Sick H, Oberling F, Guerbaoui M
Arch Anat Histol Embryol. 1974;57(2):197-220.
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.
胸骨血管分布的研究有助于明确血管蒂、胸骨前后外周网络以及胸骨内血管分布情况。1. 胸骨的众多血管蒂均来自胸廓内动脉。一个单纯肋间间隙或相邻间隙的胸骨后上动脉和胸骨后下动脉通过胸骨外侧、关节后和胸骨后弓系统相互吻合。从这些弓发出的血管直接走向胸骨或形成胸骨后外周网络。穿支动脉的胸骨前分支形成弓或直接走向胸骨前外周网络或胸骨。静脉的吻合程度低于动脉,因此其弓不太明显。2. 胸骨前后外周网络在胸骨体下半部第4和第5肋间间隙水平尤其发达。后网络比前网络更发达。动脉通常呈螺旋状走行,它们与对侧和同侧的同源动脉相互吻合。静脉的管径比动脉大,形成更密集、更不规则的网络。3. 骨骼内血管分布是外周网络、胸廓内血管的弓和分支的分支,包括密质骨网络和髓质网络。密质骨网络位于一个平面内,由多面体细长网眼组成,沿胸骨的长轴排列。髓质网络可分为皮质下部分和中央髓质部分。皮质下部分由外周区和更中央的区域组成。整个骨髓内网络包括一些细小动脉、一个非常发达且形态各异的脂肪细胞间网络。它还包括连接到静脉系统、密质骨网络或大的穿皮质静脉的各级窦,这些窦由胸骨外周网络或侧支静脉或胸廓内系统引流。