武汉大学2012年局部解剖试题二院.doc

武汉大学2012年局部解剖试题一、 名词解释（5*6=30）1、斜角肌间隙2、胆囊三角 3、收肌管;又称Hunter管。位于股中1/3段前内侧，缝匠肌深面，大收肌和股内侧肌之间。由股内侧肌、缝匠肌、长收肌和大收肌围成。是一断面呈三角形，长1517的管状间隙。前壁为张于股内侧肌与大收肌间的收肌腱板，浅面覆以缝匠肌，外侧壁为股内侧肌，后壁为长收肌和大收肌。上口与股三角尖相通，下口为收肌腱裂孔，通腘窝上角。所以收肌管又称股腘管。股三角或腘窝的炎症可借此互相蔓延。收肌管内的结构，前为股神经的股内侧肌支和隐神经，中为股动脉，后为股静脉以及淋巴管和疏松结缔组织。进入收肌管者为：股动脉、股静脉和隐神经；通过收肌管者为：股动脉和股静脉；途中穿出收肌管壁者为：隐神经和膝降动脉。4、心包裸区 5、腹股沟三角二、简答题（10*7=70）1、简述肘窝的结构，以及其间穿行的主要结构；2、何为第一肝门、第二肝门、第三肝门；3、简述胃的分部，试述当发生胃后壁穿孔时，胃内容物流注至盆腔的途径；4、简述小脑幕切迹的结构，当其发生小脑幕切迹疝时可能损伤的结构；5、简述心包的毗邻；6、简述甲状腺的血供；试述甲状腺血管与喉部神经的关系，在术中易损伤到什么神经？在手术中如何才能避免其损伤；7、简述腹股沟管的结构；当发生腹股沟斜疝时，疝内容物突入阴囊的途径，在行斜疝修补术时损伤到什么神经易导致斜疝复发？2012年武汉大学骨科试题一、名词解释（4*5=20）1、漂浮肩典型的浮肩损伤包括肩胛颈骨折合并同侧锁骨、喙肩韧带和喙锁韧带组成的环路之一中断。漂浮肩损伤常造成整个肩胛带不稳定,常伴同侧34肋骨骨折,可损伤神经血管束,包括臂丛神经。2、肘关节损伤三联征肘关节后脱位同时伴有桡骨头和尺骨冠突骨折。 3、Allen试验：检查手部的血液供应，桡动脉与尺动脉之间的吻合情况。术者用双手同时按压桡动脉和尺动脉；嘱患者反复用力握拳和张开手指57次至手掌变白；松开对尺动脉的压迫，继续保持压迫桡动脉，观察手掌颜色变化。若手掌颜色10s之内迅速变红或恢复正常，即Allen试验阳性，表明尺动脉和桡动脉间存在良好的侧支循环；相反，若10s手掌颜色仍为苍白，Allen试验阴性，这表明手掌侧支循环不良。4、Pilon骨折 5、骨质疏松症二、简答题（10*4=40）1、骨移植“爬行替代”的基本原理；2、骨折内固定（钢板、髓内钉等）松动、断裂的原因有哪些？3、影响周围神经损伤的因素有哪些？4、儿童骨骺损伤的处理原则。三、论述题（20*2=40）1、试述脊柱微创技术及其适应征；2、骨巨细胞瘤的临床特点、影像学表现及其治疗进展。Debridement and fusion with bone grafting and instrumentation in the treatment of multiple-level spinal tuberculosis【Abstract】Objective：To investigate the results of surgical treatment for multi-level spinal tuberculosis with focal debridement,bone grafting and primary internal fixation .Method:30 cases of multi-level spinal tuberculosis treated by operation from January 2007 to December 2011 were reviewed retrospectively.3 vertebral bodies involved in 21 cases4 vertebral bodies involved in 7 cases5 vertebral bodies involved at least in 2 casesOf these，there were 8 cases in thoracic vertebra，16 cases in lumbar vertebra，6 cases in sacral vertebrae. All patients received anti-TB chemotherapy before and after operation.Anti-TB chemotherapy protocols consisting of combinations of rifampin,isoniazid,ethambutol and streptomycin,were administered for 3 months which including 2 weeks before the operation and 3 months after the operation，followed by rifampin,isoniazid and ethambutol for a total of 9 months.The clinical outcomes were evaluated according to the criteria designed by WU Qiqiu et a1Result：The average surgical time Was 190 minutes(range,150240min),There was no complication such as nerve injury and cerebrospinal fluid leakage.The incision in 2 cases presented, sinus which had a secondary healing later on，others obtained primary healingThe average postoperative Cobb angle of kyphosis was 1320(range,12-3).All cases were followed up for an average of 18 months(range,12-24 months).with no incidence of hardware failure.All ESR were nomral.At the final follow-up，all patients had evidence of clinical heal and the solid bony fusion.Conclusion:Focal debridement,bone grafting and primary internal fixation is re