摘要:

AbstractObjective: To describe thoroughly and quantitatively the morphologic features of the human tricuspid valve, to define and classify classify certain prominent normal variations, and to offer a clear and concise terminology for describing its morphology. Background. In recent years there has been growing interest in the tricuspid valve. Noninvasive imaging is now commonplace and remarkably detailed. Surgical interventions involving the tricuspid valve have become increasingly common. These factors underscore the need variations. Methods. Quantitative and anatomic features of the tricuspid valve were studied in 24 normal hearts at autopsy from subject evenly distributed by age and sex. Leaflet length, surface area, chordal number, and leaflet morphology were recorded. Results. Valves demonstrated some degree of leaflet subdivision in 92% of cases. Mean tricuspid valve length was 11.3 ± 0.1 cm and the surface area was 21.0 ± 1.1 cm2. Mean lengths and surface areas were similar for the anterior, posterior, and septal leaflets (38–42 mm and 5.9–7.8 cm2, respectively). However, for a given valve, the longest leaflet could be twice the length and three times the area of the smallest. Calculated valvular diameter was 2.13 ± 0.03 cm/m2. The tricuspid valve was served by and average of 170 ± 36 chordae tendineae, 49% inserted on the free edge of the valve, 44% on the undersurface, and 7% on the basal regions. Chordal density (number of chordae/cm2) was greater in women than men (9.9 ± 0.5 vs. 7.3 ± 0.7 chordae/cm2,P<0.02). The septal leaflet had the greatest chordal density and the anterior leaflet the lowest (12.7 ± 0.9 vs. 5.9 ± chordae/cm2). Conclusions. The concept of chordal density for the tricuspid valve has not been previously described and may be clinically relevant in the pathogensis of valvular prolapse. Modifications of existing tricuspid valve nomenclature are suggested. © 1993 Wil

ISSN:0897-3806    

DOI:10.1002/ca.980060402

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractThe basic feature related to survival and the ultimate functioning of a transplanted segment or whole pancreas is the preservation and continuation of an adequate blood flow. The current study examined the anatomical variability of the arterial vascularization in 126 pancreases following their removal form cadavers by the technique routinely used for transplantation. Arteriography was conducted initially by the injection of either 75% uropolin or barium sulfate in 70 specimens following removal of the specimen. All 126 specimens were injected with latex, and corrosion casts were prepared through maceration with either sodium hydroxide or hydrochloric acid. The dorsal pancreatic artery showed the greatest variability with respect to the mode of origin and division into branches. Also 42.1% of the cases were found to have poor anastomoses between the body and tail segments. These observations suggest that it is necessary to carefully assess the origins of the vascular supply of the donor organ 1) as resection at the celiac rather than the splenic artery can increase preservation of the dorsal pancreatic artery; 2) whole organ transplantation may be indicated to ensure adequate vascularization; and 3) the presence of a separate arterial supply to the caudal segment in 42.1 % of the cases allows the consideration of its use as an independent transplant from a live donor. © 1993 Wiley‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980060403

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractThe increasing number of esophagectomies coupled with the importance of microvasculature for anastomotic healing and a paucity of published data have prompted this study. Human esophagi were harvested from 12 male and 13 female cadavers with a mean age of 57.7 years (21–84) and an average length of 30.7 cm (22–40). Transverse sections (31) of each esophagus were made at equidistant intervals and prepared for microscopy. The number of intramural capillaries was counted in each section, the mean being 51.8 (45.4–61.3). Vascularization of the esophagus was best at the level of the cricoid cartilage (57. 12), proximal to the clavicles (57.44), and in its distal thoracic part (61.28), and worst cranial to the aortic arch (47.64) and above the diaphragm (45.36). The differences were significant (p<0.05). The parts with the least number of capillaries correspond to the zones between the different origins of the main arterial sources. © 1993 Wiley‐L

ISSN:0897-3806    

DOI:10.1002/ca.980060404

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractThe anatomy of the lateral extensor compartment of the wrist has been extensively studied, since it is the site of stenosing tenosynovitis of the tendons of abductor pollicis longus and extensor pollicis brevis (de Quervain's disease). Septation of the compartment and multiplicity of the tendons within it have been thought, by some surgeons, to cause overcrowding and thus contribute to the pathogenesis of the condition.This anatomical study of ten pairs of cadaveric hands has shown that these variations are common, confirming previous reports in the literature, and, more importantly, that they are frequently bilaterally symmetrical. Since de Quervain's disease tends to occur unilaterally, it seems unlikely that anatomical variations are important in its pathogenesis.Appreciation of these variations is, however, important in surgical treatment.Adequate exposure is necessary to recognize the anatomical structures, so that all subcompartments within the fibroosseous tunnel may be decompressed. © 1993 Wiley‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980060405

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractCommon variations in muscles and tendons of the hand were determined by dissecting 40 pairs of hands (20 male, 20 female). Contrary to some anatomy textbooks which describe only three palmar interossei, with the thumb lacking one, this study foundfour palmar interosseipresent in 85% of hands and 90% of bodies. This first palmar interosseous typically arose from the base of the first metacarpal and inserted along with the tendon of the oblique head of adductor pollicis into the base of the proximal phalanx. Forty hands (50%) did not have the usual arrangement oflumbricals.Twenty‐seven (34%) third lumbricals and four (5%) fourth lumbricals split at their insertions; four third lumbricals and four fourth lumbricals inserted on the ulnar side of the middle and ring fingers, respectively. Theabductor pollicis longusinserted by 2 or 3 tendons in 91% of hands. The tendon ofextensor digiti minimisplit into 2 or 3 slips in practically all of the hands studied (96%). The tendon ofextensor indicissplit into 2 slips in more than a third (38%) of hands. In almost a third (30%) of hands there wereaccessory extensor musclespresent deep to the tendons of extensor digitorum. Lastly, extra slips of origin of theabductor digiti minimiwere present in 10% of hands. This study confirms the presence of a palmar interosseous muscle for the thumb and demonstrates that some variations occur more frequently than was expected. © 1993 Wiley‐Liss,

ISSN:0897-3806    

DOI:10.1002/ca.980060406

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractAccessory spleens may be overlooked during splenectomy. Consequently, a second splenectomy may be necessary. This report concerns the occurrence of multiple accessory spleens discovered during routine dissection of a male cadaver. Their size ranged from 0.5 to 6 cm, and they were located in the hilus and ligaments of a spleen with a normal appearance. Their splenic structure was confirmed histologically. The embryological basis of accessory spleens is re‐examined, and the frequency of their occurrence and their clinical significance are reviewed. The purpose of this paper is to alert the practicing surgeon again to the existence and significance of accessory spleens. © 1993 Wiley‐Liss,

ISSN:0897-3806    

DOI:10.1002/ca.980060407

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractDifferent models of medical education in the basic sciences have arisen in the last decade, some in response to issues raised in the 1984 GPEP Report. Each model attempts to redress problems of identifying core content in any particular discipline, within which the knowledge base is continually expanding, and of providing optimal educational experience outside of the traditional lecture/laboratory format. These objectives must also be achieved within a collapsing allocation of time for instruction as it has been commonly understood. In this paper, we discuss instructional method, developed to meet these demands, which are currently used in the Anatomical Sciences Program of the Alternative Curriculum, Rush Medical College's problem‐based curriculum. Although circumstances determining curricular constraints vary among medical colleges, we offer our positive experience with this particular format as a potential guide to curricular reform in the anatomical sciences. © 1993 Wiley‐Liss,

ISSN:0897-3806    

DOI:10.1002/ca.980060408

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractAlthough many are aware of the existence of a document called the Uniform Anatomical Gift Act (UAGA), few are aware that there are actually two such Acts (1968 and 1987), and even fewer have read the Acts themselves. Consequently, there are many different and frequently false impressions about their purpose and content. This paper is an attempt to acquaint readers with the two UAGAs. The historical background leading to the unprecedented rapid, uniform and unanimous adoption of the 1968 Act is presented. The content, rationale, and significance of that Act are outlined. The perceived shortcomings of the first Act resulting in the much less successful and less widely‐adopted 1987 Act is explained and the major changes incorporated in the second Act are outlined. Specific features of the Acts of concern to anatomists involved in willed‐body programs, and clinicians who may become involved in body/body part donation or utilization are addressed. Finally, the relationship of the UAGA to other lines of regulation and the need to be aware of them is indicated. © 1993 Wiley‐Lis

ISSN:0897-3806    

DOI:10.1002/ca.980060409

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980060410

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980060411

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY