上矢状窦的显微及内窥镜解剖

发布时间：2018-05-21 04:09

本文选题：上矢状窦 + 内窥镜　；参考：《山东大学》2006年硕士论文

【摘要】：目的：研究上矢状窦的大体及显微解剖，研究上矢状窦的静脉回流、与其他静脉窦的连通，上矢状窦腔内纤维索结构、蛛网膜颗粒及窦汇区的内窥镜解剖，窦汇区分流优势方向的临床意义。方法：5具成人头颅标本，去除颅盖，，观察上矢状窦的大体解剖、静脉属支、与其他静脉的交通及窦汇处回流方向。应用内窥镜研究窦腔内纤维索结构、蛛网膜颗粒及窦汇区的原始结构特征；并纵行剖开管腔，显微镜下观察纤维索、蛛网膜颗粒及窦汇区解剖。65张DSA造影片选择充盈最佳的静脉窦期片，侧位像观察上矢状窦与与其他静脉窦的连通，正位像观察窦汇区上矢状窦分流方向及脑皮质表面观察大脑上、中、下静脉的吻合连通。最后于蛛网膜颗粒及板层状纤维索处作病理切片观察细微结构。结果：上矢状窦收集额顶枕叶外侧面上部及内侧面上部，额叶下表面前部的静脉血。前段接受额极静脉、额前静脉和额中静脉；上矢状窦中段接受额后静脉、中央前静脉、中央静脉、中央后静脉和顶前静脉；上矢状窦后段接受顶后静脉和枕静脉。不同皮质区域的静脉汇入SSS形成特征性格局。起自额叶前部附近的静脉在其与矢状窦接头处向后走行，与窦内血流方向相同。起自额叶后半部分的静脉近乎直角汇入上矢状窦。顶叶和枕叶的静脉末端汇入SSS角度与与窦内血流方向相反。静脉汇入上矢状窦方向由前段的与窦内血流方向相同向中后段的与窦内血流方向相反逐渐移行。大脑上、中静脉间的吻合，使上矢状窦先与大脑中浅静脉相连通，由于后者的末端达大脑半球的底面后注入海绵窦、蝶顶窦和岩上窦，所以上矢状窦又借助大脑中浅静脉与上述硬脑膜静脉窦构成了吻合；上矢状窦通过大脑上、下静脉间的吻合和大脑上、中、下静脉间的吻合与横窦之间构成了直接吻合；又先通过大脑上、中静脉间的吻合，继之通过大脑中、下静脉间的吻合与横窦之间构成了间接吻合。存在于大脑镰中与上矢状窦有关的吻合静脉使上矢状窦与下矢状窦、与直窦之间构成了直接吻合。内窥镜下观察上矢状窦管腔内纤
[Abstract]:Objective: to study the gross and microscopic anatomy of the superior sagittal sinus, the venous drainage of the superior sagittal sinus, the connection between the superior sagittal sinus and other venous sinuses, the structure of the fibrous cord in the superior sagittal sinus, the endoscopic anatomy of the arachnoid granules and the confluence area of the sinus. Clinical significance of shunt dominance in sinus confluence. Methods the cranial cap was removed from 5 adult head specimens and the gross anatomy of the superior sagittal sinus was observed. The branches of the veins were observed and the flow direction of the superior sagittal sinus was observed. The structure of fiber cord, arachnoid granules and sinusoidal confluence were studied by endoscope, the fibers were dissected longitudinally, and the fibers were observed under microscope. Anatomy of arachnoid granules and sinus confluence. 65 DSA films were selected for filling the best venous sinus films. Lateral images were used to observe the connection between the superior sagittal sinus and other venous sinuses. The direction of the superior sagittal sinus shunt in the confluence area and the surface of the cerebral cortex were observed. Finally, the fine structures of arachnoid granules and lamellar fibers were observed. Results: the venous blood was collected from the superior part of the lateral and medial occipital lobe of the frontal parietal lobe and the anterior part of the inferior frontal surface of the superior sagittal sinus. The anterior segment received the frontal polar vein, the anterior frontal vein and the middle frontal vein; the middle segment of the superior sagittal sinus received the posterior frontal vein, the precentral vein, the posterior central vein and the anterior parietal vein; the posterior parietal vein and the occipital vein were accepted in the posterior segment of the superior sagittal sinus. The venous influx of SSS in different cortical regions formed a characteristic pattern. The vein from the prefrontal lobe runs backward at the junction with the sagittal sinus, the same direction as the blood flow in the sinus. The veins from the posterior part of the frontal lobe converge almost at right angles into the superior sagittal sinus. The SSS angle at the end of the vein in the parietal and occipital lobes is opposite to that in the sinus. The direction of the vein flowing into the superior sagittal sinus changed gradually from the direction of the anterior segment and the direction of the blood flow in the sinus to the direction of the blood flow in the middle and posterior part of the sinus. The superior sagittal sinus is connected to the superficial cerebral vein by the anastomosis of the superior and middle veins, because the end of the latter reaches the bottom of the cerebral hemisphere and then infuses the cavernous sinus, the sphenoid apex sinus and the superior petrosal sinus. So the superior sagittal sinus is anastomosed with the dural sinus with the aid of the superficial cerebral vein, and the superior sagittal sinus is anastomosed through the superior, inferior and superior cerebral veins, and the anastomosis between the middle and inferior veins forms a direct anastomosis between the transverse sinus and the superior sagittal sinus. The anastomosis of the inferior vein and the transverse sinus is formed by the anastomosis of the superior cerebral vein and the middle vein, followed by the indirect anastomosis between the inferior vein and the transverse sinus. The anastomotic veins associated with the superior sagittal sinus in the falx make the superior sagittal sinus, the inferior sagittal sinus, and the straight sinus a direct anastomosis between the superior sagittal sinus and the inferior sagittal sinus. Endoscopy of the superior sagittal sinus
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R651.1;R322

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