this work, 286 patients (73.52%) had the standard anatomy of celiac trunk and superior mesenteric arteries, and 103 patients (26.47%) had a single or multiple vessel variation. The inferior phrenic artery originates from celiac trunk in 2.05% of patients, while quadrifurcation of the celiac trunk was noticed in only 0.51% of patients. Absence of celiac trunk is also found in 0.51% of patients. Left gastric artery showed an abnormal origin from the splenic artery in 0.51% of patients. Quadrifurcation of common hepatic artery was also noticed. Variant anatomy of the left hepatic artery (LHA) was seen in 9.51% of patients, while variations of the right hepatic artery (RHA) were 14.13%. With the different origin of hepatic arteries, the gastroduodenal artery arose either from the LHA (2.82%), RHA (2.31%) or even from the celiac trunk (1.79%).

腹腔干和肠系膜上动脉(SMA)是肝脏和胰腺的主要供血动脉。这些动脉或其分支的解剖变异数据在临床和手术中都非常重要。本研究的目的是通过对大量埃及人的血管造影检查来描述这些动脉的不同变异。这项研究对腹腔动脉、其分支和 SMA 进行了 389 次选择性血管造影。对接受过内脏血管造影术的人的目标动脉解剖进行了审查并记录了数据。在所有可获得的血管造影中,286 名患者(73.52%)的腹腔干和肠系膜上动脉解剖结构符合标准,103 名患者(26.47%)的解剖结构存在单根或多根血管变异。2.05% 的患者的膈下动脉起源于腹腔干,而只有 0.51% 的患者腹腔干出现四叉。也有 0.51% 的患者发现腹腔干缺失。0.51%的患者的胃左动脉显示出异常,起源于脾动脉。还发现肝总动脉四叉。9.51%的患者出现肝左动脉(LHA)解剖结构变异,而肝右动脉(RHA)的变异率为14.13%。由于肝动脉的起源不同,胃十二指肠动脉要么来自肝左动脉(2.82%),要么来自肝右动脉(2.31%),甚至来自腹腔干(1.79%)。
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引用次数: 0
Morphological aspects of small intestinal mucosal injury and repair after electron irradiation. 电子辐照后小肠粘膜损伤和修复的形态学方面。
IF 1.1 Q3 Medicine Pub Date : 2024-06-17 DOI: 10.5115/acb.24.050
Grigory Demyashkin, Elza Karakaeva, Siuzanna Saakian, Vladimir Shchekin, Emir Elbuzdukaev, Umar Bamatgiraev, Daniia Ashgalieva, Makka Evsultanova, Daniil Kovalev, Darya Kabanova, Oleg Shatunov, Dmitrii Atiakshin

Morphological evaluation of the small intestine mucosa and apoptosis activity (caspase-3) is necessary to assess the severity of damage to the small intestine. At the same time, proliferative index based on Ki-67 can be used to assess the regenerative potential of the small intestine. Fragments of small intestine of Wistar rats (n=60) of three groups: I) control (n=20); II) experimental group (n=20; local single electron irradiation at a dose of 2 Gy), III) experimental group (n=20; local single electron irradiation at a dose of 8 Gy) were studied by light microscopy using hematoxylin and eosin staining and immunohistochemical reactions with antibodies to Ki-67 and caspase-3. In all samples of the experimental groups, a decrease in all morphometric indices was observed on day 1 with a tendency to recover on day 3. Small intestinal electron irradiation led to disturbances in the histoarchitecture of varying severity, and an increase in cell apoptosis was observed (increased expression of caspase-3 and decrease in Ki-67). In addition, modulation of the PI3K/AKT and MAPK/ERK signaling pathways was detected. The most pronounced destructive changes were observed in the group of 8 Gy single electron irradiation. Local irradiation of the small intestine with electrons at a dose of 2 and 8 Gy results in a decrease in the number of enterocytes, mainly stem cells of the intestinal crypts.

小肠粘膜的形态学评估和细胞凋亡活性(caspase-3)是评估小肠损伤严重程度的必要条件。同时,基于 Ki-67 的增殖指数可用于评估小肠的再生潜力。三组 Wistar 大鼠(n=60)的小肠片段:I)对照组(n=20);II)实验组(n=20;局部单次电子辐照,剂量为 2 Gy);III)实验组(n=20;局部单次电子辐照,剂量为 8 Gy)采用苏木精和伊红染色以及 Ki-67 和 Caspase-3 抗体免疫组化反应进行光镜研究。在实验组的所有样本中,所有形态指数在第 1 天均出现下降,并在第 3 天呈恢复趋势。小肠电子辐照导致不同程度的组织结构紊乱,并观察到细胞凋亡增加(caspase-3 表达增加,Ki-67 降低)。此外,还检测到 PI3K/AKT 和 MAPK/ERK 信号通路的调节。8 Gy 单次电子辐照组的破坏性变化最为明显。用 2 Gy 和 8 Gy 剂量的电子对小肠进行局部辐照会导致肠细胞(主要是肠隐窝干细胞)数量减少。
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引用次数: 0
A unilateral partial duplication of a fetal variant posterior cerebral artery associated with anomalous origin of duplicated superior cerebellar artery: a case report. 胎儿变异大脑后动脉单侧部分重复伴小脑上动脉重复异常起源:病例报告。
IF 1.1 Q3 Medicine Pub Date : 2024-05-31 DOI: 10.5115/acb.24.026
Ehab Mostafa Elzawawy, Mumen Hamdi Al-Mutori, Hadil Salim Al Awaisi, Abdulrahman Abdulrahman Al Dagher, Mustafa Mohamed Allayeth, Hassan Reda Hassan Elsayed

Variations at the junction of embryonic internal carotid and vertebrobasilar systems are rare and associated with a high incidence of stroke. During cadaver dissection, we demonstrated for the first time a case of hypoplastic right vertebral artery associated with partial duplication of the distal part of the right P1 segment of a partial fetal posterior cerebral artery (FPCA) and bilateral duplication of superior cerebellar arteries (SCAs), of which, the upper right SCA originated from PCA. We hypothesize that the poor development of the right half of the vertebrobasilar system caused the persistence of FPCA with anomalous origin of the right upper SCA as well as partial duplication of P1 segment of PCA as a remnant of the weak anastomosis between the embryonic right PCA and the basilar system. Such complex variations provide a huge challenge in their diagnosis and in choosing the suitable treatment modality for the stroke.

胚胎颈内动脉和椎基底动脉系统交界处的变异非常罕见,而且与中风的高发病率有关。在尸体解剖过程中,我们首次发现了一例右侧椎动脉发育不良的病例,该病例伴有胎儿部分大脑后动脉(FPCA)右侧 P1 段远端部分重复和双侧小脑上动脉(SCA)重复,其中右侧 SCA 上段起源于 PCA。我们推测,椎基底动脉系统右半部发育不良导致 FPCA 持续存在,右上 SCA 起源异常,以及 PCA P1 段部分重复,这是胚胎期右 PCA 与基底动脉系统之间薄弱吻合的残余。这些复杂的变异给中风的诊断和选择合适的治疗方法带来了巨大的挑战。
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引用次数: 0
Alcohol intake during pregnancy reduces offspring bone epiphyseal growth plate chondrocyte proliferation through transforming growth factor β-1 inhibition in the Sprague Dawley rat humerus. 妊娠期酒精摄入会通过抑制转化生长因子β-1,减少 Sprague Dawley 大鼠肱骨后代骨骺生长板软骨细胞的增殖。
IF 1.1 Q3 Medicine Pub Date : 2024-05-31 DOI: 10.5115/acb.23.313
Diana Pillay, Vaughan Perry, Robert Ndou

Intrauterine alcohol exposure delays bone maturation and intensifies osteoporosis and fracture risk. As most studies emphasize the neurological aspects of intrauterine alcohol exposure, there is a lack of research on the implications pertaining to osseous tissue. Previous studies investigated these effects in fetuses, with limited studies on postnatal life. Postnatal studies are crucial since peak bone growth occurs during adolescence. This study aimed at assessing the effects of prenatal alcohol exposure on the humerus proximal and distal growth plate chondrocytes in 3-week-old rats. Sprague Dawley rats (n=9) were assigned to either the ethanol group (n=3), saline (n=3), and untreated (n=3) group and time-mated. Once pregnant, as confirmed by the presence of a copulation plug, the former 2 groups were treated with 0.015 ml/g of 25.2% ethanol and 0.9% saline. The untreated group received no treatment. The left humeri belonging to 6 pups per group were used. Serial sections were cut with a microtome at 5 µm thickness. These sections were stained with haematoxylin and eosin for assessment of normal morphology or immunolabeled with anti-Ki-67 and transforming growth factor β-1 (TGFβ-1) antibody. Prenatal alcohol exposure adversely effected the growth plate sizes and the number of cells in the proliferative zone. Fewer TGFβ-1 immunopositive and proliferative chondrocytes were found using the anti-Ki-67 antibody. This may explain the growth retardation in offspring exposed to gestational alcohol, showing that gestational alcohol exposure inhibits cell proliferation, aiding the diminished stature.

宫内酒精暴露会延迟骨骼成熟,加剧骨质疏松症和骨折风险。由于大多数研究强调宫内酒精暴露对神经系统的影响,因此缺乏对骨组织影响的研究。以往的研究调查了这些对胎儿的影响,但对产后生活的研究有限。出生后的研究至关重要,因为骨骼生长的高峰期在青春期。本研究旨在评估产前酒精暴露对 3 周龄大鼠肱骨近端和远端生长板软骨细胞的影响。将 Sprague Dawley 大鼠(9 只)分为乙醇组(3 只)、生理盐水组(3 只)和未处理组(3 只),并进行时间交配。一旦妊娠,即出现交配栓后,前两组分别用 0.015 毫升/克的 25.2%乙醇和 0.9%生理盐水处理。未处理组不进行任何处理。每组使用 6 只幼鼠的左肱骨。用显微切片机切取厚度为 5 µm 的连续切片。这些切片用血红素和伊红染色以评估正常形态,或用抗Ki-67和转化生长因子β-1(TGFβ-1)抗体进行免疫标记。产前酒精暴露对生长板的尺寸和增殖区的细胞数量有不利影响。使用抗-Ki-67抗体可发现较少的TGFβ-1免疫阳性和增殖软骨细胞。这可能解释了妊娠期酒精暴露的后代生长迟缓的原因,表明妊娠期酒精暴露会抑制细胞增殖,导致身材矮小。
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引用次数: 0
Surgical anatomy of transversus abdominis muscle for transversus abdominis release. 腹横肌松解术的腹横肌手术解剖。
IF 1.1 Q3 Medicine Pub Date : 2024-05-27 DOI: 10.5115/acb.23.305
Pauline Shanthi, Femina Sam, Jenny Jacob, Beulah Roopavathana S, Suganthy Rabi

Transversus abdominis release (TAR) is a myofascial release technique which helps in surgical repair of large ventral abdominal wall defects. In this procedure, the medial margin of muscular part of transversus abdominis (TA) is of great importance. Hence, the authors sought to describe the extent of medial margin of TA muscle. The surgical steps of TAR were performed in 10 formalin-fixed cadavers and distance between medial margin of TA muscle, lateral margin of rectus abdominis, to linea alba at five anatomical levels were documented respectively. The distance between the inferior epigastric vessels and the medial border of TA muscle was also noted. The TA muscle was within the posterior rectus sheath in all cadavers, at the xiphisternum (R, 61.6 mm; L, 58.9 mm), and at midway between xiphisternum and umbilicus (R, 25.4 mm; L, 27.1 mm). The TA muscle exited the posterior rectus sheath between this point and the umbilicus. The mean incongruity at the next three levels were -24.6 mm, -24.9 mm, and -22.9 mm respectively on the right and -21.4 mm, -19.9 mm, and -18.9 mm respectively on the left. The mean distance between the medial border of TA and inferior epigastric vessels was 18.9 mm on the right and 17.2 mm on the left. The muscular part of TA was incorporated within the posterior rectus sheath above the umbilicus, and it completely exited the rectus sheath at the umbilicus. This is contrary to the traditional understanding of posterior rectus sheath formation.

腹横肌松解术(TAR)是一种肌筋膜松解技术,有助于腹壁大面积缺损的手术修复。在这种手术中,腹横肌(TA)肌肉部分的内侧缘非常重要。因此,作者试图描述腹横肌内侧缘的范围。在 10 具福尔马林固定的尸体上进行了 TAR 的手术步骤,并分别记录了 TA 肌肉内侧缘、腹直肌外侧缘到白线之间在五个解剖层次上的距离。此外,还记录了上腹部下血管与 TA 肌肉内侧缘之间的距离。所有尸体的腹直肌都在后直肌鞘内,分别位于腹股沟(R,61.6 毫米;L,58.9 毫米)和腹股沟与脐之间的中间位置(R,25.4 毫米;L,27.1 毫米)。TA肌在该点和脐之间从后直肌鞘退出。接下来三个水平的平均不一致性分别为右侧-24.6毫米、-24.9毫米和-22.9毫米,左侧-21.4毫米、-19.9毫米和-18.9毫米。TA内侧边界与上腹下血管之间的平均距离右侧为18.9毫米,左侧为17.2毫米。TA的肌肉部分被纳入脐部上方的后直肠鞘内,并在脐部完全退出直肠鞘。这与人们对后直肌鞘形成的传统理解相反。
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引用次数: 0
Middle meatal nasal recesses of the maxillary sinuses and dangerously modified nasal anatomy. 上颌窦中肉鼻腔凹陷和危险的鼻腔解剖学改变。
IF 1.1 Q3 Medicine Pub Date : 2024-05-22 DOI: 10.5115/acb.24.023
Mugurel Constantin Rusu, Alexandru Nicolae Mureşan, Carol Antonio Dandoczi, Alexandra Diana Vrapciu

Pneumatisation of the maxillary sinus (MS) is variable. The archived cone-beam computed tomography file of a 54-year-old female was retrospectively evaluated anatomically. Nasal or retrobullar recesses of the MSs (NRMS) were found. The MSs were bicameral. NRMSs extended from the postero-lateral chambers of the MSs into the lateral nasal walls. The right NRMS was reached superior to the middle turbinate and the ethmoidal bulla was applied on its anterior side. The left NRMS had two medial pouch-like ends, one beneath the ethmoidal bulla and the other on the anterior side of the basal lamella of the middle turbinate. Additional anatomical findings were the uncinate bulla, infraorbital recesses of the MS, maxillary recess of the sphenoidal sinus, and atypical posterior insertions of the superior nasal turbinates, maxillo-ethmoido-sphenoidal and ethmoido-sphenoidal. The NRMS is a novel finding and could lead to erroneous endoscopic corridors if not documented before the interventions.

上颌窦(MS)的充气情况多种多样。我们对一名 54 岁女性的锥形束计算机断层扫描档案进行了回顾性解剖评估。发现了上颌窦的鼻腔或髓后凹陷(NRMS)。多发性硬化症为双侧。NRMS 从 MS 的后外侧腔延伸至鼻侧壁。右侧 NRMS 位于中鼻甲上方,乙状鼓室位于其前侧。左侧 NRMS 有两个内侧袋状末端,一个位于乙状鼓室下方,另一个位于中鼻甲基底层前侧。其他的解剖学发现包括钩状鼓室、MS 的眶下凹陷、蝶窦的上颌凹陷以及上鼻甲、上颌-乙状-蝶窦和乙状-蝶窦的非典型后方插入。NRMS 是一项新发现,如果不在干预前记录下来,可能会导致错误的内窥镜走廊。
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Anatomy & Cell Biology
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