The anatomic basis for the platysma skin flap

Meticulous anatomic dissection of the vasculature of the superficial anterolateral neck indicates that the platysma and overlying skin are supplied by direct cutaneous arteries measuring 0.5 mm in diameter. The small arteries are branches of the postauricular and occipital arteries in the upper lateral neck, the facial and submental arteries in the upper medial neck, the superior thyroid artery in the middle of the neck, the subclavian artery in the lower medial neck, and the transverse or superficial cervical arteries in the lateral aspect of the neck. These vessels traverse the undersurface of the platysma muscle to provide blood flow to the overlying skin. As opposed to this direct cutaneous system, the myocutaneous blood supply perforating through the sternocleidomastoid is scant. The platysma skin flap will survive if the blood supply from at least one region is preserved. In addition, it may be beneficial to include the external jugular and/or the communicating veins in the flap. By following these guidelines, the platysma flap has been successfully used for facial reconstruction in 7 of 8 consecutive patients.     

Vasculature of the parotoid glands of four species of toads (bufonidae: bufo)

The parotoid glands of toads (Bufonidae) consist of large aggregations of granular glands located between the otic region of the skull and the scapular region. To determine the circulatory pattern of these glands, we perfused the vascular systems of Bufo alvarius, B. marinus, B. terrestris, and B. valliceps with either India ink or Microfil, a fine latex. The perfused glands were studied by gross dissection, microscopic examination, and histology. The vascular patterns of the parotoid glands were compared to the arrangement of vessels in the dorsal skin of Rana sphenocephala (Ranidae), a frog that lacks parotoid glands. The parotoid glands of the four species of toads are supplied with blood by the lateral and dorsal cutaneous arteries and are drained by one or more branches of the internal jugular vein. The dorsal cutaneous artery supplies most of the blood to the parotoid glands in B. terrestris and B. valliceps. In B. alvarius and B. marinus, both the lateral and dorsal cutaneous arteries serve major roles in the blood supply of the glands. These patterns of blood flow have not been described previously for parotoid glands and conflict with earlier accounts for B. alvarius and B. marinus. The arteries and veins associated with the parotoid glands of toads are present in R. sphenocephala, but are arranged differently. In R. sphenocephala, the lateral cutaneous artery supplies the dorsal and lateral skin posterior to the shoulder region, whereas the dorsal cutaneous artery supplies the skin of the shoulder region. In toads, both the lateral and dorsal cutaneous arteries supply the skin of the shoulder region and ramify into subcutaneous capillaries that surround the secretory units of the parotoid glands. Extensive vasculature presumably is important for delivering cholesterol and other precursor molecules to the parotoid glands, where those compounds are converted into toxins.     

The legacy of Capt. Gino Pieri: a forgotten Italian contribution to the study of cutaneous blood supply during World War I

Among the many scientists who studied the cutaneous blood supply, Gino Pieri, an Italian Army surgeon operating during World War I, deserves attention. During those times, amputations were frequent, and flaps used to cover stumps were often inadequately designed and became necrotic, because of poor knowledge of the skin's blood supply. Pieri solved the problem after drawing a perforator map of human body skin, injecting the main arteries with methylene blue dye. His flaps were mainly designed along the course of what Ian Taylor would call "source" arteries, to capture the greatest perforators.     

Applied anatomy of the anterolateral femoral flap

A study of the source of the blood supply to the anterolateral femoral flap was carried out on 42 lower limbs of adult cadavers (among them 35 cadavers with injection of red latex and 1 with india ink into the arteries and 6 vascular cast specimens), and the surface locations of the vascular pedicle were detected on 50 healthy adults. It was found that the descending branch of the lateral circumflex femoral vessel was an ideal axial vessel. There are constant perforating branches of the myocutaneous artery or cutaneous branches from the intermuscular space to the anterolateral femoral skin. The area extends about 12 x 30 cm. Within the flap, the anterior branch of the anterolateral cutaneous nerve of the high is located. This flap has been widely used for free transplantation in China since 1983 with satisfactory results.     

The vasculature of the rat penis: a scanning electron microscopic and histologic study.

As a basis for understanding the mechanism of erection in an animal model frequently used in research in reproductive biology, the angioarchitecture of the penis of the rat has been described using scanning electron microscopy. Study of the penile vasculature of the rat indicates that the corpora cavernosa penis and the corpus spongiosum are independent erectile tissues, each with its own arterial and venous vessels. The large vascular spaces and abundant smooth muscle of the penile crura are compatible with its role in regulating blood flow to more distal penile tissues. Helicine arteries of the crura, but not the parent deep penile artery or arteries elsewhere, have muscular cushions in their walls. The venous drainage of the penile crura is via subtunical veins which are thought to be compressed during erection to elevate pressure within the penis. Large, paired cavernous veins drain the shaft of the penis. A unique method for inhibiting blood flow from the penis is indicated by the division of the cavernous veins into smaller channels prior to joining the subtunical venous plexus. Erectile tissue in the bifid origins of the corpus spongiosum has abundant cavernous muscle, while in the remainder of the corpus spongiosum little smooth muscle lines the cavernous spaces. The cavernous spaces on either side of the urethra coalesce to form vessels, each of which communicates with cavernous spaces in the glans. In addition, a bypass of the glans is effected by communication of these vessels directly with the deep dorsal vein. The apparent absence of muscular pads in vessels of the spongiosum, the relative paucity of cavernous smooth muscle, and the ample venous drainage provided by the deep dorsal vein may account for the lack of a venous occlusive mechanism similar to that of the corpora cavernosa penis.     

Blood supply and the atrioventricular conduction system of the dog heart

In 30 experiments in order to specify the blood supply and conducting system in the dog heart, coronal arteries were injected with a contrasting mass that was followed by roentgenography and preparation of the coronal arteries. The topography and blood supply of the atrioventricular conducting system with application of prevital blood supply, and the left coronal artery is the main source of blood supply for all the parts of the cardiac atrioventricular conducting system.     

Blood supply of the human cervical sympathetic chain and ganglia

OBJECTIVE: Cadaveric studies of the blood supply to the human cervical sympathetic chain and ganglia are lacking in the English literature. This study seeks to elucidate the gross blood supply of the cervical sympathetic chain so as to avoid surgical disruption of these vessels and thus decrease the risk of vascular insufficieny and subsequent dysfunction of thoracolumbar autonomic outflow to the head and neck. METHODS: Twelve (24 sides) human cadavers (8 male and 4 female) were dissected and their brachiocephalic veins, internal carotid arteries, and vertebral arteries cannulated. Red and blue latex was injected into the arteries and veins respectively. Dissection of the neck was carefully performed and the blood supply of the cervical sympathetic chain identified. RESULTS: The primary arterial supply to the sympathetic chain and ganglia were from superior to inferior the ascending pharyngeal, ascending cervical, thyrocervical trunk, and supreme intercostal arteries. The primary venous drainage of these structures was primarily by direct posterior branches into the internal jugular vein. In addition, we have found an area at the junction of the lower two-thirds and upper one-third of the neck, which is deficient in blood supply (both arterial and venous). CONCLUSIONS: Although sympathetic injury is a rare consequence of cervical operations, the current data should be useful to the surgeon who operates in the cervical region so as to avoid potential complications from disruption of the primary blood supply of the cervical sympathetic chain and ganglia. Also, future techniques of selective iatrogenic disruption of the blood supply to portions of these structures e.g. stellate ganglion may be helpful in treating entities such as hyperhydrosis.     

川金丝猴脑的动脉供应

为了探讨川金丝猴脑动脉供应的形态学特征,为脑生物学研究提供结构基础,用血管铸型和组织透明方法追踪观察了川金丝猴幼体脑动脉的来源和分支分布。结果表明川金丝猴与人脑的动脉供应基本相同,也由颈内动脉和椎动脉供应。上述动脉的分支于垂体周围形成大脑动脉环。颈内动脉通过大脑前动脉和大脑中动脉主要供应大脑半球前部的血液,椎动脉参与形成基底动脉、小脑动脉系和大脑后动脉,供应脑干、小脑和大脑后部的血液。另外,川金丝猴幼体左、右大脑前动脉间缺少前交通动脉。     

Neural and endothelial nitric oxide synthase activity in rat penile erectile tissue

NADPH-diaphorase (NADPH-D) activity and immunoreactivity for neural and endothelial nitric oxide synthase (nNOS and eNOS, respectively) were used to investigate nitric oxide (NO) regulation of penile vasculature. Both the histochemical and immunohistochemical techniques for NOS showed that all smooth muscles regions of the penis (dorsal penile artery and vein, deep penile vessels, and cavernosal muscles) were richly innervated. The endothelium of penile arteries, deep dorsal penile vein, and select veins in the crura and shaft were also stained for NADPH-D and eNOS. However, the endothelium of cavernous sinuses was unstained by both techniques. Fewer fibers were seen in the glans penis, those present being associated with small blood vessels and large nerve bundles near the trabecular walls. All penile neurons in the pelvic plexus, located by retrograde transport of a dye placed in the corpora cavernosa penis, were stained by the NADPH-D method. Essentially similar results were obtained with an antibody to nNOS. These data suggest that penile parasympathetic neurons comprise a uniform population, as all seem capable of forming nitric oxide. However, in contrast to the endothelium of penile vessels, the endothelium lining the cavernosal spaces may not be capable of nitric oxide synthesis.     

Myocutaneous vascular territory of the thoracoacromial artery. A topographical and morphometric study of the arterial vascularization of the pectoralis major myocutaneous flap

In order to clarify the vascularization of the pectoralis major muscle by the pectoral branch of the thoracoacromial artery, morphometric investigations and selective injection studies of the vessel were performed. A comparison with the anatomical orientation points clinically used for locating the vessel and its course confirms that the origin of the artery is at a constant spot at half the sternoacromial distance; the main vessel axis, however, deviates considerably from the clinically used acromioxiphoid axis in lateral direction. The lumen of the thoracoacromial artery has a range of more than 150% of the smallest vessel. Atherosclerotic alterations are not the reason for this variety but only an additional handicap for the vessel capacity. Two types of muscle-perforating arteries were found, and the cutaneous area of blood supply was defined.     

Impaired Ca2+ handling in penile arteries from prediabetic Zucker rats: involvement of Rho kinase

Diabetes is associated with an increased vascular tone usually involved in the pathogenesis of diabetic cardiovascular complications such as hypertension, stroke, coronary artery disease, or erectile dysfunction (ED). Enhanced contractility of penile erectile tissue has been associated with augmented activity of the RhoA/Rho kinase (RhoK) pathway in models of diabetes-associated ED. The present study assessed whether abnormal vasoconstriction in penile arteries from prediabetic obese Zucker rats (OZRs) is due to changes in the intracellular Ca(2+) concentration ([Ca(2+)](i)) and/or in myofilament Ca(2+) sensitivity. Penile arteries from OZRs and lean Zucker rats (LZRs) were mounted on microvascular myographs for simultaneous measurements of [Ca(2+)](i) and tension. The relationships between [Ca(2+)](i) and contraction for the α(1)-adrenergic vasoconstrictor phenylephrine (PE) were left shifted and steeper in OZRs compared with LZRs, although the magnitude of the contraction was similar in both groups. In contrast, the vasoconstriction induced by the thromboxane A(2) receptor agonist U-46619 was augmented in arteries from OZRs, and this increase was associated with an increase in both the sensitivity and maximum responses to Ca(2+). The RhoK inhibitor Y-27632 (10 μM) reduced the vasoconstriction induced by PE to a greater extent in OZRs than in LZRs, without altering Ca(2+). Y-27632 inhibited with a greater potency the contraction elicited by high KCl in arteries from OZRs compared with LZRs without changing [Ca(2+)](i). RhoK-II expression was augmented in arteries from OZRs. These results suggest receptor-specific changes in the Ca(2+) handling of penile arteries under conditions of metabolic syndrome. Whereas augmented vasoconstriction upon activation of the thromboxane A(2) receptor is coupled to enhanced Ca(2+) entry, a RhoK-mediated enhancement of myofilament Ca(2+) sensitivity is coupled with the α(1)-adrenergic vasoconstriction in penile arteries from OZRs.     

家鸽胃动脉的解剖学研究

用血管铸型和透明方法观察研究家鸽胃的血供情况。家鸽腺胃由腺胃右动脉和腺胃左动脉营养，肌胃由肌胃右动脉和肌胃左动脉营养，它们均起自腹腔动脉。另外，家鸽胃动脉间缺乏吻合现象。     

Arterial anatomy of the face: an analysis of vascular territories and perforating cutaneous vessels.

The cutaneous arterial circulation of the face and scalp was investigated by using multiple anatomic techniques in fresh cadaver specimens. Selective ink injections, dissection and measurement of latex-hardened perforators, and radiographic examination of transverse sections of barium-injected specimens defined 11 vascular territories of the face and scalp. Three distinct patterns of arterial vascularization were observed: (1) small, densely populated musculocutaneous perforating arteries supply the anterior face (facial, infraorbital arteries), (2) large, sparsely populated fasciocutaneous perforators that occur in predictable locations supply the lateral region of the face (branches of the transverse facial, submental, and zygomatico-orbital arteries), and (3) small, densely populated fasciocutaneous perforators supply the scalp (occipital, superficial temporal, and posterior auricular arteries). The locations of the perforation sites of the transverse facial, zygomatico-orbital, supratrochlear, supraorbital, and superficial temporal arteries may be predicted statistically within 2-cm limits with 95 percent certainty for individuals in the general population. The results of this study provide the anatomic framework to potentially revise or improve current reconstructive or aesthetic procedures on the face based on known arteries.     

Numerical simulations of the blood flow in the patient-specific arterial cerebral circle region

The Cerebral Circle Region, also known as the Circle of Willis (CoW), is a loop of arteries that form arterial connections between supply arteries to distribute blood throughout the cerebral mass. Among the population, only 25% to 50% have a complete system of arteries forming the CoW. 3D time-varying simulations for three different patient-specific artery anatomies of CoW were performed in order to gain a better insight into the phenomena existing in the cerebral blood flow. The models reconstructed on the basis of computer tomography images start from the aorta and include the largest arteries that supply the CoW and the arteries of CoW. Velocity values measured during the ultrasound examination have been compared with the results of simulations. It is shown that the flow in the right anterior artery in some cases may be supplied from the left internal carotid artery via the anterior communicating artery. The investigations conducted show that the computational fluid dynamic tool, which provides high resolution in both time and space domains, can be used to support physicians in diagnosing patients of different ages and various anatomical arterial structures.     

Vessels of the brachial plexus]

The blood supply of brachial plexus is described by means of lightened injected specimens of older human fetus. The following arteries have direct branches to brachial plexus: the aortic arch/brachiocephalica trunk, subclavia a., thyrocervical trunk, ascending cervical a., transverse cervical a., suprascapular a., and the acromial network. Secondary branches leave them that partly anastomose and also return from distal to proximal. The blood supply is luxurious.     

The arterial supply of the cervical vertebral body in newborns

The cervical vertebral column is mainly supplied by both vertebral arteries. A regular ladder pattern of arteries is on the dorsal plane as well as on the ventral plane of the cervical vertebral bodies, opposite to the thoracal and the lumbar area of the vertebral column with only a dorsal ladder pattern of arteries. The cervical arterial anastomoses are built by the segmental arteries of the vertebral arteries, in the back of the cervical vertebral bodies by the arteriae canalis vertebralis anteriores and in the front by the rami anteriores (corporum vertebrarum). The thyrocervical and the costocervical trunks are an additional blood supply especially to the ventral anastomoses. A loss of a segmental artery may have no effect because of the good anastomoses. Some decades of aa. nutriciae come in the vertebral body from all sides, but only 2 up to 4 rr. centrales anteriores and 2 rr. centrales posteriores join in the middle of the vertebral body. There are parallels to the arterial blood supply of the thoracal and the lumbar vertebral bodies. The longitudinal ligaments are supplied by both ladder patterns of arteries.     

Rho kinase is involved in Ca2+ entry of rat penile small arteries

Tonic physiological activity of RhoA/Rho kinase contributes to the maintenance of penile flaccidity through its involvement in the Ca(2+) sensitization of erectile tissue smooth muscle. The present study hypothesized that Rho kinase is also involved in the modulation of Ca(2+) entry induced by alpha(1)-adrenoceptor stimulation of penile arteries. Rat penile arteries were mounted in microvascular myographs for simultaneous measurements of intracellular Ca(2+) ([Ca(2+)](i)) and force. The Rho-kinase inhibitor Y-27632 markedly reduced norepinephrine-mediated electrically induced contractions and the increases in both [Ca(2+)](i) and tension elicited by the alpha(1)-adrenoceptor agonist phenylephrine (Phe). In contrast, the protein kinase C (PKC) inhibitor Ro-31-8220 reduced tension without altering the Phe-induced increase in [Ca(2+)](i). In the presence of nifedipine, Y-27632 still inhibited the non-L-type Ca(2+) signal and blunted Phe contraction. Y-27632 did not impair the capacitative Ca(2+) entry evoked by store depletion with cyclopiazonic acid but largely reduced the Ba(2+) influx stimulated by Phe in fura-2 AM-loaded arteries. The addition of Y-27632 to arteries depolarized with high KCl markedly reduced tension without changing [Ca(2+)](i). In alpha-toxin-permeabilized penile arteries stimulated with threshold Ca(2+) concentrations, Y-27632 inhibited the sensitization induced by either guanosine 5'-O-(3-thiotriphosphate) (GTPgammaS) or Phe in the presence of GTPgammaS. However, Y-27632 failed to alter contractions induced by a maximal concentration of free Ca(2+). These results suggest that Rho kinase, besides its contribution to the Ca(2+) sensitization of the contractile proteins, is also involved in the regulation of Ca(2+) entry through a nonselective cation channel activated by alpha(1)-adenoceptor stimulation in rat penile arteries.     

Marriage of resistance and conduit arteries breeds critical limb ischemia

Atherosclerosis in a major leg artery leads to impaired blood supply, which normally progresses to critical limb ischemia. Atherosclerosis produces substantial alterations of structure and endothelial function in the large conduit arteries. Pressure unloading and ischemia in the distal vasculature bring about alterations in microvascular function. Resistance arteries undergo significant wall thinning and changes in their contractile regulation. Optimization of large artery dimensions by the small arteries through flow-mediated vasodilation is impaired. Angiogenesis is stimulated, which can result in the formation of major collateral feeder vessels in addition to small nutritive blood vessels. However, angiogenesis can also contribute to instability of atherosclerotic plaques, which ultimately leads to further deterioration in blood supply. Surgical bypass grafting to restore blood supply to the distal leg generates a sudden increase of pressure in the weakened resistance vasculature, leading to uncontrolled changes in capillary hydrostatic pressure, extravasation of fluid, and tissue edema. This review aims to highlight the importance of the resistance vasculature in critical limb ischemia and the interdependence of pathophysiological changes in the large conduit and small resistance arteries. The major unresolved question is why the physiological mechanisms that regulate vascular structure and function ultimately break down, leading to circulatory failure within the distal limb.     

Gender differences in myogenic regulation along the vascular tree of the gerbil cochlea

Regulation of cochlear blood flow is critical for hearing due to its exquisite sensitivity to ischemia and oxidative stress. Many forms of hearing loss such as sensorineural hearing loss and presbyacusis may involve or be aggravated by blood flow disorders. Animal experiments and clinical outcomes further suggest that there is a gender preference in hearing loss, with males being more susceptible. Autoregulation of cochlear blood flow has been demonstrated in some animal models in vivo, suggesting that similar to the brain, blood vessels supplying the cochlea have the ability to control flow within normal limits, despite variations in systemic blood pressure. Here, we investigated myogenic regulation in the cochlear blood supply of the Mongolian gerbil, a widely used animal model in hearing research. The cochlear blood supply originates at the basilar artery, followed by the anterior inferior cerebellar artery, and inside the inner ear, by the spiral modiolar artery and the radiating arterioles that supply the capillary beds of the spiral ligament and stria vascularis. Arteries from male and female gerbils were isolated and pressurized using a concentric pipette system. Diameter changes in response to increasing luminal pressures were recorded by laser scanning microscopy. Our results show that cochlear vessels from male and female gerbils exhibit myogenic regulation but with important differences. Whereas in male gerbils, both spiral modiolar arteries and radiating arterioles exhibited pressure-dependent tone, in females, only radiating arterioles had this property. Male spiral modiolar arteries responded more to L-NNA than female spiral modiolar arteries, suggesting that NO-dependent mechanisms play a bigger role in the myogenic regulation of male than female gerbil cochlear vessels.