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The morphology of the extra- and intraorganic neurovascular apparatus of the hepatoligamentary complex

Author: Ilia Catereniuc
Degree:doctor habilitat of medicine
Speciality: 14.00.02 - Human Anatomy
Scientific consultants: Mihail Ştefaneţ
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Piotr I. Lobko
doctor habilitat în medicină, profesor universitar, AŞM din Belarus, Minsk, Belarus
Scientific council:


The thesis was presented on the 19 September, 2007
Approved by NCAA on the 18 October, 2007


Adobe PDF document6.92 Mb / in romanian


CZU 611.36+611.381+611.83+611.1+611.423

Adobe PDF document 16.00 Mb / in romanian
316 pages


hepatoligamentary complex, macroscopy, macromicroscopy, microscopy, neurovascular apparatus, liver hydatidosis


This research work constitutes a multi-aspectual study of the morphology of the hepatoligamentary complex (HLC), represented by particularly type structures (liver with its annexed ligaments and neurovasculoductal consisting elements), which constitutes a morpho-functional unit, which being functionally connected by performing some common functions, make up a morphofunctional unit.

Due to the utilization of original classic and modern, usual and special methods of examination, and by establishing the specifics of organization, the morpho-functional peculiarities and laws of distribution of the vessels and nerves, in the present study, we have elucidated in details the general structure and obtained a general view of the extra- and intraorganic neurovascular apparatus of the HLC.

By using the anatomical dissecting method of examination we have established the auxiliary and basic sources of innervation of the liver and its annexed ligaments from both ipsi- and opposite sides, some of which are not elucidated in the specialty literature.

The macromicroscopic technique of selective dyeing of the total anatomical pieces with the Schiff's reagent permitted us to reveal the morphological specific features and correlations of the neurovascular structures with the tissue substrate elements, and offered us the possibility to penetrate the transitional zone between histology and anatomy, and we could study the anatomical specimen three-dimensionally. This method helped us to point out the formation of uni- and intersystemic zones of nerves overlapping and interference, and to establish zones of double and triple innervation. New data have been obtained concerning the structure and architectonics of the vascular and lymphatic bed of the perihepatic serous membrane, data which are absent in the specialty bibliographic sources.

The particular aspects of intraparenchymatous spatial distribution of the vessels and bile ducts of the liver have been highlighted by corrosive method. We have analyzed the types of distribution and anastomoses of the hepatic vessels, comparing our data with the bibliographical ones on the obtained pieces, which offered a three-dimensional model of study of the hepatic vasculoductal systems.

The microscopic examination of the extra- and intrahepatic neurovascular system gave us the possibility to study the group of its component elements: the microcirculatory blood and lymph bed, the nervous trunks and nervous fibers myelinated and devoid of myelin, solitary neurocytes, solitary and aggregate neuroganglia of different dimensions and cellular composition, the peri-, paravascular and polyvalent plexuses and the receptive apparatus, which represents the biological “monitor” of the afferent sensory pathways of the organocomplex. By using of diverse techniques of silver impregnation, it gave us the possibility to highlight specifically the neurofibrilar composition, the receptors, the histological and morphological aspects of the neurocytes, of the blood and lymph vessels, estimating their co-report in the axis nerve-vessel-tissue. This data have been confirmed and considerably enriched by applying techniques of emphasizing the adrenergic and cholinergic nervous structures and by applying the Nissl's, Weigert-Pal's methods.

The peculiarities of the substrate's histoarchitectonics have been established by using of van Gieson's method, hematoxiline-eozine colouring and other usual methods.

The morphometric data concerning some biomechanical organospecific properties of the coronary, triangular and falciform ligaments of the liver have been informationally estimated and analyzed, and we established that the elastomechanical properties of these ligaments depended on the age and differ from case to case. At the same time tensometric indexes correlate with the sex and are determined by the fibroarchitectonics of the substrate that means they are determined by the spatial orientation of its fibrilar component.

The morphopathological examination of the histological specimens in hepatic hidatosis highlighted the specific changes of the structural elements of the hidatidic larva cyst, of the fibrous capsule and of the pericystic parenchyma, changes that depend on clinical evolutional stages of the vital activity of the parasite. The pathological manifestations of the neurovascular elements of the pericystic tissue have a mosaic character, due to the reciprocal alternation of zones which are characterized by the presence of obvious affectations of the neurovegetative and vascular structures, with zones in which the affectations are weakly obvious or absent, these modifications denote the high potential of the neurovascular apparatus for regeneration, which is an important fact for favorable evolution of the regenerative processes of the residual postsurgical cavity.

The data provided by the current study led to the formulation and elaboration of a general concept and an original vision and valuable conclusions concerning the morphology of the neurovascular apparatus of the HLC, the morphofunctional organization of the neurovegetative system, as well for the thoroughgoing study concerning their functional significance, which can have a great importance for practical medicine.