The findings in a study of the general circulation of the suprarenal glands in 25 cases, and particularly of the left glands in 50 cases, are presented. The vessels arose from three pedicles: superior, middle and inferior. The inferior pedicle was the most irregular, with a frequent contribution from the gonadal artery to the inferior part of the gland; this artery should not be regarded as merely an accessory vessel. On the left side an inconstant posterior pedicle, separate from the others, was found in 26% of cases. Two forms of gonadal artery supplying the gland (8%) are described, an upper origin type at the renal artery level and an aberrant type.
Background:In recent years, distal nerve transfers have become a valid tool for nerve reconstruction. Though grafts remain the gold standard for proximal median nerve injuries, a new distal transfer of flexor carpi ulnaris branches of the ulnar nerve to selectively restore anterior interosseous nerve function, concomitant with median nerve graft repair, could enhance outcomes. The objective of this paper is to anatomically analyze a technique to selectively reinnervate the thumb and index flexors.Methods:Both the median and ulnar nerves were dissected in 10 cadavers. First and second branches to the flexor carpi ulnaris (FCU) were measured for length at its emergence from the ulnar nerve, and for width. The emergence of the AIN, just proximal to the arch of the flexor digitorum superficialis, was dissected, and the distance measured from this point to its motor entry at the long flexor pollicis and its branch to the long index flexor. A tensionless repair was performed between one FCU branch and the AIN.Results:The mean AIN length was 32.3±8.20 mm and width 2.4±0.49 mm. The first branch from the ulnar nerve to the FCU measured 20.8±2.04 mm and 1.52±0.44 mm, while the second, more distal branch measured 24.3±6.71 and 1.9±0.17 mm, respectively. In all dissections, it was possible to contact both the proximal and distal branches of the ulnar nerve to the FCU with the distal stump of the divided AIN, with no tension or need for interposed nerve grafts.Conclusions:Though proximal reconstruction remains the gold standard, new distal nerve transfer techniques may improve outcomes.
Variations in the relative percentage of innervation from the radial nerve could be due to the different sizes and shapes of this branch. The functional significance of this branch can become crucial if the main innervation to the brachialis muscle fails. When planning surgical antero-external approach to the humerus, it should be kept in mind and preserved.
The present work deals with a study of the supraduodenal a. in 30 specimens. It was present in 28 cases: when absent it was substituted by the right gastric a. Its origin is discussed, the most frequent being the gastroduodenal a., with 2 cases in the pericholedochal plexus. Distribution to the distal two thirds of the upper portion of the duodenum was constant, extending to the supra- and retroduodenal portions of the common duct. Its anastomosis with the gastric right a. and the posterior superior pancreaticoduodenal a. was established in half the cases, being more frequent with the former.
This is a study of the origin of the palmar collateral arteries of the thumb and radial side of the index finger. The different patterns of the main trunk, the first palmar interosseous artery, in the commissure are discussed, together with the relations of its branches with those of the superficial palmar arch and its relations with the accessory fasciculi of the adductor pollicis and first dorsal interosseous muscles.
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