Mikromorfološke karakteristike distalnog segmenta i grana žbične arterije
Micromorphological characteristics of the distal segment and braches of the radial artery
Докторанд
Ilić, Marko A.Ментор
Maliković, AleksandarЧланови комисије
Manojlović, RadovanKadija, Marko
Milisavljević, Milan
Đorđević, Boban
Метаподаци
Приказ свих података о дисертацијиСажетак
Hirurške procedure, kao što je odizanje tenarnih režnjeva ili stabla radijalne
arterije, traže detaljno poznavanje anatomije stabla i grana a. radialis (AR). Ciljevi ove
disertacije bili su da se definišu pružanje i šema grananja radijalne arterije i njenih
grana, i da se definišu morfometrijske karakteristike i varijacije radijalne arterije i
njenih grana.
Eksperimentalno istraživanje distalnog segmenta radijalne arterije je obavljeno
na 50 podlaktica i šaka kadavera (leševa) oba pola. Krvni sudovi 15 podlaktica i šaka su
perfundovani toplim fiziološkim rastvorom i neutralnim formalinom (4% neutralni
rastvor formaldehida) nakon čega je izvršeno ubrizgavanje 10% tuš želatina u
proksimalni deo stable radijalne arterije. Ovi preparati su korišćeni za mikrodisekciju
distalnog dela radijalne arterije i njenih grana u cilju proučavanja morfologije,
topografskih odnosa i anastomoza ovih krvnih sudova.
Drugi deo istraživanja je izveden ubrizgavanjem metil metakrilata u arterijski
sistem 35 po...dlaktica i šaka i naknadno sprovedenom korozijom u 40% rastvoru KOH
što nam je omogućilo da dobijemo plastične odlivke arterijske mreže distalnog dela
radijalne arterije na kojima su vršena merenja istraživanih krvnih sudova. Dalja
mikroanatomska istraživanja su obuhvatala tri dela distalnog segmenta žbične arterije
(a. radialis): 1) stablo distalnog segmenta a. radialis (AR), 2) a. princeps pollicis (APP)
i 3) arcus palmaris profundus (ArcPP). Posebno smo izdvojili r. palmaris superficialis
(RPS) i aa. metacarpales dorsales (AMD).
Prečnik distalnog dela stabla a. radialis (AR) u nivou zgloba ručja iznosio je
prosečno 2,9±0,3 mm. R. palmaris superificialis (RPS) je identifikovan na svim
preparatima (100%). RPS se u većini slučajeva (75% preparata) pružao potkožno i
njegov prosečan dijametar (prečnik) je iznosio 1,42±0,45 mm. Definisali smo postojanje
dva tipa RPS: dobro razvijen RPS (tip A) i hipoplastičan RPS (tip B). Dobro razvijen
RPS (tip A) bio je prisutan na 11 (31,4%) preparata, odlikovale su ga vrednosti
dijametra koje su bile veće od 1,7 mm, pri čemu je vrednost njegovog prosečnog
dijametra iznosila 1,95±0,36 mm. Ovaj tip RPS je učestvovao u vaskularizaciji
kažiprsta, a zavisno od uključenosti u vaskularizaciju palca izdvojili smo podtip A1,
koji je bio prisutan u 6 (17,1%) slučajeva i podtip A2 koji je bio nešto ređi, 4 (11,4%)
slučajeva...
Surgical procedures such as the thenar flaps and radial artery (RA) harvesting
call for an detailed anatomical study of the radial artery and its branches. The aims of
this dissertation were to define the extent and branching patterns of the distal segment
and branches of the radial artery, as like as to define the morphometric characteristics
and anatomical variations of these blood vessels.
The distal segment of the RA and its branches were investigated in 50 postmortem
specimens of human forearms and hands. In the first part of our study, 15
specimens of the forearms and hands were perfused with 0.9% saline solution and
buffered formalin (4% neutral solution of formaldehyde), and further injected with
black India ink. These specimens were used for the microdissection of the distal
segment of the RA and its branches in order to investigate the morphology, topographic
relationships and anastomoses of these blood vessels.
Second part of our study was performed in 35 specimens of the fo...rearms and
hands we injected with methyl-methacrylate and afterwards corroded in 40% potassium
hydroxide solution. Using this method we obtained corrosion plastic casts in order to
perform measurements of investigated blood vessels. Further microanatomical studies
covered three parts of the distal segment of the RA: 1) the main stem of the distal
segment of the RA, 2) the princeps pollicis artery (PPA) and 3) the deep palmar arch
(DPA), including the superficial palmar branch and dorsal metacarpal arteries (DMA).
The average diameter of the main stem of the RA distal segment was 2.9±0.3
mm. The superficial palmar branch (SPB) of the RA was always present and in the
majority of cases the course of the SPB was superficial (75%). The mean diameter of
the SPB was 1.42±0.45 mm. We defined two types of the SPB according to its diameter:
well developed SPB (type A) and hypoplastic SPB (type 2). Well developed SPB (type
A) was present in 11 hands (31.4% of cases) with the diameter larger than 1.7 mm
(mean diameter of 1.95±0.36 mm) and it was extending distally in order to continue as
the radialis indicis artery (RIA). This type of the SPB supplied the index finger and it
gave of two important branches to the thumb we further classified as the A1 subtype,
which was present in 6 hands (17.1% of cases) and A2 subtype, which was present in 4
hands (11.4% of cases)...