Method of Anterior Femoral Region Preparation for Establishing the Fetal Anatomical Variability of Vasculonervous Formations

Abstract

Determining of projection-syntopic relationships of vasculonervous structures within the femoral ring, femoral triangle, and obturator and adductor canal in human fetuses is particularly important in fetal surgery, and requires the use of an appropriate set of methods of morphological examination. Obtaining data on the topographic and anatomical features of nerves, superficial and deep blood vessels of the anterior femoral region during the fetal period of human ontogenesis is a topical urgent task of fetal anatomy. The purpose of the study was to determine the method of the most rational sequence of actions during the preparation of the vasculonervous structures of the anterior femoral region in human fetuses to obtain standard results suitable for comparison in the age aspect. Material and methods. The study was performed on 80 human fetuses 81.0-375.0 mm parietal-coccygeal length using macromicroscopic preparation. After the selected sequence of preparation of nerves and vessels of the anterior femoral region in human fetuses 4-10 months we used additional methods such as vascular injection, surface staining of dissected vessels and nerves and morphometry to determine the forms of their age and individual anatomical variability. Results and discussion. The chosen sequence of preparation of nerves and vessels of the anterior femoral region in human fetuses allowed determining the forms of their age and individual anatomical variability. In particular, features of intramuscular branching of nerves and arteries in the muscles of the anterior and medial femoral groups, anatomical variability of the femoral artery and its branches, variant anatomy of the great saphenous vein, characterized by variability in shape, topography and bilateral asymmetry of its tributaries and formation of anastomoses were found in human fetuses. The identified connections and complexes of the femur cutaneous nerves, as well as areas of overlap and displacement are compensatory mechanisms in the peripheral nervous system and are observed not only between ontogenetically related nerves, but also nerves of different segmental affiliation. Conclusion. The proposed and tested method of preparation of vasculonervous structures of the anterior femoral region in human fetuses provides a standard for obtaining data on their typical and variant anatomy. The sequence of actions used during the preparation of the vasculonervous formations of the anterior femoral region of the human fetus preserves the natural appearance and relationships between the structures of the object of study. Age-related and individual fetal anatomical variability of vasculonervous formations of the anterior femoral region was discovered during the gradual preparation of the lumbar plexus branches, superficial and deep veins of the lower extremities, superficial and deep inguinal lymph nodes, and femoral artery branches