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30 具尸体的解剖观察:腹股沟管后壁与提睾肌之间关系的新见解。

Anatomical observations on 30 cadavers: new insights into the relationship between the posterior wall of the inguinal canal and the cremaster.

机构信息

Department of Anorectal Surgery, Shaanxi Provincial People's Hospital, Xi'an, 710068, China.

Yan'an University, Yan'an, 716000, China.

出版信息

BMC Surg. 2024 Aug 14;24(1):231. doi: 10.1186/s12893-024-02511-2.

Abstract

PURPOSE

Clarify the composition of the Posterior wall of the Inguinal Canal(PWIC), the location and composition of the Transverse Fascia(TF), and the tissue origin of the Cremaster(C) by observing the anatomy of the inguinal region of the cadaver.

METHODS

30 cadavers were dissected to observe the alignment of the muscles and fascia of the inguinal canal and the anterior peritoneal space. the anatomical levels of the posterior wall of the inguinal canal and the alignment of the Spermatic Cord(SC) were observed.

RESULTS

(1) The posterior wall of the inguinal canal was white, bright, and tough tendon membrane-like tissue; (2) the transverse fascia was a thin fascial tissue with only one layer of membranous structure located in the abdominal wall under the abdominal wall on the side of the blood vessels of the peritoneal cavity; (3) the internal oblique muscle and its tendon membrane, and the transversus abdominis muscle and its tendon membrane extended on the surface of the spermatic cord, and fused and continued to the cremaster on the surface of the spermatic cord.

CONCLUSIONS

  1. PWIC is mainly composed of Internal oblique muscle of abdomen (IOMA), Aponeurosis of internal oblique muscle of abdomen (AIOMA), Transverse abdominal muscle (TAM), and Transverse abdominal aponeurosis(TAA) as the following four types: (1) TAM and AIOMA fused to form a tendinous layer; (2) IOMA and TAM form the posterior wall of the muscle in the PWIC; (3) IOMA and AIOMA continue in the PWIC; 4) TAM and TAA continue in the PWIC. 2.TF is a thin fascial tissue with only one layer of membrane structure, TF is not involved in the composition of PWIC, so this fascia has nothing to do with resisting the occurrence of inguinal hernia. 3. The spermatic cord that travels in the inguinal canal is fixed to the lower wall of the inguinal canal by the tendon membrane of the cremaster, which is organized from the internal oblique and transversus abdominis muscles and their tendon membranes, The inguinal canal is a musculotendinous canal.
摘要

目的

通过观察尸体腹股沟区的解剖结构,阐明腹股沟管后壁(PWIC)的组成、横筋膜(TF)的位置和组成以及提睾肌(C)的组织来源。

方法

解剖 30 具尸体,观察腹股沟管的肌肉和筋膜排列以及前腹膜间隙。观察腹股沟管后壁的解剖水平和精索(SC)的排列。

结果

(1)腹股沟管后壁为白色、明亮、坚韧的腱膜样组织;(2)横筋膜为薄的筋膜组织,仅在腹腔血管侧腹壁下有一层膜状结构;(3)腹内斜肌及其腱膜、腹横肌及其腱膜在精索表面延伸,并在精索表面融合并延续至提睾肌。

结论

  1. PWIC 主要由腹内斜肌(IOMA)、腹内斜肌腱膜(AIOMA)、腹横肌(TAM)和腹横肌腱膜(TAA)组成,分为以下四种类型:(1)TAM 和 AIOMA 融合形成腱膜层;(2)IOMA 和 TAM 形成 PWIC 的后壁;(3)IOMA 和 AIOMA 在 PWIC 中延续;(4)TAM 和 TAA 在 PWIC 中延续。2.TF 是一种薄的筋膜组织,仅具有一层膜状结构,TF 不参与 PWIC 的组成,因此该筋膜与防止腹股沟疝的发生无关。3.在腹股沟管中穿行的精索通过提睾肌的腱膜固定在腹股沟管的下壁上,该腱膜由腹内斜肌和腹横肌及其腱膜组成,腹股沟管是一个肌腱管。
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/345c/11323628/aa52ee6934e9/12893_2024_2511_Figb_HTML.jpg

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