A suprasternal approach to the mediastinum using real-time ultrasonography. Echoanatomical correlations.

This work was undertaken in order to define the potential capabilities of real-time echography for the exploration of the mediastinum by a suprasternal approach. We present the results of a comparative study between anatomical frontal oblique sections of the mediastinum and echographic slices performed along the same planes from the suprasternal fossa. From these data, it seems possible to enlarge the applications of echography in the study of mediastinal pathology.

[The 7th sterno-costal articulation (author's transl)]. / La 7e articulation sterno-costale.

A study of 200 human thoracic anterior walls (150 of adults and 50 of children) allows to distinguish 3 types of articulations at the internal extremity of the 7th costal cartilage: a lateral sterno-costal articulation, a prexiphoïdian sterno-costal articulation and an articulation between the two 7th costal cartilages. Each type may or may not have an articulating space. The only diarthrodial articulating spaces are found at the level of the articulation between the two 7th costal cartilages. All the other articulations may be considered as symphyses which, with age, may present a non-synovial space. The different types of articulations vary with age, the 7th cartilages being closer together in the child than in the adult. In the child there is a characteristic vascular network between the sternum and the 7th costal cartilages.

[The vascular patterns in choroïd tela of the fourth ventricle in dog (Canis familiaris) (author's transl)]. / La vascularisation de la toile choroïdienne du quatrième ventricul7 chez le chien (Canis familiaris).

The tela choroïdea of the fourth ventricle of the dog is vascularized principally by the principal and accessory caudal cerebellar arteries but also by the middle cerebellar arteries and dorsal network of the medulla oblongata. The choroïdal branches arising from these arteries supply the capillary network of the choroïd plexus. The latter drains towards the sigmoïd sinus, either directly or through the dorsal plexus of the medulla oblongata. The choroïd plexus drains also partially towards the cerebellar veins and the ventral petrosal sinuses.

[Vascularization of the corpus callosum in humans]. / Systématisation de l'angioarchitectonie du corps calleux chez l'homme.

The blood supply of the corpus callosum is studied in 20 brains by injecting the vascular system with gelatinous Indian ink. The arterial vascularization derives mainly from the anterior cerebral arteries, accessed from the median artery of the corpus callosum or from the terminal and choroidal branches of the posterior cerebral arteries. The various arteries give off perforating branches which are direct or indirect, short, of middle length or long. All these arteries concentrate on the peripheral wall of the corpus callosum. Inside of it these various arteries give off numerous terminal and collateral branches running between the nervous fibres and forming a characteristic vascular network which nourishes the capillary network. The venous vascularization of the corpus callosum is tributary to the deep venous system of the brain and concentrates on the central wall of the commissure.

[Extra-osseous and intra-osseous microvascularization of the sternum of the child]. / La microvascularisation extra-osseuse et intra-osseuse du sternum de l'enfant.

The microvascularization of the sternum of the child has been studied by a method of India ink injection and by histology. Extra-osseous vasculature includes vascular pedicles and sternal vascular networks. Vascular anterior and posterior pedicles issue from internal mammary vessels. Sternal anterior and posterior networks are disposed on the faces of the sternum and are divided in a superficial one and a deep one; both are included in the perichondrium. In newborns and in young infants, vascular structures looking like baskets are affixed to the deep sternal network. It is unlikely that they intervene in the constitution of the adult pattern of the sternal vasculature. The early complete development of sternal networks contrasts with the existence of evolutive characteristics of the intra-osseous vasculature. Intra-osseous vasculature includes the cartilage canal vessels and the vessels of the ossification centers. Cartilage canals are provided with an axial artery, issued from the deep sternal network, which produces short capillaries which continue in peripheral sinuses. Cartilage canals permit the penetration of perichondral tissue deep in the cartilage of the developing sternum, allowing the formation of the ossification center. The ossification center is vascularized by centrifugal arteries, issued from the cartilage canal artery, and disposed in a radiant pattern. They continue, through a conical progressive dilatation, into a sinusoid network, which presents a convergent disposition towards the center of the ossification point. Vascular events precede ossification. Hematopoietic development is consecutive to the vascular events too. The slenderness of vascular pedicles contrasts in neonates with the wide development of the sinusoid network. Adipose tissue is rare in the bone marrow sternum of the child. Secondary evolution of the ossification center vasculature permits its connections with the deep sternal vascular network, with adjacent cartilage canals, and with adjacent ossification centers. Progressively, the number and the importance of the peripheral pedicles of the ossification centers increase. Thus, a multiple and centripetal vascular provision takes the place of the initial, unique, centrifugal one. These modifications correspond to the transition from the vascular pattern of an expanding structure (the ossification center) to the one which is adapted to the full expression of its hematopoietic function.

[Dimensions of the human scapula]. / Contribution a l'étude des dimensions de la scapula humaine.

The study of human scapula dimensions is carried out on 110 scapulas of european adults. The statistical analysis of the results concerning the maximum height of the scapula, as well as those of the supraspinous and infraspinous fossa, and also the medial angle, show the absence of statistically significant difference between right and left sides.

[Vascularization of the tela choroidea of the prosencephalon in the cat (Felis domestica)]. / La vascularisation de la toile choroïdienne du prosencéphale chez le chat (Felis domestica).

The tela choroidea of the prosencephalon in cat is vascularized by an anterior choroidal artery arising from the carotid system and by a posterior choroidal artery arising from the vertebral basilar system. The first essentially supplies the tela and the choroid plexus of the lateral ventricle. The second above all supplies the tela choroidea of the third ventricle. Both, the anterior and posterior choroidal arteries anastomose with their terminal branches. The choroidal branches which arise from these arteries nourish the capillary networks of the tela. These vessels drain into venules and veins which are tributary of the venous circle of the base and of the internal cerebral veins.

[Vascularization of the tela choroidea of the prosencephalon of the sheep (Ovis aries)]. / La vascularisation de la toile choroïdienne du prosencéphale chez le mouton (Ovis aries).

The tela choroidea of the prosencephalon in sheep is vascularized by an anterior choroidal artery arising from the rostral branch of the carotid cerebral artery and by a posterior choroidal artery, arising from the caudal cerebral artery, branch of the carotidobasilar system. These two choroidal arteries give off choroidal branches which nourish the capillary networks of the tela. The latter consist of a velar capillary network and of a choroidal capillary network. Together, they drain into choroidal veinules and veins which are tributary of the superficial and of the deep venous systems of the brain.

[Associations among non-metric features of the atlas in the human species]. / Associations entre caractères non-métriques de l'atlas dans l'espèce humaine.

Six non-metrical variants has been studied in a series of 500 human atlases. A bipartition of the superior articular facet has been observed in 20.8% of cases, a posterior ponticulus in 14.2% of cases, a retrotransverse ponticulus in 14.2% of cases, an anterior dehiscence of the foramen tranversarium in 10.2% of cases, a dehiscence of the posterior arch in 2.8% of cases, and a lateral ponticulus in 1.8% of cases. Bilateral occurrence has been noted in 42.2 to 46.2% of cases for the anterior dehiscence of the foramen transversarium, the posterior ponticulus, and the bipartition of the superior articular facet. Bilateral occurrence is less frequent for the retrotransverse ponticulus (29.6%), and particularly for the lateral ponticulus (11.1%). The incidence of a given lateral character according to the side has been found identical or similar on the left and on the right sides. In the present series, 51.6% of the atlases showed none of the six variants studied; 46.8% of the atlases showed one or two variants; and only 1.6% of the atlases showed more than two variants; any cases with more than four variants were observed. The most interesting association observed is the association of the lateral ponticulus with the posterior ponticulus.

[The posterior intervertebral spaces of the craniovertebral joint]. / Les espaces intervertébraux postérieurs de la jointure crânio-rachidienne.

Closing of the posterior intervertebral spaces of the craniovertebral joint is not performed by the classical posterior atlanto-occipital and atlantoaxial membranes. In the atlanto-occipital space, the connective laminae come from the occipital periosteum and from the anterior fascia of the rectus capitis posterior minor muscle, and pass round the anterior side of the posterior arch of the atlas to reach the spinal dura mater. In the atlantoaxial space, the anterior fasciae of the rectus capitis posterior major muscle and of the inferior oblique muscle, as well as the periosteum of the posterior arch of the atlas, extend to reach the spinal dura mater. Thus, the epidural space is sealed posteriorly by the connective laminae of the atlantoaxial space, and lets above a superior recessus containing the ganglia of the spinal nerves C1 and C2 and in which the vertebral artery transits.

[Systematization of the angioarchitectonics of the colon in adult man]. / Systématisation de l'angioarchitectonie du côlon chez l'homme adulte.

The systematization of the angioarchitecture of the human colon was studied in 25 colons, the vascular system of which was injected with gelatinous indian ink. The arterial vascularization of the colonic wall is organized in two morphologically very different types of networks. The first type forms the distributional networks which consist of the subserosal, intermuscular and submucosal networks distributing harmoniously the blood running from the straight arteries. The second type forms the functional networks which consist of the muscular and mucosal networks related to the supply of the essential structure of the colonic wall. These consist essentially of pre- and postcapillary vessels. The venous vascularization of the colonic wall is organized according to a similar pattern. It also consists of three venous networks: the submucosal, intermuscular and subserosal networks which are tributaries of the straight veins and which receive the mucosal and muscular veins.

[Microvascularization of the sternum in children]. / La microvascularisation du sternum chez l'enfant.

46 sternums originating from 1-day- to 17-year-old children were injected with India ink and transparified. The intraosteal and medullary vasculature is described at different stages, as well as cartilage canals, vessels of the isolated ossification center, vessels of the ossification center connected with peripheral vascular structures or neighboring cartilage canals, and finally the transition to the adult pattern. With age, the centrifugal vascular distribution develops to a centripetal pattern.

[Arterial vascularization of the corpus callosum in man]. / Vascularisation artérielle du corps calleux chez l'Homme.

The blood supply of the corpus callosum in Man is studied in 20 brains by injecting the vascular system with gelatinous indian ink. The arterial vascularization of the corpus callosum is derived, although in an unequal way, from both of the arterial systems of the brain: the carotid system and the vertebral-basilar system. The carotid system contributes mainly to this supply by the anterior cerebral artery which is the main artery of the corpus callosum. It accessorily contributes to it by the anterior communicating artery which gives off an inconstant artery called median artery of the corpus callosum. The vertebral-basilar system contributes to the blood supply of the corpus callosum by the terminal branches and by choroidal branches of the posterior cerebral artery. These various arteries give off perforating arteries which are direct or indirect, short, of middle length or long. Inside the corpus callosum, these various arteries give off numerous terminal and collateral branches which run between the nervous fibers. They anastomose with homologous neighbouring branches to form a characteristic vascular network. The arrangement of this network is in close connection with the disposition and the orientation of the commisural fibers which form the different parts of the corpus callosum.

[The vascular patterns in choroïd tela of the fourth ventricle in man (author's transl)]. / La vascularisation de la toile choroïdienne inférieure chez l'homme.

The human inferior choroid tela is vascularized by the posterior inferior cerebellar arteries and the anterior inferior cerebellar arteries. These arteries give off small choroid branches which supply the velate and choroid capillary networks. The latter drain downwards, into the posterior bulbar veins system, or upwards, into the veins of the lateral recess of the fourth ventricle, all of which are tributary to the two superior petrosal veins.

[The vascular networks of the subserous layer of the human colon]. / Les réseaux vasculaires de la couche sous-séreuse du côlon chez l'homme.

The subserous layer of the colon has, like the small intestine, a rich vascular network. The subserous arteries arise from the straight arteries and are directed towards the taeniae, the surface and free margin of the colon. They terminate at various levels and, by their collateral and terminal branches, form an anastomotic network of vessels whose morphology varies at the level of surface, taenia and the free margin of the colon. From this subserous arterial network arise branches destined to vascularise the muscularis, the fat of the colon and the greater omentum. The subserous venous network copies closely the morphology of the arterial network and is connected by large perforating veins to the submucous venous network.

[The vascular network of the subserous layer of the colon in man]. / Les réseaux vasculaires de la couche sous-séreuse du côlon chez l'homme.

The subserous layer of the colon has, like the small intestine, a rich vascular network. The subserous arteries arise from the straight arteries and are directed towards the taeniae, the surface and free margin of the colon. They terminate at various levels and, by their collateral and terminal branches, form an anastomotic network of vessels whose morphology varies at the level of surface, taenia and the free margin of the colon. From this subserous arterial network arise branches destined to vascularise the muscularis, the fat of the colon and the greater omentum. The subserous venous network copies closely the morphology of the arterial network and is connected by large perforating veins to the submucous venous network.

[Topography, structure and vascularization of the fat pad of the lumbar trigone (corpus adiposum trigoni lumbalis)]. / Topographie, structure et vascularisation du coussinet adipeux lombo-fessier (corpus adiposum trigoni lumbalis).

The corpus adiposum trigoni lumbalis is an adipose mass which is separated from the hypodermic fat pad by the fascia superficialis and placed on the trigonum lumbale and higher part of gluteal region. It gives some extension toward the flanks, the middle line of the body, the lower put of the gluteal region and is also very close to the subperitoneal fat pad. It's vascularization depends in greater part of it's own vessels, but also on vessels that irrigate the integument.

[Vascularization of the sub-mucosal and mucosal layers of the colon in man]. / La vascularisation des tuniques sous-muqueuse et muqueuse du côlon chez l'homme.

The vascularization of the submucosal and mucosal layers of the human colon has been studied in 25 cases whose vascular system was injected with gelatinous indian ink. The submucosal layer presents a true vascular crossroads for the arterial and venous anastomotic networks, which are tributaries of the straight vessels. The morphology of these vascular networks is exactly similar. The straight arteries and veins form vascular rings all along the colon, and they anastomose by means of longitudinal and transverse vessels. Many vessels of the muscular and all those of the mucosal layer are tributaries of these vascular networks. The vessels of the mucosal layer include the precapillary arteries, capillary network of the intestinal glands and postcapillary veins. The latter joint and form the mucosal venous trunks, which, in turn, form the mucosal veins, which flow into the submucosal venous network.