ANATOMICAL VARIABILITY OF CUTANEOUS NERVES OF ANTERIOR FEMORAL REGION IN HUMAN FETUSES.

OBJECTIVE: The aim: Is to find out the features of innervation of the skin of the anterior femoral region and the fascia lata during the fetal period of human development. PATIENTS AND METHODS: Materials and methods: The study was carried out on 64 preparations of the lower extremities of human fetuses of 4-10 months using macromicroscopic preparation and morphometry. Macropreparations of the skin nerves of the lower extremities of different age fetuses with anatomical variants were subject to photo documentation. RESULTS: Results: The features of cutaneous nerve fetal topography of the anterior femoral region and the broad fascia of the femur were revealed, their connections were established, and their layering was determined. It was found that in human fetuses, not only the lateral cutaneous femoral nerve but in most cases the branches of other nerves of the lumbar plexus, except for the obturator nerve, are directed to the skin of the anterior-lateral femur surface. The innervation of the medial femur surface is provided by the following nerve complex: obturator, femoral, saphenous and genitofemoral nerves. CONCLUSION: Conclusions: Taking into account the fact that the terminal branches of adjacent cutaneous nerves of the femoral region intersect and overlap, innervation bypasses are formed, due to which, in case of possible damage to one of the nerves, its insufficiency is compensated to a certain extent. Anastomoses were found between the cutaneous nerves, in the form of loops of various shapes and sizes, namely: between the cutaneous-fascia branches of the femoral and ilioinguinal nerves and the femoral and obturator nerves.

COMPLEX ORPHAN PATHOLOGY: COMORBIDITY OF MUCOVISCIDOSIS AND CONGENITAL DYSFUNCTION OF ADRENAL GLANDS CORTEX (REFERENCES REVIEW AND OWN RESEARCH).

OBJECTIVE: The aim: The clinical case was studied: comorbidity of mucoviscidosis and congenital dysfunction of adrenal glands cortex. PATIENTS AND METHODS: Materials and methods: The clinical case of combined orphan pathology - cystic fibrosis and congenital dysfunction of adrenal glands cortex (adrenogenital syndrome) has been described. RESULTS: Clinical case: A 2-month child has been diagnosed with mucoviscidosis, of a mixed form, which was genetically confirmed. The proband and the father were found to be heterozygotes for the F508del mutation of the CFTR gene (the father suffers from mucoviscidosis). Congenital dysfunction of the adrenal glands, a viral form, was diagnosed when he was three years old. The child is currently receiving: Creon 100 000 units per day with eating, Colomycin 1 vial per day, Pulmozyme 2.5 mg/2.5 ml daily in the morning for inhalations, Ursofalk 600 mg every day constantly, Hydrocortisone 50 mg/day. CONCLUSION: Conclusions: This clinical case can be attributed to rare, as most such pathological conditions are usually diagnosed in maternity homes along with the prescription of appropriate therapy. This is an example of late diagnosis of the viral form of congenital adrenal dysfunction against the background of cystic fibrosis, indicating the need for earlier detection and timely introduction of substitution therapy to improve favourable prognosis for a disease.

Fetal anatomy of parathyroid glands.

OBJECTIVE: The aim: To study the forms of anatomical variability of the external structure of the upper and lower parathyroid glands in the fetal period of human ontogenesis. PATIENTS AND METHODS: Materials and methods: The study involved 48 specimens of human fetuses with 81,0-375,0 mm of crown-rump length (CRL). The study was conducted by means of macromicroscopic preparation, morphometry and variation statistics method. RESULTS: Results: The age and individual anatomical variability, complex way of development and formation of synotopic embryotropographic correlations of the upper and lower parathyroid glands in the prenatal period of human ontogenesis create numerous prerequisites for the emergence of variants of their external structure and topography in the fetuses of both different and the same age groups. CONCLUSION: Conclusions: There is a significant anatomical variability of the upper and lower parathyroid glands in 4-10-month-old fetuses, which is manifested by varieties of their shape and topical location. Aplasia of the upper parathyroid glands, which was found in two human fetuses aged 7 months, was due to the fetures of their organogenesis and the formation of syntopy in the embryonic and prefetal periods of their development. Parathyroid glands are mainly supplied with blood by the branches of the inferior thyroid artery. The branches of the upper thyroid artery and the arteries of adjacent organs: larynx, trachea and esophagus are involved in the blood supply. The right and left inferior thyroid veins are tributaries of the corresponding brachiocephalic vein, paired (right and left) superior and middle thyroid veins are those for the internal jugular vein.