摘要:

AbstractThe usual dissection by medical students of the anterior abdominal wall and the inguinal region proceeds from superficial to deep; special emphasis is placed on the sheath of the rectus abdominis muscle and lateral muscular layers. We suggest an alternate approach to dissection of this region that has the following advantages: (1) sparing of delicate deep structures not often fully appreciated by students; (2) provision of an opportunity to visualize the region from a laparoscopic surgeon's vantage point; (3) considerably reduced time spent dissecting and identifying structures and relationships, especially peritoneal reflections important in laparoscopic procedures. Our dissection begins with bilateral subcostal incisions through the entire thickness of the anterior abdominal wall and peritoneum, which extend laterally and inferiorly to the level of the anterior superior iliac spines, thereby forming a large, inverted, U‐shaped flap. This flap is reflected inferiorly, allowing abdominal viscera to be dissected, and ultimately removed en bloc. The flap is then drawn cranially and stretched somewhat to approximate its position when the abdomen is inflated with C02during laparoscopic procedures. Major land‐marks, including the deep inguinal ring, are noted and the flap is again reflected inferiorly for dissection beginning with the peritoneum and transversalis fascia. This method of dissecting the anterior abdominal wall and inguinal region results in more facile and timely identification of both superficial and deep structures of the anterior abdominal wall and inguinal region, and superficial and deep structures of the anterior abdominal wall and inguinal region, and provides a clinically relevant demonstration of anatomy from a laparoscopic perspective. © 1995 WiIey‐Lis

ISSN:0897-3806    

DOI:10.1002/ca.980080402

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

年代:1995

数据来源: WILEY

摘要:

AbstractThirty‐two morphologically normal spleens from adult corpses were excised and immersed into a graduated water tank and the water volume displaced was considered as the actual spleen volume. after that, the splenic maximal height, width, and breadth were determined by a pachimeter. all the reference points were marked with a metal clip. utilizing the metal clip references ultrasound maximal height, width, and breadth were determined. it was assumed that the ultrasound spleen volume was the result of the multiplication of the three ultrasonographic measurements previously obtained.There was no significant difference between pachimeter and ultrasound determinations. The mean actual spleen volume was 147.5 cm3 (SD = 81.46). The mean ultrasound spleen volume was 283.8 cm3 (SD = 168.27). A roughly linear correlation between actual spleen volume (y) and ultrasound spleen volume (x) was found, y = 14.23 + 0.469 × (R2 = 0.94,P<0.01). © 1995 WiIey‐Liss

ISSN:0897-3806    

DOI:10.1002/ca.980080403

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

年代:1995

数据来源: WILEY

摘要:

AbstractThis explanation of the previously described left bronchus syndrome (Ashour et al., 1990, Thorax,45:210–212) is based on a prospective study of 17 additional cases with unilateral lung destruction. It is likely that the anatomic peculiarities of the left main bronchus predispose the left lung to more frequent bronchial obstruction and hemodynamic changes than the right. Broncho‐pulmonary shunt formation and retrograde filling of the pulmonary artery most likely lead to increased oxygen tension and impaired lymph flow in the entire lung, thus spreading tuberculosis in the lung and ultimately leading to left lung destruction. © 1995 WiIey‐Lis

ISSN:0897-3806    

DOI:10.1002/ca.980080404

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

年代:1995

数据来源: WILEY

摘要:

AbstractMost of the details regarding the course of the sympathetic fibers to human ocular structures are based on anatomical and physiological studies in lower animals. While studying a clinical problem involving pericarotid sympathetic fibers, it became obvious that these animal observations cannot adequately explain the findings in human diseases affecting these pathways. An attempt was made, therefore, to clarify this situation.We were able to gather enough information from human clinical and experimental studies, from our own clinical observations, and from our cadaver dissections to conclude that these pathways are somewhat different from those which are usually described in the literature. Based on this information, we conclude that (1) the oculosympathetic fibers in man do not course through the tympanic plexus and/or trigeminal ganglion, and (2) the sweat glands of the face receive their innervation from both internal and external carotid sympathetic plexuses. We also have suggestive, but inconclusive, evidence regarding the final mode of distribution of these fibers to the dilator of the pupil and the smooth muscle portion (deep layer) of the levator palpebrae superioris muscle (superior tarsal muscle). © 1995 WiIey‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980080405

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

年代:1995

数据来源: WILEY

摘要:

AbstractThe subglottic regions of 54 human adult male and female larynges were studied with regard to anatomical aspects of postintubational stenosis. Fourteen specimens were impregnated with curable polymers and cut into 600–800 μm sections along different planes. Forty formalin‐fixed hemilarynges were dissected. Measurements of the upper cricoid lamina and the thickness of the endocricoid soft tissues were taken for statistical analysis. Immediately beneath the glottis, the upper part of the cricoid lamina consists of two lateral plates with an average angle of 110°. Distally, the cricoid adopts a more and more rounded lumen. At the level of the cricothyroid joint, the definite airway lumen is always laterally narrowed by a prominent thickening of the endocricoid soft tissue. Large amounts of loose connective tissue facilitate the development of edema in case of injury in this region. Dorsally, the submucous stratum is smaller and consists mainly of dense connective tissue. The blood vessels are fixed to the cricoid perichondrium by collagenous fibers. Any pressure applied from the airway lumen will force the vessels against the nonresilient cartilage, resulting in occlusion and ischemia. These pathophysiologic mechanisms are important for the development of early laryngeal damage during endotracheal intubation, possibly resulting in posterior stenosis due to scarring later on. © 1995 WiIey‐L

ISSN:0897-3806    

DOI:10.1002/ca.980080406

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

年代:1995

数据来源: WILEY

摘要:

AbstractDigits of the hand vary from each other with respect to bone and joint architecture, muscles, tendons, and degree of functional independence. The hand may be conceived as having a central rigid framework moved at the wrist by flexors, extensors, abductors, and adductors. But on each side of this central structure lies a mobile (hinged) segment necessary for pinch and to increase the strength of grasp. At the distal end of this triplex framework lie multijointed appendages essential for any type of pinch or grasp more sophisticated than that of a lobster claw. The thumb has a highly mobile carpometacarpal joint but lacks a middle phalanx. Therefore, it has no proximal interphalangeal (PIP) joint and consequently no mechanical need for a lumbrical. Since the thumb has excellent coordination without a lumbrical, the lumbrical's function as a sense organ cannot be simply to coordinate finger movement. Mechanically the lumbrical is a deflexor of the PIP joint. Because lumbricals are richly endowed with muscle spindles, their passive stretch by contraction of the flexor digitorum profundus might both inhibit finger extensors and facilitate wrist extensors. Since each digit is unique, accurate mathematical and computer modelling of the hand must take into consideration this uniqueness. © 1995 WiIey‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980080407

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

年代:1995

数据来源: WILEY

摘要:

AbstractThe topography of the celiac trunk and superior and inferior mesenteric arteries was studied by dissection in 27 embalmed cadavers. Variant vascular patterns were noted in four subjects. These consisted of: (1) an accessory right hepatic artery from the superior mesenteric artery, (2) an anomalous middle colic artery from the proximal segment of the splenic artery, and (3) two instances of an accessory left colic artery originating from the superior mesenteric artery. The precarious course of the middle colic artery (coming from the splenic artery) and its dominance in the formation of the marginal artery were thought to predispose the ascending and transverse colon to an increased risk of vascular damage. These cases also illustrate two variant patterns of formation of the marginal artery. In the case of the anomalous middle colic artery, the only contribution of the superior mesenteric artery to the marginal artery was through the anastomosis of its ileocolic branch with the right branch of the aberrant middle colic artery. In subjects with accessory left colic arteries, the superior mesenteric artery played a dominant role in the formation of the marginal artery by contributing the accessory left colic artery, which supplied the splenic flexure and the proximal part of the descending colon. These arterial variations underscore the importance of doing vascular studies prior to major abdominal surgery. © 1995 WiIey‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980080408

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

年代:1995

数据来源: WILEY

摘要:

AbstractA survey of U. S. departments of anatomy, physiology, and biochemistry shows that 39% of the respondent anatomy departments reported declines in the numbers of graduate students taking the human gross anatomy course. Similarly, 42% of the departments reported decreases in the numbers of graduate students teaching human gross anatomy. These decreases were greater in anatomy than in physiology and in biochemistry. The percentages of departments reporting increases in students taking or teaching their courses was 6% for human gross anatomy and 0% to 19% for physiology and biochemistry courses. To reverse this trend the establishment of specific programs for the training of gross anatomy teachers is advocated. These new teachers will be available as the need for them is increasingly recognized in the future. © 1995 WiIey‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980080409

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

年代:1995

数据来源: WILEY

摘要:

AbstractA dissection table ventilation system that draws air across the cadaver and away from the table top was designed to fit the Shandon‐Lipshaw AN‐52 dissection table. Each U‐shaped unit consists of a pair of hollow collection arms that attach to a collecting manifold at one end. During dissection the manifold is coupled to a central ventilation system through a flexible duct. The air from the table ventilation system is exhausted after passing through a heat recovery system. The unit is raised from the table surface during dissection of the body cavities to increase the efficiency of fume/odor removal. Eight hour exposure data for formaldehyde concentrations are presented. Data were collected from detectors positioned at selected levels above the cadaver during dissection, and above a tray on the table top containing a known volume of 4% formaldehyde or the West Virginia School of Osteopathic Medicine embalming fluid under varying airflow conditions. The results demonstrate that the table ventilation system is effective in reducing exposure to formaldehyde in the dissection laboratory. © 1995 WiIey‐L

ISSN:0897-3806    

DOI:10.1002/ca.980080410

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

年代:1995

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980080411

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

年代:1995

数据来源: WILEY