The aim of the present study was to establish a precise topography of the arterial supply of the different layers in the palm of the human hand. Two hundred upper extremities from fresh human cadavers aged 20–80 years were injected either by coloured latex or by India ink and gelatine. Some of our specimens were treated by the Spalteholz technique of transclarification, while some others were treated by acid corrosion. All of the specimens were dissected under the dissecting microscope. The superficial palmar arch (SPA) is the main vascular structure of the palm of the hand. Regardless of its size and of its variation, in addition to the common palmar digital arteries, the SPA supplies the superficial flexor tendons, flexor retinaculum, median and ulnar nerves, tendon of the flexor pollicis longus muscle, lumbrical muscles, palmar aponeurosis and the skin of the palm of the hand. These data may be of interest to those involved in hand surgery.
After having been the subject of several studies during the first half of the 20th century, the anatomical and morphological measurements of the ocular rectus muscles have recently been reinvestigated (e.g. L. Apt). At the Anatomy Institute in Geneva, similar measurements were performed on 25 human orbits as well as the depth of the subtenon space. The results show a large variation from one individual to another, although the "Tillaux spiral" was always respected. We have also shown that the ratio of the arc between each pair of opposed rectus muscles is a constant equal to 1 (0.997 +/- SD = 0.031). The subtenon space was defined morphometrically and confirmed histologically. All these measurements are important for practical aspects involved in the surgery of strabismus.
The arterial supply to the flexor tendons of the fingers was studied by means of angiography, by the injection of coloured latex, and by microdissection. It was established that there were no anastomoses between the intra-osseous circulation and that of the synovial sheath. Two separate sources of blood supply to the sheath were found: the digitopalmar arches and the specific arteries of the sheath. The findings indicate that the ideal location for incision into the digital sheath is in the midline of the palmar surface. The flexor tendons within the sheath are supplied only by branches of the digitopalmar arches. Considerable differences were observed in the details of blood supply of the tendon of flexor superficialis and that of flexor profundus.
The blood supply of the lumbrical muscles was studied in 100 upper extremities from fresh human cadavers. Layer by layer dissection revealed the existence of different types of vascularity for the four muscles. The injection of coloured latex or Indian ink solution with gelatin showed the complex arterial network of these muscles together with their various sources of blood supply. Four separate sources of blood supply for each of the muscles were found: the superficial palmar arch (SPA), the common palmar digital artery, the deep palmar arch (DPA) and the dorsal digital artery. It was established that there were no anastomoses between the blood vessels of the tendons of the flexor digitorum profundus muscle and those of the lumbrical muscles. Considerable differences were observed in the details of the blood supply of the individual lumbrical muscles.
Twenty-five normal adult eyes, taken from fresh human cadavers, were specially prepared in view of the measurements of the arc length of different segments of the globe. The distances measured between the anterior limbus and the scleral insertions of the rectus muscles were similar to those in previous studies with respect to the ‘spirale de Tillaux’ and a high interindividual variability, i.e. medial rectus 6.2 ± 0.6 mm, inferior rectus 7.0 ± 0.6 mm, lateral rectus 7.7 ± 0.7 mm, superior rectus 8.5 ± 0.7 mm. The distance between each pair of opposite rectus muscle insertions shows a high interindividual variability (horizontal axis 25.45 ± 1.38 mm, vertical axis 25.55 ± 1.45 mm), but the ratio between both distances was always equal to 1 (0.997 ± 0.031) with a statistically significant correlation (2-tailed p = 0.96). This new approach to rectus muscle insertions may be important for a better understanding of some possible anatomically related factors in strabismus.
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