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膈肌脚的变异形态及动脉供应与卵圆孔未闭探查

Variant morphology and arterial supply of diaphragmatic crura with probe patent foramen ovale.

作者信息

Poonia D, Goswami P, Mishra S

机构信息

Department of Anatomy, Maulana Azad Medical College, Bahadur Shah Zafar Road, 01 New Delhi, India.

Department of Anatomy, Maulana Azad Medical College, Bahadur Shah Zafar Road, 01 New Delhi, India.

出版信息

Morphologie. 2018 Dec;102(339):289-293. doi: 10.1016/j.morpho.2018.07.002. Epub 2018 Sep 7.

DOI:10.1016/j.morpho.2018.07.002
PMID:30197033
Abstract

Crura are the posterior pillars of the tendino-muscular partition between thoracic and abdominal cavity. This study highlights bilaterally an unfamiliar morphology of diaphragmatic crura with uncommon origin of inferior phrenic artery and accompanying atrial septal defect in a 63-years-old female cadaver with scoliosis. An attempt is made to portray the clinical implications of these variations. In addition authors have discussed the embryological and genetic basis of these variations. In the recent few decades, surgical correction of scoliosis involving intervention with the crura has gained pace. Knowledge about the normal as well as variant crural morphology is imperative for the surgeons to decide the correct approach during spinal corrective surgeries and for radiologist to prevent any diagnostic pitfall. Familiarity about the variant origin of inferior phrenic artery may prevent complications during treatment of pathological conditions related to inferior phrenic artery. Preoperative awareness about the coexisting atrial septal defect is vital for anesthesiologists promoting them to administer cardioprotective anesthetic drugs. To the best of our knowledge, description of such a combination of variations in anatomical literature is rare and scarcely reported. Awareness of these anatomical variations is relevant for operating surgeons, radiologists, anesthesiologists and anatomists.

摘要

膈脚是胸腔和腹腔之间腱性肌性分隔的后柱。本研究双侧突出了一位63岁脊柱侧弯女性尸体膈脚的一种不常见形态,伴有膈下动脉起源异常及房间隔缺损。本文尝试阐述这些变异的临床意义。此外,作者还讨论了这些变异的胚胎学和遗传学基础。在最近几十年里,涉及膈脚干预的脊柱侧弯手术矫正发展迅速。了解正常及变异的膈脚形态对于外科医生在脊柱矫正手术中决定正确的手术入路以及放射科医生防止任何诊断失误至关重要。熟悉膈下动脉的变异起源可能会预防与膈下动脉相关的病理状况治疗过程中的并发症。术前了解并存的房间隔缺损对于麻醉医生促进他们使用心脏保护麻醉药物至关重要。据我们所知,解剖学文献中对这种变异组合的描述很少且鲜有报道。了解这些解剖变异对于手术外科医生、放射科医生、麻醉医生和解剖学家都具有重要意义。

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