A bilateral maxillofacial trunk in man: an extraordinary anomaly of the carotid system of arteries.

In a Caucasian male, the maxillary artery (M) bilaterally arose with the facial artery anteromedially from the external carotid artery. On the right side, the M entered the infratemporal fossa between the neck of the mandible and the medial pterygoid muscle, whereas the left M pierced the medial pterygoid muscle, first being covered by the muscle and the angle of the mandible. On both sides, the M ran deep to the inferior head of the lateral pterygoid muscle and the buccal nerve. The right M lay deep to the inferior alveolar, but superficial to the lingual nerve, whereas the left inferior alveolar and lingual nerves had formed two roots, thus encircling the left M. The ascending palatine artery was replaced on both sides by palatine branches of the ascending pharyngeal artery. Since a bilaterial maxillofacial trunk with topographical relations as described herein has not been previously reported in man, the embryology and comparative anatomy of this variation are discussed.     

The intrarenal and pericapsular venous systems of kidneys of the ringed seal, Phoca hispida

The kidneys of Phoca hispida are comprised of many closely adherent renculi, each of which is a small kidney, functionally independent of its neighbours except with respect to venous drainage. Venous blood from the rencular parenchyma drains to the periphery through interlobular veins. These interlobular veins empty into a perirencular plexus comprised of subcapsular veins on the free surface of the renculus, interrencular veins on adjoined surfaces, and marginal subcapsular veins lying in the furrows between adjoined renculi. A pericapsular plexus of large veins overlies the marginal subcapsular veins and has frequent connections with them. Blood drains from the pericapsular plexus into large superficial collecting veins that converge over the surface of the kidney toward the divided hilum and connect directly to the paired trunks of the posterior vena cava. There are also connections to other major venous systems of the region. There is no arcuate venous system, no major vein at the rencular hilum, and no vein of consequence emerging from the renal hilum. Venous outflow is virtually entirely directed to the peripheral plexuses. The venous pattern differs from that of most mammals in which blood drains from the renal parenchyma to arcuate veins and leaves the kidney through a renal vein, or veins, emerging from the hilum. The walls of veins in the kidney are remarkably thin in comparison to their size. Subcapsular veins up to 0.5 mm wide have walls on the parenchymal side that in places consist only of a thin, fenestrated endothelium and a basal lamina.     

Structural characteristics and functional significance of the buccal fat pad (corpus adiposum buccae)

Corpus adiposum buccae (c.a.b.) was studied on 42 human subjects (fetuses and adults) using microdissection under magnifying glass after injection of the great vessels of the head with plastics, transparency technique of Spalteholtz and current histological methods. In fetuses, c.a.b. appeared as a well-developed mass located between Buccinator and inferior border of the Masseter. In adults, it emanated three prolongations among which the anteriorly directed molar prolongation was more conspicuous in edentulous old people. Externally, it was covered by a fine conjunctival wrap, which sent septa dividing the buccal fat pad in a series of minute fibroadipous compartments. C.a.b. contained a rich vascular network deriving from the branches of the facial and maxillary arteries. In this vascular net a more developed artery emanated branches to the prolongations of the c.a.b. The veins were tributaries of the pterygoid venous plexus. Beside the vessels, c.a.b. contained also lymphatics and myelinated nerves. The authors postulated that c.a.b. assumed the following functions: a) It filled up the masseter-zygomaticus-buccinator space forming an amortizing and a slipping platform for the masticatory muscles in action; b) in the baby, it resisted to the negative pressure which acted into the buccal cavity during sucking; c) its rich venous net, provided with valve-like structures, may be implicated in the exo-endocranial blood flow by means of the pterygoid plexus.     

Orbital muscle of Müller: observations on human fetuses measuring 35-150 mm

The arrangement and relationships of the orbital muscle of Müller in human fetuses have been analyzed. This is a constant muscle made of smooth muscle fibers arranged over the longer axis of the inferior orbital fissure; some of its fibers reach the inferior wall of the cavernous sinus. The muscle layer is pierced by orbital rami of the medial maxillary artery and by thin veins communicating with the ophthalmic vein system and pterygoid plexus. The zygomatic nerve can be found in the midst of the muscle mass along most of its course. It is innervated by short rami from the sphenopalatine ganglion.     

New buccinator myomucosal island flap: anatomic study and clinical application

The authors studied the vascular anatomy of the buccinator muscle by dissecting fresh cadavers. The anatomy of the buccal branches of the facial artery consistently confirmed the existence of a posterior buccal branch, a few inferior buccal branches, and anterior buccal branches to the posterior, inferior, and anterior portions of the buccinator. The buccal artery and posterior buccal branch anastomose to each other and ramify over the muscle. Several veins originate from the lateral aspect of the muscle, converge into the buccal venous plexus, and drain into the facial vein (from two to four tributaries) or into the pterygoid plexus and the internal maxillary vein (from the buccal vein). These vessels and nerves enter the posterior half of the buccinator posterolaterally. The facial artery and vein are located at variable distances from each other around the oral commissure and the nasal base. Two patterns of buccinator musculomucosal island flaps supplied by these buccal arterial branches are proposed in this article. The buccal musculomucosal neurovascular island flap (posteriorly based), supplied by the buccal artery, its posterior buccal branch, and the long buccal nerve, can be passed through a tunnel under the pterygomandibular ligament for closure of mucosal defects in the palate, pharyngeal sites, the alveolus, and the floor of the mouth. The buccal musculomucosal reversed-flow arterial island flap (superiorly based), supplied by the distal portion of the facial artery through the anterior buccal branches, can be used to close mucosal defects in the anterior hard palate, alveolus, maxillary antrum, nasal floor and septum, lip, and orbit. The authors have used the flaps in 12 patients. There has been no flap necrosis, and results have been satisfactory, both aesthetically and functionally.     

Orbital venous anatomy of the rat

Ten rats were embalmed, the veins of the head latex-injected, and the heads were dissected. Five rats were used to prepare corrosion casts of the venous structures of the head. It was found that the rat has an orbital venous plexus rather than an orbital venous sinus as seen in the mouse and hamster. The orbital venous plexus was formed by the external dorsal ophthalmic vein, the external ventral ophthalmic vein and numerous anastomoses between these veins. Of major interest was a large anastomotic vein located in the caudaldorsal area of the orbit. The anastomotic vein joined the orbital venous plexus and the superficial temporal vein.     

A morphological study of the vertebral venous plexus and its connections in the Cape dune mole‐rat,Bathyergus suillus (Bathyergidae)

Bathyergus suillus are subterranean rodents found in the Western Cape of South Africa, where they inhabit sandy, humid burrows. Vertebral venous plexuses around the vertebral column have been implicated in aiding the maintenance of a constant central nervous system temperature via its connections with muscles and interscapular brown adipose tissue. The morphology of the vertebral venous plexuses and its connections in B.suillus were investigated. Frozen (n = 10) animals were defrosted; the venous system injected with latex and the vertebral venous plexuses, azygos‐ and intercostal veins dissected along the dorsal and ventral aspects of the vertebral column. Specimens (n = 4) were used for histological serial cross sections of the thoracic vertebrae. Veins drained from the interscapular brown adipose tissue to the external vertebral venous plexus, via a dorsal vein at the spinous process of T2 which might represent the “vein of Sulzer” described in rats. The intercostal veins cranial to the level of T8 drained directly into the ventral external vertebral venous plexus instead of into the azygos vein as seen in rats. The azygos vein was situated ventrally on the thoracic vertebral bodies in the median plane as opposed to most rodents that have a left sided azygos vein. The internal vertebral venous plexus consisted of two ventrolateraly placed longitudinal veins in the spinal epidural space. Veins from the forelimbs entered the internal vertebral venous plexus directly at the levels of C7 and T1 and have not been described in other rodents. Serial histological sections, revealed no regulatory valves in vessels leading toward the internal vertebral venous plexus, allowing blood to presumably move in both directions within the vertebral venous plexus. The vertebral venous plexus of B. suillus shows similarities to that of the rat but the vessels from the forelimbs draining directly into to the internal vertebral venous plexus and the position of the azygos vein and the intercostal veins draining into the external vertebral venous plexus are notable exceptions. J. Morphol., 2011. © 2010 Wiley‐Liss, Inc.     

Thymic vascular system of the European common frog,Rana temporaria: a scanning electron-microscopic study of vascular casts

Vascular corrosion casts of the thymus of adult individuals of the European common frog, Rana temporaria, were analysed by scanning electron microscopy. The main arterial vessel, which is derived either from the temporal artery or from the auricular ramus, approaches the central territory of the gland and branches into twigs that, on penetrating the parenchyma, give rise to capillaries. Most of these capillaries run vertically towards the surface of the gland; they either join the superficial capillary plexus or follow this plexus for a variable distance and then run back towards the medulla, forming capillary loops. The former capillaries link with the extensive venous plexus composed of irregular meshes, whereas the latter capillaries join the venules at the cortico-medullary boundary and finally escape into collecting veins on the gland surface. The venous twigs, which join together near the gland, form the main thymic vein, which empties into the external jugular vein. The details of the thymic vasculature of the anuran amphibian, R. temporaria, are compared with those described in mammalian species, viz. the mouse, rat and guinea pig.     

Cholinergic innervation of the human pulmonary circulation

The cholinergic innervation of the pulmonary circulation was studied in man. Both extra- and intrapulmonary branches of the pulmonary artery and vein are provided with a cholinergic of the vein. In the main branches of the pulmonary vessels, the existence of two nerve plexuses, a superficial and a deep one, was observed. The superficial plexus is localized in the outer adventitial layer while the deeper plexus is localized in the adventitial-medial transitional zone. In smaller arteries and veins, the existence of a single plexus (adventitial-medial) was observed. In some specimens, the presence of diffuse masses of acetylcholinesterase (AChE)-positive material or elbow-shaped AChE-positive formations was observed. The nature of these formations as well as the possible functional role of a cholinergic system in the pulmonary circulation are discussed.     

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.     

The extrinsic blood vessels of the ovary of the sheep.

The extrinsic ovarian blood vessels were studied in 134 ewes. In view of recent evidence that uterine luteolysis may involve venoarterial transfer of prostaglandin F2alpha in the ovarian pedicle, particular attention was paid to the interrelationships between veins and arteries. The ovarian artery and utero-ovarian vein are large vessels of conventional structure and lie in close apposition. Their walls are slightly thinner on their apposing sides. The ovarian branches of the ovarian artery are very tortuous, and closely intertwined with the plexiform ovarian branches of the utero-ovarian vein. An extensive plexus of small veins surrounds the ovarian artery and its ovarian branches. Within this plexus are many thin-walled, dilated regions, interspersed with narrow, thick-walled segments. Valves are inconstantly present at sites of entry of branches of the plexus into the major veins. Small numbers of arterio-venous anastomoses are present in the distal part of the ovarian pedicle. Unless blood can flow in a veno-arterial direction through arterio-venous anastomoses or capillary beds, the structural barrier between uterine venous and ovarian arterial blood is substantial.     

Blood supply of the abdomen revisited, with emphasis on the superficial inferior epigastric artery

The key to understanding the blood supply of the anterior hemiabdomen is knowledge of the central superficial inferior epigastric artery system and the peripheral contribution of the epigastric, deep and superficial circumflex, and iliac arteries and external oblique perforators. These systems all feed into the subdermal plexus of the anterior abdominal wall. Angiographic confirmation of multiple communications between the superficial inferior epigastric artery and other major sources of abdominal wall blood supply has been obtained. Experience using the superficial inferior epigastric artery flap as a pedicled and microsurgical transfer has been described.     

Angioarchitecture of the bovine spermatic cord

We described the topography and morphometry of the testicular artery, pampiniform plexus veins, and indirect connections between them in the spermatic cord of the bull. Sixty microcorrosive casts of bovine spermatic cords were analyzed macroscopically, by stereomicroscopy, and by scanning electron microscopy. The average size of the testicles was 94.6 × 49.7 × 54.7 mm. The testicular artery formed a superiorly pointed cone‐like structure with its base fixed to the proximal part of the gonad. The artery gave off one or two branches to the head of epididymis and to the deferens duct. The pampiniform plexus originated from intra‐tunical veins. Veins of the pampiniform plexus were of smaller diameter but larger number than intra‐tunical ones. The density of the veins of the pampiniform plexus was 9.37 ± 1.07 mm^?2. The testicular vein began 90–121 mm above the superior pole of the testis. In 2.9% of specimens, the testicular vein was doubled. Numerous anastomoses among veins of pampiniform plexus were observed. Additionally, indirect anastomoses between the testicular artery and pampiniform plexus veins formed by the capillary network of the vasa vasorum of the testicular artery were visualized by scanning electron microscopy. In all cases, narrowings in the casts of the precapillary vessel were observed. We also documented the vasa vasorum of the testicular artery in bulls. The density of these vessels was 22.87 ± 11.48 mm^?2. The indirect arteriovenous connections together with the presence of circular constrictions of the lumen in precapillary vessels may play a role in testicular blood flow regulation. J. Morphol., 2011. © 2011 Wiley‐Liss, Inc.     

Masticatory motor patterns in ungulates: a quantitative assessment of jaw-muscle coordination in goats, alpacas and horses

We investigated patterns of jaw-muscle coordination during rhythmic mastication in three species of ungulates displaying the marked transverse jaw movements typical of many large mammalian herbivores. In order to quantify consistent motor patterns during chewing, electromyograms were recorded from the superficial masseter, deep masseter, posterior temporalis and medial pterygoid muscles of goats, alpacas and horses. Timing differences between muscle pairs were evaluated in the context of an evolutionary model of jaw-muscle function. In this model, the closing and food reduction phases of mastication are primarily controlled by two distinct muscle groups, triplet I (balancing-side superficial masseter and medial pterygoid and working-side posterior temporalis) and triplet II (working-side superficial masseter and medial pterygoid and balancing-side posterior temporalis), and the asynchronous activity of the working- and balancing-side deep masseters. The three species differ in the extent to which the jaw muscles are coordinated as triplet I and triplet II. Alpacas, and to a lesser extent, goats, exhibit the triplet pattern whereas horses do not. In contrast, all three species show marked asynchrony of the working-side and balancing-side deep masseters, with jaw closing initiated by the working-side muscle and the balancing-side muscle firing much later during closing. However, goats differ from alpacas and horses in the timing of the balancing-side deep masseter relative to the triplet II muscles. This study highlights interspecific differences in the coordination of jaw muscles to influence transverse jaw movements and the production of bite force in herbivorous ungulates.     

Duplex-Doppler ultrasonography in the detection of lower extremities deep venous thrombosis and in the detection of alternative findings

The diagnoses observed in patients referred for the Doppler ultrasonographic examination of peripheral and iliac veins for suspected deep venous thrombosis (DVT) are presented in this study. During 48 months 2,610 patients were examined by duplex Doppler ultrasonography (US). Among these, 1,879 were women (72%) and 731 men (28%), with the age-range 16-91 (mean 56, 2) years. Ultrasonic scanners Acuson 128 XP 10, ATL HDI 5000, GE Logiq 7, and GE Logiq 9 were used, with transducers in the frequency range from 2.5-14 MHz. Findings were categorized into four main categories: (1) deep venous thrombosis (DVT); (2) pathology predominantly related to superficial veins without DVT, (3) pathology of adjacent structures; (4) normal findings. 562 patients had DVT (21.5%). 1,108 patients (42.5%) had predominant pathology of superficial veins: postthrombotic syndrome, superficial thrombophlebitis and varicose veins. 390 patients (14.9%) had pathology of surrounding structures, unrelated to veins, the most common pathology being popliteal cysts and muscular hematomas. These lesions must be properly diagnosed by US to avoid erroneous anticoagulant treatment.     

The early development of the lymphatic system in mouse embryos.

The early development of the lymphatic system was studied in embryos of an inbred strain of the laboratory mouse. During the first stage of its development the system is represented by a more or less regular series of small and blind-ending outgrowths of the major embryonic veins which develop in a cranio-caudalward direction from the jugular to the pelvic region. As a result of differences in growth rates of adjacent anatomical structures this series of early lymphatic primordia becomes subdivided into 4 singular primordia and 12 groups of primordia. After the constituents of each group of early primordia have fused, 16 isolated lymphatic plexuses (sacs) are formed of which 14 are in bilaterally symmetric and 2 are in a median line position: i.e. bilaterally: (1) the jugulo-axillary lymph sac situated lateral to the anterior cardinal vein and dorsal to the primitive ulnar vein and its major branch, the external mammary vein, (2) the paratracheal lymph plexus situated medial to the anterior cardinal vein, (3) the internal thoracic lymph plexus situated lateral to the thoracic part of the posterior cardinal vein, (4) the thoracic ducts situated medial to the thoracic part of the posterior cardinal vein, (5) the lumbar lymph plexus situated dorso-lateral to the abdominal part of the posterior cardinal vein, (6) the subcardinal lymph plexus and (7) the iliac lymph plexus situated ventro-lateral to the abdominal part of the posterior cardinal vein; and in the median line: (8) the subtracheal lymph plexus situated at the confluence of the pulmonary veins and (9) the mesenteric lymph plexus situated near the confluence of the splenic and the superior mesenteric veins. Except for some openings at the jugulo-subclavian confluence all connections with the veins disappear. From the primordia extensions grow out centrifugally. They invade the surrounding tissues and, in part, fuse with similar sprouts of adjacent primordia. In this way a continuous system of lymph truncs is formed that opens into the venous system at the jugulo-subclavian confluence.     

Neurovascular territories of the external and internal oblique muscles

The purpose of this study was to document the extent of the arteries supplying the external and internal oblique muscles and the connections among the vascular territories. Ten adult human cadavers underwent whole-body arterial perfusion (200 ml/kg) with a mixture of lead oxide, gelatin, and water, through the carotid artery. The external and internal oblique muscles were dissected and subjected to radiography. The vasculature of each muscle was analyzed by using the paper template technique. The areas of the vascular territories of the individual intercostal arteries within the external oblique muscle varied from 9 to 22 percent. The area of the vascular territory of the muscular branch of the deep circumflex iliac artery was 5 to 18 percent. The ascending branch of the deep circumflex iliac artery supplied a mean of 35.7 percent of the vascular territory of the internal oblique muscle. The lower six posterior intercostal arteries supplied a mean of 48.5 percent. The lateral branches of the deep inferior epigastric artery supplied a mean of 15.8 percent. This information provides the basis for the design of external and internal oblique muscle flaps for functional muscle transfer.     

The vascular territories of the superior epigastric and the deep inferior epigastric systems

The vascular territories of the superior and the deep inferior epigastric arteries were investigated by dye injection, dissection, and barium radiographic studies. By these means it was established that the deep inferior epigastric artery was more significant than the superior epigastric artery in supplying the skin of the anterior abdominal wall. Segmental branches of the deep epigastric system pass upward and outward into the neurovascular plane of the lateral abdominal wall, where they anastomose with the terminal branches of the lower six intercostal arteries and the ascending branch of the deep circumflex iliac artery. The anastomoses consist of multiple narrow "choke" vessels. Similar connections are seen between the superior and the deep inferior epigastric arteries within the rectus abdominis muscle well above the level of the umbilicus. Many perforating arteries emerge through the anterior rectus sheath, but the highest concentration of major perforators is in the paraumbilical area. These vessels are terminal branches of the deep inferior epigastric artery. They feed into a subcutaneous vascular network that radiates from the umbilicus like the spokes of a wheel. Once again, choke connections exist with adjacent territories: inferiorly with the superficial inferior epigastric artery, inferolaterally with the superficial circumflex iliac artery, and superiorly with the superficial superior epigastric artery. The dominant connections, however, are superolaterally with the lateral cutaneous branches of the intercostal arteries. For breast reconstruction, it would appear that prior ligation of the deep inferior epigastric artery would be of advantage when elevating the lower abdominal skin on a superiorly based rectus abdominis musculocutaneous flap. The vascularity of this flap would be further increased by positioning some part of the skin paddle over the dense pack of large paraumbilical perforators. Based on these anatomic studies, the relative merits of the superior and deep inferior epigastric arteries with respect to local and distant tissue transfer using various elements of the abdominal wall are discussed in detail.     

Anatomic study of the venous drainage architecture of the forearm skin and subcutaneous tissue

The venous anatomy of the forearm skin was examined radiographically in 15 fresh cadavers that had been injected systemically with a lead oxide-gelatin mixture. In 10 specimens, the forearm skin was divided into the skin and superficial adipofascial layer and the deep adipofascial layer. Five specimens were radiographed stereoscopically. Despite the thinness of the skin and subcutaneous tissue of the forearm, the cutaneous vein was seen three-dimensionally. Judging from the architecture and direction of the venous valves, most of the venous blood that had perfused the dermis was believed to: (1) pool in a venous network located in the superficial zone of the skin and subcutaneous tissue, (2) flow chiefly in the accessory cephalic and median antebrachial veins, and (3) enter the cephalic and basilic veins near the antecubital fossa. Venae comitantes of the septocutaneous and musculocutaneous perforators of the radial or ulnar arteries were thought to be only bypasses to the deep vein.