Applied Anatomy for Trans-hepatic Vein Catheterization to Intrahepatic Portal Veins and Bile Ducts / 第三军医大学学报

The relationship between the hepatic vein and the Glisson's system was studied on 59 cast specimens of normal adult liver. There are 3 large branches of the hepatic vein, that is, the sinister, medial and dexter hepatic veins. The trunk formed by the union of the sinister and medial hepatic veins is present in 79.66% of the cases.The sinister vein with its middle branch crosses in front of the superior segmental portal vein and behind the inferior segmental portal vein of the left lateral lobe of the liver. At the crossing point, the two veins are close to each other.The medial hepatic vein is situated in the medial fissure of the liver. In 62.50% of cases, the medial hepatic vein crosses over the transverse portion of the left branch of the portal vein, while in 31.25% of cases, it crosses over the bifurcation of the portal vein. At the crossing point, the distance between the two veins is about 1 cm.The infero-posterior branch of the dexter hepatic vein crosses over the right posterior branch of the portal vein, At the crossing point, the distance between the two veins is about 0.5 cm.The crossing points mentioned above are useful to perform an intrahepatic cholangiography or establish a porto-systemic shunt by way of trans-jugulo-hepatic vein catheterization.

Applied Anatomy of the Platysma / 第三军医大学学报

The platysma of 50 sides of abult cadavers were studied under operating microscope. 9 areas are divided on each side of the neck, and the anterior 6 of the 9 are occupied by the platysrna. The medial border of the muscle corresponds to a line starting from the middle point of the mental-hyoid line and ending laterally to the sternal end of the clavicle. The angle formed by the medial borders of the platysmas of two sides is about 40. The lateral border corresponds to a line starting from a little back of the angle of the mandible and ending 3 cm medial to the acromion end of the clavicle. The inferior border of the platysma lies in the first intercostal space. There are several gaps in the lower portion of some of the muscles. The superior border attaches to the body of the mandible and fuses with some of the expression muscles. The area of the platys-ma is about 150cm2, of which about 120 cm2 are located above the clavicle. The fibers of the posterior portion of the muscle are in the form of a double curve. The platysma is loosely attached to the underlying structures.Several branches of the facial nerve and the cervical plexus were also studied. In addition, certain problems concerning the plastic reconstruction on the neck and face were discussed.

The Applied Anatomy of Intrahepatic Ducts / 第三军医大学学报

The architectural arrangement of the intrahepatic ducts was studied on 55 specimens of normal adult liver. The right and left hepatic ducts could be categorized according to the pattern of their formation into regular and irregular types.The regular right hepatic duct formed by the union of the anterior and posterior lobar ducts was present in 27 cases (49.09%). The right anterior or right posterior lobar duct opened directly into the left hepatic duct or the common bile duct in 8 cases (14.55%). The right hepatic duct and the right anterior lobar duct were located on the anterior and sinister sides of the accompanying branches of the portal vein respectively. The right posterior lobar duct, after crossing superiorly over the root of the portal vein branch to the right anterior lobe, passed rightward.The regular left hepatic duct formed by the union of the left medial and left lateral lobar ducts was present in 18 cases (32.73%) . The main intrahepatic ducts of the left side of the liver were located on the anterior or ante-ro-medial side of the left branch of the portal vein.The problem concerning the architectural arrangement of the main intrahepatic ducts and its clinical significance was discussed.

THE VESSELS OF THE SKIN FLAPS AT GROIN REGION——1. THE MACRO-MICRO-ANATOMY OF THE SUPERFICIAL CIRCUMFLEX ILIAC VESSELS / 解剖学报

In many textbooks and literatures the superficial circumflex iliac artery (SCIA) is generally described, but only its superficial main branch (SMB) is referred, Its deep main branch (DMB) is always neglected, though it is present constantly. In 56％ of fifty cases we studied the SCIA trunk possesses both these main branches.The SMB is present in 86％ of the cases studied. After it originates from the trunk, it usually emerges promptly from the back of deep fascia into the subcutaneous layer. The points of emergence were found in an area around a center located 15 mm lateral and 10 mm below the origin of femoral artery. The course of the SMB can be marked as a line which located between a point 15 mm below the origin of femoral artery and anterior superior iliac spine. The SMB supplies an area along the lateral half of inguinal ligament, and its terminal branch usually turns upwards to the lateral portion of the abdominal wall.The DMB is a constant branch in our cases. It runs parallel to and 15mm beow the inguinal ligament, It supplies the upper lateral portion of the thigh, and its terminal branch usually turns downwards and laterally into the superficial layer of the gluteal region. The site where the DMB penetrates the deep fascia was found in an area around a center located 20 mm below the anterior superior iliac spine.The caliber of each of the two main branches is intimately correlated with the size of the skin which supplies. The course of the(SCIV)is similar to one of the main branches of the SCIA or runs between them (70％) The axes, thickness, size of the groin skin flaps were discussed.

THE VESSELS OF THE SKIN FLAPS AT GROIN REGION Ⅲ. THE MACRO-MICRO-ANATOMY OF THE SUPERFICIAL EXTERNAL PUDENDAL VESSELS / 解剖学报

In 82% of fifty groin regions of the cadavers studied, the superficial external pudendal artery (SEPA) possesses an upper and a lower main branches (UMB, LowMB). In 66% of them, the two main branches come from one common trunk and in the rest, they arise independently. Most of the SEPA trunks or main branches arise from the femoral artery. The penetrating points of the SEPA trunk or main branches through the cribriform fascia are located at the medial or lateral margin of the terminal end of the great saphenous vein around a center 10 mm medial and 50 mm distal to the origin of femoral artery. If the SEPA trunk or main branches are crossing the great saphenous vein, it is frequently found that the SEPA trunk and LowMB are crossing behind but the UMB in front of it.The UMB supplies the suprapubic, prepubic and medial part of the inguinal regions. A line which connects a point 50 mm distal to the origin of femoral artery with the pubic tubercle is suggested as the axis of UMB free skin flap. The LowMB supplies the upper part of anterior medial femoral and prepubic regions. A line which is parallel to the pubic crest and 50 mm distal to the origin of femoral artery is suggested as the axis of LowMB free skin flap. The caliber of each of the two main branches is intimately correladed with the area of the skin which they supplied.In 82% of cases, two sets of superficial veins are not present. These superficial external pudendal veins are also the accompanying veins of the corresponding arteries.The advantages of using these vessels as skin flap pedical vessels were discussed.

MORPHOLOGY OF HUMAN FIBULA / 解剖学报

1000 fibulae of Chinese adults were observed and measured. It was found that the angle between the capital articular surface and the long axis of fibula is positively correlated with the circumference of the fibula. In 84.3% among the 1000 specimens, the body of the fibula posesses four borders and four surfaces. It would be more rational, if the nomination of these surfaces were based on their muscle attachments.The average maximum length of the fibula is 340.42?22.76 mm, the smallest circumference is 33.68?4.40 mm, the middle circumference is 39.52?4.99 mm. The caliber index, middle caliber index and the diaphyseal index were calculated respectively. The results obtained show that the side difference as a whole was statistically insignificant, but the diameter at the middle part is an exception. In the paired bones, there are more cases with larger circumference and diameter at the middle on the right side than on the left.According to our observations, some of the relationships between the morphology and function of the fibula were discussed.

THE ARTERIES OF THE DORSALIS PEDIS FLAP / 解剖学报

The Arteria dorsalis pedis of 50 lower limbs of adult Chinese cadavers were injected with the chloroform solution of red pigment.Then the cutaneous arteries of the Ar- teria dorsalis pedis were dissected,observed and measured under an operating microscope. The arteria dorsalis pedis was divided into proximal,intermediate and distal portions. In all cases this artery gives off direct cutaneous arteries which are more concentrated in the proximal and distal portions. In the proximal portion,the cutaneous arteries are constantly provided with larger caliber and longer length of extension.The percentage of the presence of the cutaneous arteries of the distal portion is rather high,yet both their caliber and length of extension are smaller than the branches of the proximal portion. There are certain anastomoses between the neighboring cutaneous arteries.Most of the cutaneous arteries run along the course of the medial dorsal cutaneous nerves.This nerve may be considered as a guide to find those cutaneous arteries. The caliber of the most cutaneous arteries is large enough for microsurgical vaso- anastomosis.Thus the data of this article may be helpful to clinicians who want to make a vascularized free dorsalis pedis skin flap.

THE BLOOD SUPPLY OF THE RAMUS SUPERFICIALIS OF THE RADIAL NERVE, AND NERVUS CUTANEOUS ANTEBRACHII LATERALIS / 解剖学报

1. Fifty upper limbs of adult cadavers were dissected under an operating microscope.2. The ramus superficialis of the radial nerve is about 180 mm long, and springs from the radial nerve at a level about 16 mm below the medial epicondyle of the humerus. As the radial artery, it can be divided into superficial and deep parts by the overlapping of musculus brachioradialis. The junction between the two parts corresponds to a plane which divides the forearm into upper 2/3 and lower 1/3. The width of the ramus superficialis increases gradually as it runs downwards, and its cross section looks elliptical distally and somewhat circular proximally. Each of the two parts of the ramus superficialis receives 1～4 arteries from the lateral cutaneous arteries or muscular branches of the radial artery. Measurements were made to determine the position of the origin of these arteries.3. The nervus cutaneous antebrachii lateralis divides into two branches in the forearm, and receives 2～8 arteries mainly from the lateral cutaneous branches of the radial artery. It usually gives a branch communicating with the ramus superficialis of the radial nerve. The nervus cutaneous antebrachii lateralis can be found easily at the point just 5～6 mm lateral to the junction of the superficial and deep parts of the radial artery.4. The applied anatomy of the vascular pedicle nerve graft was discussed.

THE VESSELS OF THE SKIN FLAPS AT GROIN REGION 2. THE MACRO-MICROANATOMY OF THE SUPERFICIAL EPIGASTRIC VESSELS / 解剖学报

In many textbooks and literature, the course and distribution of the superficial epigastric artery (SEA) was described as a single vessel corresponding to the medial main branch (MMB) in our series, the lateral main branch (LMB) was always neglected. In 20% of fifty cases we observed, the SEA possesses a trunk which divides into two main branches.The LMB is present in 66%. It enters the superficial fascia by passing through the fascia lata. The penetrating points of the LMB are found mostly around a center 5 mm lateral and 15 mm distal to the origin of the femoral artery. It ascends along a vertical line 10 mm lateral to the origin of the femoral artery, and supplies the lateral part of the middle portion of the lower abdomen at that side.The MMB is present in 68%. It enters the superficial fascia by passing through the fossa ovalis. The penetrating points of the MMB are found mostly around a center 25 mm distal to the origin of the femoral artery. It ascends along a vertical line 10mm medial to the origin of the femoral artery, and supplies the medial half of lower abdomen at that side.The caliber of each main branch is intimately correlated with the area of the skin it supplies. The axis, depth, distribution of the SEA or its main branches as vessels of the skin flaps at groin region has been discussed.