Morphometric characteristics of common carotid arteries bifurcation in men with different shape of the neck

Introduction: In the last decade, the anatomical structure of the bifurcation of common carotid arteries has attracted particular attention of anatomists and clinicians. Objective: To identify the morphometric characteristics of the bifurcation of common carotid arteries in men with different forms of the neck. Techniques: 90 male cadavers (36-60 years) were studied. The lengths of the neck, its frontal and sagittal dimensions of its base were measured. Classification of forms of the neck by A. Sozonov-Yaroshevich: long and narrow neck, index < 67,2; neck of average length and average diameter, index = 67,3-79,5; short and wide neck, index > 79,6. Morphometry was performed at bifurcation of the common carotid artery (CCA) on the right and left (length, diameter, angle of bifurcation, the lateral angles with the external (ECA) and internal (ICA) carotid arteries). Results: Cadaveric material was distributed into 3 groups: men with long, narrow neck, n = 27, men with a neck of medium length and average diameter, n = 38; men with short and wide neck, n = 25. The length of the bifurcation of the OCA in men with long, narrow neck was the highest in comparison with the other groups studied, and was right on average 23,2 ± 5,4 mm, and left to 21,4 ± 5,1 mm, while the diameter was the smallest - 9,3 ± 2,2 mm on the right and 9,2 ± 2,3 mm on the left. The angle of bifurcation of men in this group was also lower and averaged 6,6 ± 0,6 ° to the right and 7,2 ± 0,8 ° to the left. The average value of the right side corner of the NSA was 178 ± 1,2 °, on the left, it was 176 ± 0,7 °. The value of the lateral angle of the ICA was equal to an average of 174 ± 0,9 ° right and 175 ± 0,5 ° to the left. A group of people with short and wide neck, the average length of the bifurcation of the CCA was minimal, with both its greatest diameter. Its length is right on average 14,9 ± 5,3 mm, and left to 14,6 ± 5,0 mm. The diameters were equal to the values of 22,2 ± 6,4 mm and 23,5 ± 6,9 mm on the right and left, respectively. The apical angle in this group of men studied was 27,0 ± 0,9 ° to the right and 29,3 ± 0,8 ° to the left. Angle with the NSA was on average 167 ± 1,5 °, and the left - 164 ± 2,6 °. Side angle with the right internal carotid artery was 158 ± 2,4 °, the left was equal to the value of 160 ± 1,4 °. On the neck of average length and average diameter values of the parameters studied the bifurcation of the OCA, both right and left were located between the similar values of the two above groups. Length of the bifurcation of the right CCA average was equal to 18,5 ± 5,2 mm, and left to 19,8 ± 5,3 mm. The average value of the diameter of the bifurcation of the right CCA was 16,3 ± 3,9 mm and the left - 16,9 ± 4,9 mm. The angle of the branch on the right CCA was equal to 17,2 ± 0,6 °, left it was 19,6 ± 1,1 °. Side right angle with the NSA was equal to 176 ± 1,7 °, the left is the value was 170 ± 1,5 ° Side angle with the internal carotid artery was equal to 161 ± 0,9 ° right and 161 ± 1,9 ° to the left. Conclusions: Our studies have revealed clear differences of morphometric characteristics of the bifurcation of the OCA in men with different forms of the neck

Анатомическое обоснование транспозиции грудоспинного нерва при невротизации поврежденных нервов плечевого сплетения

 The goal is to identify topographic, anatomic, and constitutional features of thoracodorsal and musculocutaneous nerves of brachial plexus.Materials and methods. Anthropometry of 45 corpses was carried out to determine growth; length of the trunk and upper extremities; circumference of neck, thoracic cage, shoulder and forearm; lateral dimensions of shoulders, thoracic cage and pelvis; anteroposterior size of thoracic cage; neck circumference. Morphometry of all brachial plexus components (length, thickness of nerves and angles of their origin) was performed after its  anatomic preparation.Results. The cephalic type of brachial plexus with participation of C4 spinal nerve was found in 7% of cases. The caudal type with inclusion of Th2 spinal nerve was found in 4% of cases. In 4% of cases, there was no musculocutaneous nerve, at the same time shoulder biceps innervates median nerve. In 93% of cases, the thoracodorsal nerve originates from posterior secondary bundle along lower posterior surface, in 7% it is an axillary nerve branch. Neck circumference is directly correlated with thoracodorsal nerve length: the larger the neck circumference is, the greater is the nerve length. In females, linear regression equations were derived, which allow estimating thoracodorsal nerve length knowing the thoracic cage width.Conclusion. The length of the thoracodorsal nerve determines the possibility of its transplantation into the musculocutaneous position. The size of neck circumference and, in females, the width of the thoracic cage, for reliability, should be used as external size biomarkers for donor and recipient nerves.  Цель. Выявление топографо-анатомических и  конституциональных особенностей грудоспинного и  мышечно-кожного нервов плечевого сплетения. Материалы и методы. Проведена антропометрия 45 трупов с определением роста, длины туловища и верхней конечности, окружности шеи, грудной клетки, плеча и предплечья, поперечных размеров плеч, грудной клетки и таза, переднезаднего размера грудной клетки, обхвата шеи.  После анатомического препарирования плечевого  сплетения проведена морфометрия всех его компонентов  (длины, толщины нервов и углов их отхождения).Результаты. Цефалический тип плечевого сплетения с  участием спинального нерва С4 установлен в 7%, каудальный тип с включением спинального нерва Th2 – в 4%  случаев. В 4% случаев отсутствует мышечно-кожный  нерв, двуглавую мышцу плеча при этом иннервирует  срединный нерв. В 93% случаев грудоспинной нерв отходит  от заднего вторичного пучка по задненижней поверхности,  в 7% это ветвь подмышечного нерва. Обхват шеи имеет  прямые значимые корреляции с длиной грудоспинного  нерва – чем больше обхват шеи, тем больше длина нерва. У женщин выведены уравнения линейной регрессии, на  основании которых можно вычислить предположительную  длину грудоспинного нерва при известном значении  ширины грудной клетки. Заключение. Длина грудоспинного нерва является  определяющей детерминантой возможности его пересадки  в позицию мышечно-кожного. В качестве внешнего  биомаркера размеров нерва-донора и нерва-реципиента  целесообразно использовать размеры обхвата шеи и для  достоверности у женщин – ширину грудной клетки.