DOCSLIB.ORG

The Blood Supply of the Lumbar and Sacral Plexuses in the Human Foetus* by M

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Blood Supply of the Lumbar and Sacral Plexuses in the Human Foetus* by M J. Anat., Lond. (1964), 98, 1, 105-116 105 With 4 plates and 3 text-figures Printed in Great Britain The blood supply of the lumbar and sacral plexuses in the human foetus* BY M. H. DAYt Department of Anatomy, Royal Free Hospital School of Medicine INTRODUCTION The existence of a blood supply to peripheral nerve is well established. Recently, a number of authors have reviewed the literature of the field, among them Blunt (1956) and Abdullah (1958), who from their own observations have confirmed that peripheral nerves are supplied by regional vessels reinforcing longitudinally arranged channels which freely anastomose with each other. There is also evidence that posterior root ganglia are particularly well supplied with blood vessels (Abdullah, 1958), but the precise distribution and arrangement of arteries to some individual nerve trunks and plexuses is still in need of investigation. The literature reveals few references to the blood supply of the lumbar and sacral plexuses. The distribution of arteries to the roots and ganglia of the sacral nerves was noted by Haller (1756), but the most important contributions in this field were those of Bartholdy (1897) and Tonkoff (1898), whose observations on the lumbar and sacral plexuses form part of a general survey of the blood supply of peripheral nerve in man. They cited the lumbar, ilio-lumbar, median and lateral sacral arteries as well as the gluteal and pudendal vessels as sources of supply, but gave no indication of the frequency of these contributions. Subsequent authors including Hovelacque (1927), dealt briefly with the distribution of the lateral sacral, median sacral, gluteal and pudendal arteries to the sacral plexus, but treated more fully the blood supply of the sciatic nerve. Although Adachi (1928), described the distribution of the intra-pelvic arteries in some detail, he made no reference to the blood supply of nerves. It appears that there is nowhere a fully documented account of the blood supply of the lumbar and sacral plexuses, and accordingly a re-assessment of the matter has been undertaken. The problem is of anatomical interest and may be of clinical significance, since ischaemic damage to nerve has been reported in obliterative vascular disease (Roberts, 1948), cryopathy (Denny-Brown, Adams, Brenner & Doherty, 1945), peripheral nerve injuries (Richards, 1954) and nerve compression syndromes (Bowden & Gutmann, 1949). MATERIALS AND METHODS Material was obtained from 18 stillborn foetuses of ages ranging from 18-40 weeks, from one neonatal autopsy, and from an adult. * The results of this investigation were presented as part ot a thesis for which the degree of Ph.D. was awarded by the University of London in May 1962. t Present address: Department of Anatomy, The Middlesex Hospital Medical School, London, W. 1. 106 M. H. DAY In 15 foetuses Neoprene rubber latex, diluted with distilled water to produce a 75 % solution, was injected through the descending thoracic aorta; in 7 cases red dye was added to the solution, and in 8 India ink. Fourteen of the foetuses were injected using a manometrically controlled injection apparatus, and one by means of a hand syringe. The injection pressures were limited to 100 mm. Hg in foetuses over the age of 20 weeks and to 80 mm. Hg under that age; the injections were judged to be complete when small skin vessels of the back and feet were filled with the injection mass. The systemic venous system of one 20-week foetus was injected through the right atrium with rubber latex and India ink at a maximum pressure of 50 mm. Hg. Following injection, the lumbar spine, sacrum and pelvis were removed en bloc and fixed in 10 % formalin for 3-4 weeks. The lumbar and sacral plexuses and their blood vessels were dissected with the aid of operating spectacles and a dissecting microscope. When the intervertebral foramina were reached lam- inectomy was performed and the contents of the intervertebral canals exposed by nibbling away the pedicles of the vertebrae. Finally, the dura mater and the arachnoid were opened to expose the spinal cord and the cauda equina. After complete dehydration in graded alcohols and chloroform the specimens injected with rubber latex and India ink were cleared in tetrahydronaphthalene (Torr, 1957), to reveal the finer vessels and obtain a three dimensional view of their distribution. The intrinsic vascular arrangements were studied histologically in one adult, and in 3 foetuses whose ages ranged from 22 to 31 weeks. Blunt's modification of Pick- worth's method (sodium nitroprusside benzidine stain), MacConaill's FALG and MG blue methods (MacConaill & Gurr, 1960), and the FALGOSE method (MacConaill, 1961), were used. RESULTS The lumbar and sacral plexuses of nerves obtain their blood supply from the nearest available vessels, all of which originate indirectly from the abdominal aorta. The arterial blood supply of the roots and ganglia of the lumbar and sacral nerves The first to the fourth lumbar nerves may be grouped together, as a similar pattern of supply was found at each of these segmental levels. Lumbar spinal arteries commonly arose from the posterior division of the lumbar artery, and entered the intervertebral foramen in relation to the segmental nerve. The arteries supplying the nerve roots and ganglia were derived from the lumbar spinal arteries or, much less frequently, from the corresponding lumbar arteries directly. The segmental pattern of blood supply shown for the upper four lumbar nerves was interrupted caudally at the level of the bifurcation of the aorta. Fifth lumbar arteries were present on both sides in 9 of 15 foetuses. On the left the fifth lumbar nerve roots and ganglia were supplied by the lumbar artery through its spinal branch in nine cases and by the ilio-lumbar artery in the other six. On the right side the fifth lumbar nerve roots were supplied by the fifth lumbar spinal artery, the fifth lumbar artery, the ilio-lumbar or the superior gluteal artery in the ratios of 4:2:8:1. The right fifth lumbar ganglia were supplied by the same group of vessels in the ratios of 3:2:9:1 (Table 1). Blood supply ofplexuses in human foetus 107 As in the lumbar region, the vascular supply of the sacral roots and ganglia was basically segmental (Text-fig. 1). The lateral sacral artery supplied the sacral nerve roots in 38 of 55 roots of the left, and in 37 of 62 on the right side. With regard to the other vessels involved, on both left and right sides, the superior gluteal arteries were responsible for the supply of the sacral roots (left 12/55, right 10/62); less commonly the supply to the roots came from inferior gluteal artery (left 8/55, right 3/62), the ilio-lumbar artery (left 4/55, right 3/62), the median sacral artery (left 1/55, right 7/62) and the internal iliac arteries (left 2/55, right 2/62). The sacral ganglia were supplied by the lateral sacral artery 34/56 times on the left side and 37/61 times on the right side; the superior gluteal artery supplied the ganglia (left 12/56, right 10/61), less commonly the supply came from the inferior gluteal artery (left 8/56, right 3/61), the ilio-lumbar artery (left 4/56, right 3/61, the median sacral artery (left 1/56, right 5/61) and the internal iliac artery (left 2/56, right 3/61). Text-fig. 1. The left side of the true pelvis of a full-term foetus, showing the distribution of arteries to the ventral rami forming the sacral plexus. (Drawn from an injected specimen.) When these results were combined and tabulated (Table 1), it was clear that vessels which were not segmental in origin tended to be distributed over a group of successive segments. Thus the superior gluteal artery was distributed to the roots and ganglia of the fifth lumbar to the third sacral segments (inclusive), whilst the inferior gluteal artery was distributed to the corresponding structures from the second to the fourth sacral segments. Table 1 demonstrates that the roots and ganglia between the 108 M. H. DAY fifth lumbar and the third sacral segmental level received their arteries from a variety of sources, but there appeared to be neither profusion nor poverty of blood supply to any nerve, or group of nerves, in this region. The arrangement of the lumbar and sacral spinal arteries Three principal groups of branches were derived from each spinal artery or its parent stem. These included branches to the vertebrae, the posterior root ganglia and the nerve roots. Branches to the vertebrae. At each lumbar and sacral segmental level a vertebral branch arose and passed through the intervertebral foramen anterior to the seg- mental nerve roots. This branch divided into superior and inferior subdivisions which anastomosed with vessels entering foramina both cephalic and caudal to it, as well as with vessels from the opposite side. These arteries were distributed to the vertebral bodies forming an anastomotic network on the anterior wall of the spinal canal. (Pls. 1-3). Branches to the ganglia. These arteries arose from the posterior divisions of the lumbar arteries or from lumbar spinal arteries, in a plane posterior to the vessels to the vertebrae and ran directly to the ganglia. In the sacral region, branches to the ganglia originated from vessels supplying the intra-spinal portion of the nerve roots, these latter vessels arose from the spinal branches of the sacral segmental vessels. This alteration in the basic pattern resulted from changes in the positions of the ganglia at different levels (see below). Arteries entered the ganglia by piercing their sheaths at the poles or the equatorial region; other vessels did not pierce the ganglion sheath but continued over its surface to supply the dural root sleeves and the spinal dura (Text-fig.
Load more

Recommended publications
  • The Anatomy of the Rectum and Anal Canal
    BASIC SCIENCE identify the rectosigmoid junction with confidence at operation. The anatomy of the rectum The rectosigmoid junction usually lies approximately 6 cm below the level of the sacral promontory. Approached from the distal and anal canal end, however, as when performing a rigid or flexible sigmoid- oscopy, the rectosigmoid junction is seen to be 14e18 cm from Vishy Mahadevan the anal verge, and 18 cm is usually taken as the measurement for audit purposes. The rectum in the adult measures 10e14 cm in length. Abstract Diseases of the rectum and anal canal, both benign and malignant, Relationship of the peritoneum to the rectum account for a very large part of colorectal surgical practice in the UK. Unlike the transverse colon and sigmoid colon, the rectum lacks This article emphasizes the surgically-relevant aspects of the anatomy a mesentery (Figure 1). The posterior aspect of the rectum is thus of the rectum and anal canal. entirely free of a peritoneal covering. In this respect the rectum resembles the ascending and descending segments of the colon, Keywords Anal cushions; inferior hypogastric plexus; internal and and all of these segments may be therefore be spoken of as external anal sphincters; lymphatic drainage of rectum and anal canal; retroperitoneal. The precise relationship of the peritoneum to the mesorectum; perineum; rectal blood supply rectum is as follows: the upper third of the rectum is covered by peritoneum on its anterior and lateral surfaces; the middle third of the rectum is covered by peritoneum only on its anterior 1 The rectum is the direct continuation of the sigmoid colon and surface while the lower third of the rectum is below the level of commences in front of the body of the third sacral vertebra.
    [Show full text]
  • Rectum & Anal Canal
    Rectum & Anal canal Dr Brijendra Singh Prof & Head Anatomy AIIMS Rishikesh 27/04/2019 EMBRYOLOGICAL basis – Nerve Supply of GUT •Origin: Foregut (endoderm) •Nerve supply: (Autonomic): Sympathetic Greater Splanchnic T5-T9 + Vagus – Coeliac trunk T12 •Origin: Midgut (endoderm) •Nerve supply: (Autonomic): Sympathetic Lesser Splanchnic T10 T11 + Vagus – Sup Mesenteric artery L1 •Origin: Hindgut (endoderm) •Nerve supply: (Autonomic): Sympathetic Least Splanchnic T12 L1 + Hypogastric S2S3S4 – Inferior Mesenteric Artery L3 •Origin :lower 1/3 of anal canal – ectoderm •Nerve Supply: Somatic (inferior rectal Nerves) Rectum •Straight – quadrupeds •Curved anteriorly – puborectalis levator ani •Part of large intestine – continuation of sigmoid colon , but lacks Mesentery , taeniae coli , sacculations & haustrations & appendices epiploicae. •Starts – S3 anorectal junction – ant to tip of coccyx – apex of prostate •12 cms – 5 inches - transverse slit •Ampulla – lower part Development •Mucosa above Houstons 3rd valve endoderm pre allantoic part of hind gut. •Mucosa below Houstons 3rd valve upto anal valves – endoderm from dorsal part of endodermal cloaca. •Musculature of rectum is derived from splanchnic mesoderm surrounding cloaca. •Proctodeum the surface ectoderm – muco- cutaneous junction. •Anal membrane disappears – and rectum communicates outside through anal canal. Location & peritoneal relations of Rectum S3 1 inch infront of coccyx Rectum • Beginning: continuation of sigmoid colon at S3. • Termination: continues as anal canal, • one inch below
    [Show full text]
  • Clinical Presentations of Lumbar Disc Degeneration and Lumbosacral Nerve Lesions
    Hindawi International Journal of Rheumatology Volume 2020, Article ID 2919625, 13 pages https://doi.org/10.1155/2020/2919625 Review Article Clinical Presentations of Lumbar Disc Degeneration and Lumbosacral Nerve Lesions Worku Abie Liyew Biomedical Science Department, School of Medicine, Debre Markos University, Debre Markos, Ethiopia Correspondence should be addressed to Worku Abie Liyew; [email protected] Received 25 April 2020; Revised 26 June 2020; Accepted 13 July 2020; Published 29 August 2020 Academic Editor: Bruce M. Rothschild Copyright © 2020 Worku Abie Liyew. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Lumbar disc degeneration is defined as the wear and tear of lumbar intervertebral disc, and it is mainly occurring at L3-L4 and L4-S1 vertebrae. Lumbar disc degeneration may lead to disc bulging, osteophytes, loss of disc space, and compression and irritation of the adjacent nerve root. Clinical presentations associated with lumbar disc degeneration and lumbosacral nerve lesion are discogenic pain, radical pain, muscular weakness, and cutaneous. Discogenic pain is usually felt in the lumbar region, or sometimes, it may feel in the buttocks, down to the upper thighs, and it is typically presented with sudden forced flexion and/or rotational moment. Radical pain, muscular weakness, and sensory defects associated with lumbosacral nerve lesions are distributed on
    [Show full text]
  • Bone Grafts and Implants in Spine Surgery
    CHAPTER 39 BONE GRAFTS AND IMPLANTS IN SPINE SURGERY Ken Hsu James F. Zucherman Arthur H. White Recent advances in both fusion tech of scaffolds, bridges, spacers, fillers of J • niques and instrumentation have defects, and replacements of bone lost. markedly facilitated the treatment of Immobilization of multiple motion seg spinaldisorders. Yet asignificantnumber ments is frequently necessary in the spine; of patients exist who continue to have great demands arc made on bone grafts. pseudarthroses. Despite the surgical ad In the lumbosacral spine, body weight vances the essentials ofa successful spinal and muscular forcesimpart loads equal to fusion still appear to be the effective ap three or four times body weight. It is plication of sound bone grafting princi not surprising that the highest rate of ples. These principles, along with the bone graft failure is seen in the lumbo techniques, problems, and complications sacral spine. Hence, the following is a associated with bone grafting, arc re discussion of technical problems, bio- viewed in this chapter. mechanical and physiologic character The loss ofbone in the spine often pre istics of bone grafts, and implants. sents serious difficulties not seen in other areas. The most favorable replacement THE AUTOGRAFT would still be a bone graft that fills the Autograft, or bone graft transplanted defect and becomes incorporated into the from one site to another in the same indi spine. However, the availability of ap vidual, is considered to be the most bio propriate bone to replace the loss is a logically suitable. Its advantages include: significant problem. Alternatives to bone 1.
    [Show full text]
  • Study of Anatomical Pattern of Lumbar Plexus in Human (Cadaveric Study)
    54 Az. J. Pharm Sci. Vol. 54, September, 2016. STUDY OF ANATOMICAL PATTERN OF LUMBAR PLEXUS IN HUMAN (CADAVERIC STUDY) BY Prof. Gamal S Desouki, prof. Maged S Alansary,dr Ahmed K Elbana and Mohammad H Mandor FROM Professor Anatomy and Embryology Faculty of Medicine - Al-Azhar University professor of anesthesia Faculty of Medicine - Al-Azhar University Anatomy and Embryology Faculty of Medicine - Al-Azhar University Department of Anatomy and Embryology Faculty of Medicine of Al-Azhar University, Cairo Abstract The lumbar plexus is situated within the substance of the posterior part of psoas major muscle. It is formed by the ventral rami of the frist three nerves and greater part of the fourth lumbar nerve with or without a contribution from the ventral ramus of last thoracic nerve. The pattern of formation of lumbar plexus is altered if the plexus is prefixed (if the third lumbar is the lowest nerve which enters the lumbar plexus) or postfixed (if there is contribution from the 5th lumbar nerve). The branches of the lumbar plexus may be injured during lumbar plexus block and certain surgical procedures, particularly in the lower abdominal region (appendectomy, inguinal hernia repair, iliac crest bone graft harvesting and gynecologic procedures through transverse incisions). Thus, a better knowledge of the regional anatomy and its variations is essential for preventing the lesions of the branches of the lumbar plexus. Key Words: Anatomical variations, Lumbar plexus. Introduction The lumbar plexus formed by the ventral rami of the upper three nerves and most of the fourth lumbar nerve with or without a contribution from the ventral ramous of last thoracic nerve.
    [Show full text]
  • The Neuroanatomy of Female Pelvic Pain
    Chapter 2 The Neuroanatomy of Female Pelvic Pain Frank H. Willard and Mark D. Schuenke Introduction The female pelvis is innervated through primary afferent fi bers that course in nerves related to both the somatic and autonomic nervous systems. The somatic pelvis includes the bony pelvis, its ligaments, and its surrounding skeletal muscle of the urogenital and anal triangles, whereas the visceral pelvis includes the endopelvic fascial lining of the levator ani and the organ systems that it surrounds such as the rectum, reproductive organs, and urinary bladder. Uncovering the origin of pelvic pain patterns created by the convergence of these two separate primary afferent fi ber systems – somatic and visceral – on common neuronal circuitry in the sacral and thoracolumbar spinal cord can be a very dif fi cult process. Diagnosing these blended somatovisceral pelvic pain patterns in the female is further complicated by the strong descending signals from the cerebrum and brainstem to the dorsal horn neurons that can signi fi cantly modulate the perception of pain. These descending systems are themselves signi fi cantly in fl uenced by both the physiological (such as hormonal) and psychological (such as emotional) states of the individual further distorting the intensity, quality, and localization of pain from the pelvis. The interpretation of pelvic pain patterns requires a sound knowledge of the innervation of somatic and visceral pelvic structures coupled with an understand- ing of the interactions occurring in the dorsal horn of the lower spinal cord as well as in the brainstem and forebrain. This review will examine the somatic and vis- ceral innervation of the major structures and organ systems in and around the female pelvis.
    [Show full text]
  • Anatomy of the Rectum and Anal Canal, Surgery (2017), J.Mpsur.2016.12.008 BASIC SCIENCE
    BASIC SCIENCE been described in the previous article) are noticeably absent on Anatomy of the rectum the rectal wall. Indeed it is this abrupt change in external appearance that enables the surgeon to identify the rectosigmoid and anal canal junction with confidence, at operation. The rectosigmoid junc- tion is approximately 6 cm below the level of the sacral prom- Vishy Mahadevan ontory. Approached from the distal end, however, as when performing a rigid or flexible sigmoidoscopy, the rectosigmoid junction is seen to be 14e18 cm from the anal verge. The rectum Abstract in the adult measures 10e14 cm in length. Collectively the rectum and anal canal constitute the very terminal segment of the large intestine, and thus of the entire gastro- Relationship of the peritoneum to the rectum intestinal tract. Their distal location renders the rectum and anal Unlike the transverse colon and sigmoid colon, the rectum lacks canal readily accessible to direct inspection and examination. The a mesentery. The posterior aspect of the rectum is thus entirely prime function of the rectum is to act as a distensible reservoir for free of a peritoneal covering. In this respect the rectum resembles faeces, while the anal canal incorporates in its wall a powerful the ascending and descending segments of the colon, and all of muscular sphincter which is of paramount importance in the mecha- these segments may be therefore be spoken of as retroperitoneal. nism of faecal continence. Diseases of the rectum and anal canal, The precise relationship of the peritoneum to the rectum is as both benign and malignant, account for a very large part of colorectal follows.
    [Show full text]
  • Axis Scientific Human Circulatory System 1/2 Life Size A-105864
    Axis Scientific Human Circulatory System 1/2 Life Size A-105864 05. Superior Vena Cava 13. Ascending Aorta 21. Hepatic Vein 28. Celiac Trunk II. Lung 09. Pulmonary Trunk 19. Common III. Spleen Hepatic Artery 10. Pulmonary 15. Pulmonary Artery 17. Splenic Artery (Semilunar) Valve 20. Portal Vein 03. Left Atrium 18. Splenic Vein 01. Right Atrium 16. Pulmonary Vein 26. Superior 24. Superior 02. Right Ventricle Mesenteric Vein Mesenteric Artery 11. Supraventricular Crest 07. Interatrial Septum 22. Renal Artery 27. Inferior 14. Aortic (Semilunar) Valve Mesenteric Vein 08. Tricuspid (Right 23. Renal Vein 12. Mitral (Left Atrioventricular) Valve VI. Large Intestine Atrioventricular) Valve 29. Testicular / 30. Common Iliac Artery Ovarian Artery 32. Internal Iliac Artery 25. Inferior 31. External Iliac Artery Mesenteric Artery 33. Median Sacral Artery 41. Posterior Auricular Artery 57. Deep Palmar Arch 40. Occipital Artery 43. Superficial Temporal Artery 58. Dorsal Venous Arch 36. External Carotid Artery 42. Maxillary Artery 56. Superficial Palmar Arch 35. Internal Carotid Artery 44. Internal Jugular Vein 39. Facial Artery 45. External Jugular Vein 38. Lingual Artery and Vein 63. Deep Femoral Artery 34. Common Carotid Artery 37. Superior Thyroid Artery 62. Femoral Artery 48. Thyrocervical Trunk 49. Inferior Thyroid Artery 47. Subclavian Artery 69. Great Saphenous Vein 46. Subclavian Vein I. Heart 51. Thoracoacromial II. Lung Artery 64. Popliteal Artery 50. Axillary Artery 03. Left Atrium 01. Right Atrium 04. Left Ventricle 02. Right Ventricle 65. Posterior Tibial Artery 52. Brachial Artery 66. Anterior Tibial Artery 53. Deep Brachial VII. Descending Artery Aorta 70. Small Saphenous Vein IV. Liver 59.
    [Show full text]
  • Spinal Cord, Spinal Nerves, and the Autonomic Nervous System
    ighapmLre21pg211_216 5/12/04 2:24 PM Page 211 impos03 302:bjighapmL:ighapmLrevshts:layouts: NAME ___________________________________ LAB TIME/DATE _______________________ REVIEW SHEET Spinal Cord, Spinal Nerves, exercise and the Autonomic Nervous System 21 Anatomy of the Spinal Cord 1. Match the descriptions given below to the proper anatomical term: Key: a. cauda equina b. conus medullaris c. filum terminale d. foramen magnum d 1. most superior boundary of the spinal cord c 2. meningeal extension beyond the spinal cord terminus b 3. spinal cord terminus a 4. collection of spinal nerves traveling in the vertebral canal below the terminus of the spinal cord 2. Match the key letters on the diagram with the following terms. m 1. anterior (ventral) hornn 6. dorsal root of spinal nervec 11. posterior (dorsal) horn k 2. arachnoid materj 7. dura materf 12. spinal nerve a 3. central canalo 8. gray commissure i 13. ventral ramus of spinal nerve h 4. dorsal ramus of spinald 9. lateral horne 14. ventral root of spinal nerve nerve g l 5. dorsal root ganglion 10. pia materb 15. white matter o a b n c m d e l f g k h j i Review Sheet 21 211 ighapmLre21pg211_216 5/12/04 2:24 PM Page 212 impos03 302:bjighapmL:ighapmLrevshts:layouts: 3. Choose the proper answer from the following key to respond to the descriptions relating to spinal cord anatomy. Key: a. afferent b. efferent c. both afferent and efferent d. association d 1. neuron type found in posterior hornb 4. fiber type in ventral root b 2.
    [Show full text]
  • The Thoracic Aorta the Abdominal Aorta
    The Thoracic Aorta The Thoracic Aorta (portion of descending aorta) descends through the thorax. Visceral branches: > pericardial - posterior pericardium > bronchial - 2 left, 1 right supplying blood to the lungs and bronchial pleurae > esophageal - esophagus > mediastinal - posterior mediastinum Parietal branches: > posterior intercostals - 9-10 pairs - anastomose around the front with anterior intercostals > superior phrenics - posterior diaphragm The Abdominal Aorta The Abdominal Aorta pierces diaphragm and enters abdominal cavity and is now abdominal aorta over the vertebral column. It gives off the following branches: > inferior phrenic - to supply the inferior diaphragm > celiac trunk gives off 3 branches: 1. common hepatic artery - gives off a complex group of arteries to the stomach: • right gastric artery which meets up (anastomoses) with left gastric artery to supply the lesser curvature of the stomach. • right gastroepiploic artery that meets up (anastomoses) with left gastroepiploic artery (branch of splenic artery) to supply the greater curvature of the stomach. 2. splenic artery (to spleen), 3. left gastric artery (to stomach) > superior mesenteric - to supply the midgut (duodenum to mid-transverse colon) > suprarenals - to supply the adrenal gland > renals - to supply the kidneys > gonadals - to supply the testes and ovaries > inferior mesenteric - to supply the hindgut (mid-transverse colon to rectum) > lumbar arteries - several pairs off the posterior side of the descending aorta > median sacral artery - off the posterior
    [Show full text]
  • The Lumbosacral Plexus: Anatomic Considerations for Minimally Invasive Retroperitoneal Transpsoas Approach
    Surg Radiol Anat (2012) 34:151–157 DOI 10.1007/s00276-011-0881-z ORIGINAL ARTICLE The lumbosacral plexus: anatomic considerations for minimally invasive retroperitoneal transpsoas approach Patrick Gue´rin • Ibrahim Obeid • Anouar Bourghli • Thibault Masquefa • Ste´phane Luc • Olivier Gille • Vincent Pointillart • Jean-Marc Vital Received: 2 May 2011 / Accepted: 21 September 2011 / Published online: 5 October 2011 Ó Springer-Verlag 2011 Abstract plexus was performed. All nerve branches and sympathetic Purpose The minimally invasive transpsoas approach can chain were identified. Intervertebral disc space from L1L2 be employed to treat various spinal disorders, such as disc to L4L5 was divided into four zones. Zone 1 being the degeneration, deformity, and lateral disc herniation. With anterior quarter of the disc, zone 2 being the middle this technique, visualization is limited in comparison with anterior quarter, zone 3 the posterior middle quarter and the open procedure and the proximity of the lumbar plexus zone 4 the posterior quarter. Crossing of each nervous to the surgical pathway is one limitation of this technique. branch with the disc was reported and a safe working zone Precise knowledge of the regional anatomy of the lumbar was determined for L1L2 to L4L5 disc levels. A safe plexus is required for safe passage through the psoas working zone was defined by the absence of crossing of a muscle. The primary objective of this study was to deter- lumbar plexus branch. mine the anatomic position of the lumbar plexus branches Results No anatomical variation was found during blunt and sympathetic chain in relation to the intervertebral disc dissection.
    [Show full text]
  • Anatomy of the Abdominal Aorta in the Hoary Fox (Lycalopex Vetulus, Lund, 1842)
    1 Anatomy of the abdominal aorta in the hoary fox (Lycalopex vetulus, Lund, 1842) Anatomia da aorta abdominal em raposa-do-campo (Lycalopex vetulus, Lund, 1842) Dara Rúbia Souza SILVA1; Mônica Duarte da SILVA1; Marcos Paulo Batista de ASSUNÇÃO1; Eduardo Paul CHACUR1; Daniela Cristina de Oliveira SILVA2; Roseâmely Angélica de Carvalho BARROS1; Zenon SILVA1 1 Universidade Federal de Goiás, Regional Catalão, Instituto de Biotecnologia, Departamento de Ciências Biológicas, Catalão – GO, Brazil 2 Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Departamento de Anatomia Humana, Uberlândia – MG, Brazil Abstract The hoary fox (Lycalopex vetulus, Lund, 1842) is the smallest Brazilian canid, whose weight varies between 2 and 4 kg, has a slender body, a small head, and a short and blackened snout. Despite being considered an endemic species, little is known about the hoary fox as it is one of the seven less studied canids in the world. Thus, this study aimed to describe the anatomy of the abdominal aorta artery of the hoary fox and to compare it with the pre-established literature data in domestic canids. For this purpose, we used two adult hoary foxes without definite age. We collected the corpses of these animals along roadsides of Catalão-GO, being later fixed and conserved in a 10% formalin solution. The results showed that the abdominal aorta in hoary fox is at the ventral face of the lumbar region vertebral bodies, being slightly displaced to the left of the median plane. The first branch is visceral, named celiac artery, followed by a paired parietal branch: the phrenic abdominal arteries.
    [Show full text]