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[Vascularization of the human adult sternum (author's transl)]
Insights
This study details the sternum's vascular networks, identifying key arterial pedicles and peripheral networks crucial for blood supply. Understanding sternal vascularization is vital for surgical planning and anatomical knowledge.
Area of Science:
- Anatomy
- Vascular Biology
- Surgical Anatomy
Context:
- The sternum's vascular supply is complex and critical for thoracic procedures.
- Detailed anatomical knowledge of sternal vascularization is essential for surgeons.
Purpose:
- To meticulously describe the vascular pedicles, peripheral sternal networks, and intrasternal vascularization.
- To elucidate the arterial and venous networks within the sternum and their anatomical basis.
Summary:
- The sternum receives extensive vascularization from internal mammary arteries, forming anterior and posterior peripheral networks, particularly in the lower sternum.
- Intrasternal vascularization includes compact bone and medullary networks, with veins forming denser, more irregular patterns than arteries.
- Arterial pedicles originate from internal mammary arteries, branching into elaborate networks supplying the sternum directly and via peripheral systems.
Impact:
- Provides a detailed anatomical map of sternal vascularization for improved surgical approaches.
- Enhances understanding of blood supply to the sternum, aiding in reconstructive surgery and trauma management.
- Contributes foundational knowledge for research in thoracic surgery and vascular anatomy.
Abstract:
The study of the vascularization of the sternum allows to individualise the vascular pedicles, the anterior and posterior peripheral sternal networks and the intrasternal vascularization. 1. The numerous vascular pedicles of the sternum all come from the internal mammary arteries. The postero-superior and postero-inferior sternal arteries of one simple intercostal space or of contiguous spaces are anastomosed by systems of latero-sternal, retroarticular and retro-sternal arches. From these arches come vessels which go directly to the sternum or which form the posterior peripheral sternal network. The anterior sternal branches of perforating arteries form arches or go directly to the anterior peripheral sternal network or to the sternum. The veins are less anastomosed than the arteries and therefore their arches are less distinct. 2. The anterior and posterior peripheral sternal networks are especially developed with respect to the lower half of the body of the sternum at the level of the 4th and 5th intercostal spaces. The posterior network is more developed than the anterior network. The arteries often have a spiral course, their anastomoses occur with their contralateral and homolateral homologues. The veins, which are of larger calibre than the arteries, design a denser and more irregular network. 3. The intra-skeletal vascularization, tributary of the peripheral networks, arches and branches of the internal mammary vessels, includes a network of the compact bone and a medullary network. The network of the compact bone, situated in one plane, is composed of polyhedral elongated meshes, according to the large axe of the sternum. The medullary network may be divided into a sub-cortical and a centro-medullary part. The sub-cortical part is composed of a peripheral zone and a more central zone. The totality of the intramedullary network includes a few fine arteries, an interadipocytary network, which is very developed and is variable in form. It also include sinuses of increasing order connected into the venous system, into the network of the compact bone, or into the large trans-cortical veins, which are drained by the peripheral sternal networks or by the collateral veins or the internal mammary system.