An anatomical evaluation of the relationship between the rectus abdominis and superior epigastric artery

Arteria epigastrica superior (AES) arteria thoracica interna'nin (ATI) uc dallartndan birisidir. Musculus rectus abdominis (MRA) kilifinın arka yaprağini delerek kasin arka yüzü iizerinde uzanir; burada medial ve lateral kas dallanna ayrilir. Amaç: (Çalismamizin amaci AES'nin anatomik ozelliklerini arastirmak ve derin epigastrik damar aksının üst bölümü ile MRA 'nın ilişkisini degerlendirmektir.Gere9 ve yontem: Disseksiyonlar formalin ile fikse ediknis 25 adet eriskin insan kadavrasında 47 adet MRA'da gerçeklestirildi. Karın derisi ile fascia abdominalis'in yüzeyel ve derin yaprakları uzaklastırıldıktan sonra MRA'nın arka yüzünde, kas ile fasya arasinda yer alan AES'ye ulasildi. Bulgular: AES"nin ortalama 9api 2,26 mm (min-max: 1,2-3,0 mm) olarak belirlendi. MRA'nin arka yüzünde AES'nin tek, iki ya da 119 dala ayrıldigi olgular sirasiyla %55,3, %42,6, %2,1; AES'nin göğüs on duvari üzerine ulastığı IA'lar; 6.IA %13,3, 7.IA %37,7 ve 8.IA %49,0 olarak belirlendi. RA'nın ortalama genisligi 7,73 cm (min-max: 4,00 - 9,60 cm) olarak ölçüldü. AES'nin MRA'ya giriş noktasi olguların 74,5'inde kasınorta, %25,5'inde i9 1/3'ii olarak gozlendi. AES'nin MRA~ya giriş noktasinin kasın lateral kenarından uzaklığı ortalama 5,53 cm (min-max: 3,00 — 7,50 cm) olarak ölçüldü. Sonuc: Kasın duvarının ayrıntili vasküler anatomisi ile ilgili sonuçlanmiz, rekonstruktif cerrahide daha yararlı flep modellerinin gelistirilmesine yardimci olacaktir.

Anahtar Kelimeler:

Karın kasları, Anatomi, Kadavra, Diseksiyon, Rektus abdominis, Epigastrik arterler

Musculus rectus abdominis ve arteria epigastrica superior arasındaki ilişkinin anatomik olarak değerlendirilmesi

The superior epigastric artery (SEA) is one of the terminal branches of the internal mammary artery. It pierces the posterior rectus sheath to lie on the posterior surface of the muscle and divides into medial and lateral muscular branches. Objective of this study is to evaluate the anatomic properties of the SEA and the relationship between the upper part of the deep epigastric vascular axis and the RA. Material and method: Dissection was performed on 47 RA in 25 formalin fixed human cadavers. To reach RA, abdominal skin, superficial and deep layers of abdominal fascia were removed. SEA was identified on the posterior surface of the RA between the fascia and the muscle. Results: The average diameter of the SEA was 2.26 mm (range 1.2-3.0 mm). The number of the major divisions of the SEA on the posterior surface of the RA was observed as one, two or three branches as 55.3 %, 42.6 %, 2.1 % respectively. The perforating point of the SEA on the anterior chest wall was identified at the sixth, seventh and eighth ICSs as 13.3 %, 37.7 % and 49.0 % respectively. The mean width of the RA was measured as 7.73 cm (range 4.00-9.60 cm). It was observed that the entrance point of the SEA into the RA was localized at the medial third of the RA in 74.5 % and at the middle third of the RA in 25.5 % of all cases. The mean distance from the lateral border of the RA to the entrance point of the SEA into the RA was ^measured as 5.53 cm (range 3.00-7.50 cm). Conclusion: The results of our study concerning the vascular anatomy of the abdominal wall will help to improve more useful flap design in reconstructive surgery.

Keywords:

Abdominal Muscles, Anatomy, Cadaver, Dissection, Rectus Abdominis, Epigastric Arteries,

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