İnsan fetuslarında Arcus Palmaris Profundus ve Superficialis'in anatomik incelemesi
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Arcus palmaris profundus (APP) ve arcus palmaris superficialis (APS), sırasıyla arteria radialis (AR) ile arteria ulnaris (AU)'in ramus palmaris profundus'unun, AU ile AR'nin ramus palmaris superficialis (RPS)'inin anastomozu ile oluşur. Elin kompleks arteryel beslenmesine katkı veren APP ve APS tiplerini insan fetuslarında inceleme ve varyasyonlarını tespit etme amaçlandı. APS'nin ve elin morfometrik ölçümlerini insan fetuslarında diseksiyonla değerlendirildi. Çalışmamız, formalinle fikse edilmiş 18-37 haftalık 40 insan fetusunun (19 erkek, 21 kız) 80 membrum superius'unda diseksiyon yapılarak gerçekleştirildi. Diseksiyon mikroskobu ile mm lik ölçekli kağıtlar kullanılarak anatomik yapılar görüntülendi. APS'in tipleri ve varyasyonları incelendi. ACNM görüntülendi. El bilek genişliği, el genişliği, el uzunluğu ve parmak uzunluğu ölçümleri dijital kaliper kullanılarak yapıldı ve el indeksi hesaplandı. APS'yi oluşturan AU çapı, AR çapı, RPS çapı, arteria comitans nervi mediani (ACNM) çapı, APS'nin dalı arteria digitalis palmaris communis (ADPC)'lerin çapı, APS en geniş çapı ve APS uzunluğu ölçümleri Image J yazılımı kullanılarak dijital görüntüler üzerinde gerçekleştirildi. Bu değerlerin cinsiyet, trimester ve taraf durumlarına göre birbirleriyle ilişkisi incelendi. İncelediğimiz trimester fetuslarındaki APP'yi oluşturan dallar ve APP net görüntülenemedi. APS'ler 58 elde (%72,5) komplet tip ve 22 elde (%27,5) inkomplet tip olarak bulundu. Komplet grupta tip A %47,5, tip B %16,25, tip C %3,75, tip D %1,25 ve tip E %3,75; inkomplet grupta tip F %15, tip G %8,75, tip H %2,5 ve tip I %1,25 olarak belirlendi. İki elde (%2,5) AU kaynaklı ve seyri esnasında canalis carpi'den geçen ACNM tespit edildi. Cinsiyet grupları arasında el indeksinde anlamlı fark bulunmazken, trimester grupları arasında anlamlı olarak fark bulundu (p<0,001). Arterlerin çapları kıyaslandığında AU baskın olarak tespit edildi. El indeksi ile APS çap ve uzunluğu arasında pozitif korelasyon gösterildi (p<0,001). AU ve AR çapları ile ADPC çapları arasında pozitif korelasyon bulundu (p<0,001). APS ile ilgili oluşumların ölçümlerini el morfometrik parametreleriyle ilişkisini fetuslarda inceleyen diseksiyon çalışmasıdır. APS varyasyonlarının farkındalığı bölgedeki arter kanamalarına yapılan girişimlerde, damar greft ve serbest flep uygulamaları gibi el mikro cerrahisine katkı sağlayacaktır. ACNM'nin varlığı mikroevrimsel değişiklik kapsamında veya gerileyip kaybolması gelişimsel anatomi yönüyle, kalıcı olarak devam etmesi ise klinik semptomlara neden olması sebebiyle nörolog ve ortopedistler için klinik anatomi açısından değerlidir.
The deep palmar arch (DPA) and the superficial palmar arch (SPA) are formed by anastomosis of the radial artery (RA) and deep palmar branch of the ulnar artery (UA), UA and the superficial palmar branch (SPB) of RA, respectively. We examined the types of DPA and SPA, which contribute to the complex arterial vascular supply of the hand in human fetuses and determined their variations. It was evaluated the morphometric measurements of the SPA and hand in human fetuses by dissection. Our study was carried out by dissecting 80 upper extremities of 40 formalin-fixed human fetuses (19 male, 21 female) 18-37 weeks of age. Anatomical structures were visualized using mm scaled papers with the dissection microscope. The types and variations of SPA were examined. The MA was imaged. Wrist width, hand width, hand length, and digit lengths measurements were made using a digital caliper and hand index was computed. UA diameter, RA diameter, SPB diameter, median artery (MA) diameter, the diameter of the common palmar digital arteries (CPDA) branching the SPA, SPA widest diameter, and SPA length measurements were performed on digital images using Image J software. The relationship of these parameters with each other was analyzed according to gender, trimester, and side status. The branches forming the DPA and the DPA in the trimester fetuses we examined could not be clearly visualized. SPA was the complete type in 58 hands (72.5%) and incomplete in 22 hands (27.5%). In the complete group, type A was 47.5%, type B was 16.25%, type C was 3.75%, type D was 1.25% and type E was 3.75%. In the incomplete group, type F was 15%, type G was 8.75%, type H was 2.5%, and type I was 1.25%. The MA originating from UA and passing through the carpal tunnel during its course was detected in two hands (2.5%). While there was no significant difference in hand index between gender groups, a significant difference was found between trimester groups (p<0.001). When the diameters of the arteries were compared, UA was found to be dominant. A significant correlation was shown between hand index and SPA diameter and length (p<0.001). A correlation was found between UA and RA diameters and CPDAs diameters (p<0.001). This dissection study is examined the relationship between measurements of SPA-related anatomical structures and hand morphometric parameters in fetuses. The awareness of the SPA variations will contribute to hand microsurgery such as vascular grafts and free flap applications interventions performed on arterial bleeding in the region. The presence of the MA is valuable in terms of developmental anatomy within the scope of microevolutionary change.
The deep palmar arch (DPA) and the superficial palmar arch (SPA) are formed by anastomosis of the radial artery (RA) and deep palmar branch of the ulnar artery (UA), UA and the superficial palmar branch (SPB) of RA, respectively. We examined the types of DPA and SPA, which contribute to the complex arterial vascular supply of the hand in human fetuses and determined their variations. It was evaluated the morphometric measurements of the SPA and hand in human fetuses by dissection. Our study was carried out by dissecting 80 upper extremities of 40 formalin-fixed human fetuses (19 male, 21 female) 18-37 weeks of age. Anatomical structures were visualized using mm scaled papers with the dissection microscope. The types and variations of SPA were examined. The MA was imaged. Wrist width, hand width, hand length, and digit lengths measurements were made using a digital caliper and hand index was computed. UA diameter, RA diameter, SPB diameter, median artery (MA) diameter, the diameter of the common palmar digital arteries (CPDA) branching the SPA, SPA widest diameter, and SPA length measurements were performed on digital images using Image J software. The relationship of these parameters with each other was analyzed according to gender, trimester, and side status. The branches forming the DPA and the DPA in the trimester fetuses we examined could not be clearly visualized. SPA was the complete type in 58 hands (72.5%) and incomplete in 22 hands (27.5%). In the complete group, type A was 47.5%, type B was 16.25%, type C was 3.75%, type D was 1.25% and type E was 3.75%. In the incomplete group, type F was 15%, type G was 8.75%, type H was 2.5%, and type I was 1.25%. The MA originating from UA and passing through the carpal tunnel during its course was detected in two hands (2.5%). While there was no significant difference in hand index between gender groups, a significant difference was found between trimester groups (p<0.001). When the diameters of the arteries were compared, UA was found to be dominant. A significant correlation was shown between hand index and SPA diameter and length (p<0.001). A correlation was found between UA and RA diameters and CPDAs diameters (p<0.001). This dissection study is examined the relationship between measurements of SPA-related anatomical structures and hand morphometric parameters in fetuses. The awareness of the SPA variations will contribute to hand microsurgery such as vascular grafts and free flap applications interventions performed on arterial bleeding in the region. The presence of the MA is valuable in terms of developmental anatomy within the scope of microevolutionary change.
Açıklama
Anahtar Kelimeler
Arcus palmaris superficialis, Arteria comitans nervi mediani, Fetus, Gelişimsel anatomi, Varyasyon, Developmental anatomy, Fetus dissection, Median artery, Superficial palmar arch, Variation
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Solmaz, E. (2021). İnsan fetuslarında Arcus Palmaris Profundus ve Superficialis'in anatomik incelemesi. (Doktora Tezi). Selçuk Üniversitesi, Sağlık Bilimleri Enstitüsü, Konya.
