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腋窝弓的解剖结构:从其在人体中的发生,到对其起源的胚胎学和系统发生解释。

Anatomy of the axillary arch: from its incidence in human to an embryologic and a phylogenetic explanation of its origins.

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, 20 rue Leblanc, 75908, Paris Cedex 15, France.

Institute of Anatomy, URDIA, EA4465, UFR Biomédicale des Saints-Pères, Université de Paris, Paris, France.

出版信息

Surg Radiol Anat. 2021 May;43(5):619-630. doi: 10.1007/s00276-020-02605-5. Epub 2020 Nov 2.

Abstract

INTRODUCTION

Typically, the axillary arch is defined as a fleshy slip running from latissimus dorsi to the anterior aspect of the humerus. Phylogeny seems to give the most relevant and plausible explanation of this anatomical variant as a remnant of the panniculus carnosus. However, authors are not unanimous about its origin. We report herein the incidence of axillary arch in a series of 40 human female dissections and present an embryologic and a comparative study in three domestic mammals.

MATERIALS AND METHODS

Forty formalin-preserved Caucasian human female cadavers, one rat (Rattus norvegicus), one rabbit (Oryctolagus cuniculus) and one pig (Sus scrofa domesticus) cadavers were dissected bilaterally. A comparative, analytical and a descriptive studies of serial human embryological sections were carried out.

RESULTS

We found an incidence of axillary arch of 2.5% (n = 1 subject of 40) in Humans. We found a panniculus carnosus inserted on the anterior aspect of the humerus only in the rat and the rabbit but not in the pig. The development of the latissimus dorsi takes place between Carnegie stage 16-23, but the embryological study failed to explain the genesis of the axillary arch variation. However, comparative anatomy argues in favour of a panniculus carnosus origin of the axillary arch.

CONCLUSIONS

With an incidence of 2.5% of cases, the axillary arch is a relatively frequent variant that should be known by clinician and especially surgeons. Moreover, while embryology seems to fail to explain the genesis of this variation, comparative study gives additional arguments which suggest a possible origin from the panniculus carnosus.

摘要

简介

通常,腋窝弓被定义为从背阔肌延伸到肱骨前侧的肉质滑带。系统发生似乎为这种解剖变异提供了最相关和最合理的解释,即作为肉垂的残余物。然而,作者对于其起源并不一致。我们在此报告了腋窝弓在一系列 40 例人体女性解剖中的发生率,并在三种家养哺乳动物中进行了胚胎学和比较研究。

材料和方法

对 40 具福尔马林保存的高加索人体女性尸体、1 只大鼠(Rattus norvegicus)、1 只兔子(Oryctolagus cuniculus)和 1 只猪(Sus scrofa domesticus)尸体进行双侧解剖。对人体胚胎学切片进行了比较、分析和描述性研究。

结果

我们发现人体腋窝弓的发生率为 2.5%(n=40 例中的 1 例)。我们仅在大鼠和兔子中发现了插入肱骨前侧的肉垂,但在猪中没有。背阔肌的发育发生在卡内基 16-23 期之间,但胚胎学研究未能解释腋窝弓变异的发生。然而,比较解剖学支持腋窝弓起源于肉垂。

结论

腋窝弓的发生率为 2.5%,是一种相对常见的变异,临床医生,特别是外科医生应该了解。此外,虽然胚胎学似乎无法解释这种变异的发生,但比较研究提供了额外的论据,表明其可能起源于肉垂。

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