室间隔膜部的应用解剖学研究_医学论文.docVIP

室间隔膜部的应用解剖学研究_医学论文 室间隔膜部的应用解剖学研究_医学论文 【摘要】 目的阐明成年人心室间隔膜部的形态、位置、毗邻关系，为医学影像诊断提供形态学基础。方法成年人离体心脏64例，大体解剖观察室间隔膜部的形态、位置、毗邻结构。胸部断层标本观察室间隔膜部的原位解剖学特征。结果离体心室间隔膜部：①形态可见不规则形、三角形、半月形、圆形、卵圆形、四边形和楔形。②左侧面位于主动脉前半月瓣环和右后半月瓣环相对缘与肌性室间隔嵴之间，上缘紧邻主动脉前半月瓣环和右后半月瓣环及其瓣间三角；右侧面位于三尖瓣前内侧连合处，房室隔最前端，与三尖瓣前内侧连合、室上嵴、主动脉隆凸、Koch三角尖端和右纤维三角相邻。经四心腔横断层，MPIS占室间隔的后1/3，自左前斜向右后与矢状面、冠状面约呈45°角；经升主动脉冠状断层，MPIS自肌性室间隔嵴斜向右上方达主动脉半月瓣环的下方，与正中矢状面呈45°角。结论MPIS形态多样，左、右侧面的位置和毗邻各异；横断层和冠状断层能很好地显示MPIS的形态、位置和毗邻关系。 【关键词】 心脏 室间隔膜部 主动脉瓣 二尖瓣 三尖瓣 　 Abstract: Objective To observe the features of the shape, location and the adjacent relationships of the membranous portion of interventricular septum(MPIS) in adult hearts, for the basis of imaging diagnosis. Methods The shape，position and adjacent structures of the MPIS were investigated macroscopically on 64 embalmed human hearts as an ex-situ-organ. The features of the MPIS in-situ-dissection were observed in thoracic sectional anatomy. Results The following shapes of the MPIS were found: irregular, triangular, semilunar, circular, quadrangularand and wedge-shaped. The position: The left side of the MPIS located between the adjacent part of anterior and right posterior aortic cusps and the muscular septal crest. The right side of MPIS was in the anterior point of the atrioventricular septum and the site of the anteromedial commessure. The orientation and the angulation: the posterior 1/3 part of the interventricular septum on the thoracic transverse section through the oval fossa. On the coronary section through aorta, the MPIS lay obliquely and extends upwards and right from muscular septum to the aortic fibrous annulus to which the posterior aortic cusp was attached. The MPIS was orientated at an angle of about 45° to median plane, but the angulation varies according to the obliquity of the aortic root. Conclusion The shape of MPIS is various. The position and adjacent relationships of the MPIS on the left and the right sides are differences. The shape, position and adjacent relationsh