Marginal Arteries of Arteria et Vena Mesenterica Superior and Their Parameters Along Jejunum and Ileum Divided Parts
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Date
2023
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads. Arteria et vena mesenterica superior (A&VMS) ir svarīga loma asins apgādē un drenāzā jejunum,ileum (J&I). A. mesenterica superior (AMS) anastomozes (marginālās artērijas, starpapzarņa arkādes – SAA) ļauj tievai zarnai tolerēt lēni progresējošu asins zudumu no vienas artērijas uz otru. SAA ir līmeņi: 1. līmeņa arkādes rada taisnās artērijas, kas sadalās un anastamozē, veidojot 2. līmeņa arkādes (tāds pats mehānisms ir ar augšējā līmeņa arkāžu veidošanos). Anatomiskās variācijas arkādēm jejunum pirmai un ileum beigu daļai mācību grāmatās ir 1./2. līmenis, bet starp tām–3./4./5
Pētījuma mērķi bija: 1)noteikt arkāžu A&VMS līmeņus un salīdzināt to ar mācību grāmatām; 2) noteikt sadalīto asinsvadu skaitu no katra arkādes līmeņa (zinātniskie darbi, mācību grāmatas nesniedz nekādu informāciju); 3) atklāt korelācijas esamību/neesamību starp arkāžu līmeņiem, asinsvadu skaitu katrā arkādes līmeņa sadalījumā J&I
Materiāls un metodes. Anatomijas un antropoloģijas institūta Morfoloģijas katedra nodrošināja materiālus preparēšanai, lineālu (15,0±0,1cm), diegu. Lineāls un diegs tika izmantoti J&I mērīšanai pa daļām, katra 15cm. Tika izdalīta arteria (6cm virs abdominālās aneirismas) et vena mesenterica superior un to SAA: tauki tika noņemti no katra atsevišķa asinsvada. Pēc tam ik 15cm pa J&I tika noteikts anastamozes līmenis un sadalīto asinsvadu skaits katrā SAA līmenī
Rezultāti. Kopējais J&I garums: 292,5cm (± 0,1cm). Sadalīto asinsvadu skaits katrā SAA līmenī bija: 1.(3 līmeņi)–7/20/43; 2.(3 līmeņi) – 19.08.41.; 3. (3 līmeņi) – 23/10/43.; 4. (3 līmeņi) – 8/10/41; 5. (4 līmeņi) – 11/24/42/56; 6. (3/4 līmeņi) – 10/18/27/33; 7. (3/4 līmeņi) –11/28/34/31; 8. (4/5 līmeņi) – 11/24/35/38/52; 9. (5 līmeņi) – 7/19/18/43/31; 10. (4/5 līmeņi) – 10/23/44/59/43; 11. (4/5 līmeņi) –7/20/56/18; 12. (3/4 līmeņi) – 11/28/40/26; 13. (3/4 līmeņi) – 8/20/32/32; 14. (4 līmeņi)–17/07/29/15; 15. (4/5 līmeņi) – 15/26/45/56; 16.:37,5 cm (± 0,1cm) garumā nav asinsvadu; 17. (2/3 līmeņi) – 10/18/43; 18. (2/3 llīmeņi) – 26.12.43. Augstākais SAA līmeņu skaits 0–60 cm garumā bija 3. Pie 60–105 cm tas bija 4, pie 105–165 cm – 5, pie 165–210 cm – 4, pie 210–225 cm – 5 un pie 277,5–292,5 cm – 3 . Viena arkāde sadalījās 2-5 asinsvados un izveidoja nākamo arkādi (pēdējais sadalījums ir tas, kas saistīts ar tievo zarnu sienu)
Secinājumi. Jejunum 1. daļai ir 3 SAA līmeņi, pēdējai ileum daļai – 2/3 (atšķiras no literatūras), bet starp tām – 3/4/5 (sakrtīt ar literatūru). Lielākais asinsvadu sadalījums no pēdējā SAA līmeņa tika novērots gar un pirms tumšām un paplašinātām zarnām – iespējams angioģenēzes dēļ, kas bija asins apgādes zuduma dēļ. Pirmais arkāžu sadalījuma skaits J&I 292,5 cm garumā ik 15 cm bija 7 (4x), 8 (3x), 10 (4x), 11 (4x), 12 (1x) vai 15 (1x). Daudzas artērijas sadalās 2 asinsvados un vēlāk veido nākamo arkādi, tāpēc iepriekšējais un nākamais sadalīto asinsvadu daudzums paliek nemainīgs.
Introduction. Arteria et vena mesenterica superior (A&VMS) take an important role for blood supply and drainage to jejunum,ileum. A. mesenterica superior (AMS) anastomoses (marginal arcades, intermesenteric arcades - IMA) make possible for small intestine to tolerate slowly progressive loss of blood supply from one artery to another. IMA have levels (lvls): 1st level (lvl) arcades give rise to straight arteries, which bifurcate and anastomose to form 2nd lvl arcades (same mechanism is with upper lvl arcade formation). In textbooks of variation anatomy, first part of jejunum and last part of ileum have 1st/2nd lvl arcades but between them – 3rd/4th/5th The aims of the study were: 1) to determine lvl of arcades A&VMS and to compare it with textbooks; 2) to establish the amount of divided blood vessels from each arcade lvl (scientific papers and textbooks do not provide any information); 3) to discover the presence/absence of correlation between lvl of arcades, amount of blood vessels in each arcade lvl division and part of jejunum,ileum Material and methods. The Department of Morphology of Institute of Anatomy and Anthropology provided the materials for dissection, ruler (15.0±0.1cm), thread. Ruler and thread were used to measure jejunum and ileum (J&I) in parts, each 15cm. There were dissected arteria (6cm above abdominal aneurysm) et vena mesenterica superior and their IMA: all fat was removed from each individual blood vessel. After, a lvl of anastomosis and an amount of divided blood vessels in each lvl of IMA were established every 15cm along J&I. Results. The total length of J&I: 292.5cm(±0.1cm). An amount of divided blood vessels in each lvl of IMA was: 1st(3 lvls)–7/20/43; 2nd(3 lvls)–8/19/41; 3rd(3 lvls)–10/23/43; 4th(3 lvls)–8/10/41; 5th(4 lvls)–11/24/42/56; 6th(3/4 lvls)–10/18/27/33; 7th(3/4 lvls)–11/28/34/31; 8th(4/5 lvls)–11/24/35/38/52; 9th(5 lvls)–7/19/18/43/31; 10th(4/5 lvls)–10/23/44/59/43; 11th(4/5 lvls)–7/20/56/18; 12th(3/4 lvls)–11/28/40/26; 13th(3/4 lvls)–8/20/32/32; 14th(4 lvls)–7/17/29/15; 15th(4/5 lvls)–15/26/45/56; 16th: 37.5cm(± 0.1cm) the absence of blood vessels; 17th(2/3 lvls)–10/18/43; 18th (2/3 lvls)–12/26/43. The highest lvl of IMA at 0–60cm was 3. At 60–105cm it was 4, at 105–165 cm –5, at 165–210 cm –4, at 210–225cm –5 and at 277.5–292.5cm –3. One arcade divided in 2-5 blood vessels and formed the next arcade (last division connected with intestine wall) Conclusions. 1st part of jejunum has 3rd lvl IMA, last part of ileum–2nd/3rd(differs from textbooks) but between them–3rd/4th/5th (conforms). The highest blood vessel division from last lvl IMA was noticed along/before dark coloured,dilatated intestines–can be a reason of angiogenesis due to loss of blood supply. First arcade division along 292.5cm of J&I each 15cm was 7(4x), 8(3x), 10(4x), 11(4x), 12(1x) or 15(1x). Many arteries divide in 2 blood vessels and later form next arcade so previous and next amount of divided blood vessels stay invariable
Introduction. Arteria et vena mesenterica superior (A&VMS) take an important role for blood supply and drainage to jejunum,ileum. A. mesenterica superior (AMS) anastomoses (marginal arcades, intermesenteric arcades - IMA) make possible for small intestine to tolerate slowly progressive loss of blood supply from one artery to another. IMA have levels (lvls): 1st level (lvl) arcades give rise to straight arteries, which bifurcate and anastomose to form 2nd lvl arcades (same mechanism is with upper lvl arcade formation). In textbooks of variation anatomy, first part of jejunum and last part of ileum have 1st/2nd lvl arcades but between them – 3rd/4th/5th The aims of the study were: 1) to determine lvl of arcades A&VMS and to compare it with textbooks; 2) to establish the amount of divided blood vessels from each arcade lvl (scientific papers and textbooks do not provide any information); 3) to discover the presence/absence of correlation between lvl of arcades, amount of blood vessels in each arcade lvl division and part of jejunum,ileum Material and methods. The Department of Morphology of Institute of Anatomy and Anthropology provided the materials for dissection, ruler (15.0±0.1cm), thread. Ruler and thread were used to measure jejunum and ileum (J&I) in parts, each 15cm. There were dissected arteria (6cm above abdominal aneurysm) et vena mesenterica superior and their IMA: all fat was removed from each individual blood vessel. After, a lvl of anastomosis and an amount of divided blood vessels in each lvl of IMA were established every 15cm along J&I. Results. The total length of J&I: 292.5cm(±0.1cm). An amount of divided blood vessels in each lvl of IMA was: 1st(3 lvls)–7/20/43; 2nd(3 lvls)–8/19/41; 3rd(3 lvls)–10/23/43; 4th(3 lvls)–8/10/41; 5th(4 lvls)–11/24/42/56; 6th(3/4 lvls)–10/18/27/33; 7th(3/4 lvls)–11/28/34/31; 8th(4/5 lvls)–11/24/35/38/52; 9th(5 lvls)–7/19/18/43/31; 10th(4/5 lvls)–10/23/44/59/43; 11th(4/5 lvls)–7/20/56/18; 12th(3/4 lvls)–11/28/40/26; 13th(3/4 lvls)–8/20/32/32; 14th(4 lvls)–7/17/29/15; 15th(4/5 lvls)–15/26/45/56; 16th: 37.5cm(± 0.1cm) the absence of blood vessels; 17th(2/3 lvls)–10/18/43; 18th (2/3 lvls)–12/26/43. The highest lvl of IMA at 0–60cm was 3. At 60–105cm it was 4, at 105–165 cm –5, at 165–210 cm –4, at 210–225cm –5 and at 277.5–292.5cm –3. One arcade divided in 2-5 blood vessels and formed the next arcade (last division connected with intestine wall) Conclusions. 1st part of jejunum has 3rd lvl IMA, last part of ileum–2nd/3rd(differs from textbooks) but between them–3rd/4th/5th (conforms). The highest blood vessel division from last lvl IMA was noticed along/before dark coloured,dilatated intestines–can be a reason of angiogenesis due to loss of blood supply. First arcade division along 292.5cm of J&I each 15cm was 7(4x), 8(3x), 10(4x), 11(4x), 12(1x) or 15(1x). Many arteries divide in 2 blood vessels and later form next arcade so previous and next amount of divided blood vessels stay invariable
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Pediatrija
Pediatrics
Veselības aprūpe
Health Care
Pediatrics
Veselības aprūpe
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Keywords
Arteria et vena mesenterica superior, starpapzarņa arkādes, līmeņi, jejunum, ileum, Arteria et vena mesenterica superior, intermesenteric arcades, levels, jejunum, ileum