Anatomic variability of the intercostal neurovascular bundle in human fetuses.

Authors

DOI:

https://doi.org/10.26641/1997-9665.2019.3.86-92

Keywords:

intercostalnerve, posteriorintercostal artery and vein, topography, fetus, human

Abstract

Background. Studying the features of fetal topography of the intercostal neurovascular bundle in fetuses of different ages allows establishing general biological patterns of morphogenesis, typical structure and topography of structures of intercostal spaces, age and individual anatomical variability of intercostals nerves and posterior intercostals vessels. Objective – to clarify the peculiarities of the topography of the intercostals neurovascular bundle components in human fetuses aged 4-10 months. Methods. The study involved 70 specimens of human fetuses with 81.0-375.0 mm of crown-rump length by macro-microscopic dissection, injection of blood vessels, superficial staining of the dissected vessels and nerves as well as morphometry. Results. During the fetal period of ontogeny, there is an age and individual anatomical variability of intercostals neurovascular bundles, which is manifested by variability of structure, topography and number of their constituents, asymmetry of topography of right and left posterior intercostals vessels and nerves, different branching of the posterior intercostals arteries and nerves, by a variety of the development of the system of the azygos vein and its tributaries, both in fetuses of different and of the same age group or even in the same fetus. Conclusions. The trunks of adjacent intercostals nerves and posterior intercostals vessels are connected by means of connecting branches. Therefore, during operations on the lateral chest wall, one should be mindful of anastomoses between the vessels and nerves of adjacent intercostals spaces that realize the effect of cross-vascularization and innervations of the structures of the chest wall. Besides, connecting branches go from the nodes of the thoracic section of the sympathetic trunk to the intercostals nerves. The variants of the topography and branching of the intercostals nerves and posterior intercostals arteries in the intercostals spaces and the peculiarities of out flow of venous blood from their posterior areas should be taken into account by fetal and neonatal surgeons during surgery.

References

  1. Ellis H. The ribs and intercostal spaces. Anaesthesia & Intensive Care Medicine. 2008; 9(12): 518-519. doi: 10.1016/j.mpaic.2008.09.012
  2. Oram R, Rasburn N. Analgesia for thoracic surgery. Anaesthesia & Intensive Care Medicine. 2017; 18(12): 606-608. doi: 10.1016/j.mpaic.2017.09.009.
  3. Simpson W. Anaesthesia for thoracic surgery. Anaesthesia & Intensive Care Medicine. 2017; 18(8): 593–597. doi: 10.1016/j.mpaic.2017.09.010
  4. García-Tirado J, Rieger-Reyes C. Suture techniques of the intercostal space in thoracotomy and their relationship with post-thoracotomy pain: a systematic review. Arch Bronconeumol. 2012; 48(1): 22-28. doi: 10.1016/j.arbres.2011.04.012.
  5. Khalil AE, Abdallah NM, Bashandy GM, Kaddah TA. Ultrasound-guided serratus anterior plane block versus thoracic epidural analgesia for thoracotomy pain. J Cardiothorac Vasc Anesth. 2017; 31(1): 152-158. doi: 10.1053/j.jvca.2016.08.023
  6. Antsaklis A. Fetal surgery: new developments. Ultrasound Rev Obstet Gynecol. 2004; 4(4): 24-51.
  7. Pedreira DA. [Advances in fetal surgery]. Einstein (Sao Paolo). 2016; 14(1): 110-112. doi: 10.1590/S1679-45082016MD3449. Portuguese.
  8. Okrim II, Vasilchishina AV. [The topography of the first intercostal nerve in the fetuses is 6-8 months]. In [Materials of the 71st scientific-practical. conf. students and young scientists with international participation "Actual problems of modern medicine"; 2017 May 18-19; Samarkand, Uzbekistan]. Problems of biology and medicine; 2017; 2,1(95): P. 442. Russian
  9. Okrim II, Hmara TV. [Individual anatomical variability of II-VII intercostal nerves in human fetuses] In [Materials of the Scientific and Practical Conference with International Participation, dedicated to the 60th Birthday of Prof. Akhtemichuk Yu.T. “Individual anatomical variability of organs and structures of an organism in ontogeny”; 2018 September 13-15; Chernivtsi, Ukraine]. Medical University; 2018. P. 32-34. Ukrainian
  10. Hmara TV, Okrim II. [Age and individual anatomical variability of the internal thoracic artery in human fetuses]. Svit biologiyi i medicini. 2018; 2(64): 176-181. Ukrainian
  11. Hmara TV, Okrim II. [Correlative relationship of the parietal vascular-bundle and morphometric parameters of the chest skeleton in human fetuses 4-6 months]. Ukr. zhurnal medicini, biologiyi ta sportu. 2018; 4(13): 50-56. Ukrainian
  12. Khmara TV, Okrym II, Zamorskii II, Novychenko SD, Hahen OY, Dronyk II. Age and individual anatomical variability of intercostal nerves in human fetuses. Rom J Morphol Embryol. 2019; 60(2): 27-32.
  13. Semenov SN, Alekseeva NT, Anohina ZhA, Lopatina LA. [Variant anatomy of the formation and topography of unpaired and semi-unpaired veins]. Vestnik eksperimentalnoj i klinicheskoj hirurgii. 2010; 3(1): 68-71. Russian
  14. lyuj EA, Baeshko AA, Tihon SN, Dechko VM. [Topographic and anatomical parameters of unpaired and semi-unpaired veins] In [Collection of articles scientific and practical conference dedicated to the memory of prof. V.P. Yurchenko "Spring anatomical readings" [Electronic resource]; 2013; Grodno, Belarusian]. ГрГМУ; 2013. P. 61-63. Russian

Downloads

How to Cite

Okrim, I. I. (2019). Anatomic variability of the intercostal neurovascular bundle in human fetuses. Морфологія / Morphologia / Morfologìâ, 13(3), 86–92. https://doi.org/10.26641/1997-9665.2019.3.86-92

Issue

Vol. 13 No. 3 (2019)

Section

Статті

License

Copyright (c) 2019 Morphologia

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 The authors reserve the right to authorship of their work and transfer to the Journal the right to the first publication of this work under the terms of a license Creative commons Attribution 4.0 International (CC BY 4.0), which allows other people to freely distribute the published work with a mandatory reference to the authors of the original work and the first publication of the work in this journal.
        By submitting a manuscript to the editorial office of the Journal ‘Morphologia’ authors agree to transfer the rights to protect and use the manuscript (all supplemental materials, particularly protected objects such as photos, drawings, diagrams, tables, etc.), including the reproduction in the press and distribution via the Internet; translation of the manuscript into any language; export and import of journal copies with the Authors’ article in order to make it available for public. Authors convey the rights mentioned above to the editorial office without any temporal or territorial limitation all over the world. 
        The Authors guarantee that they have the exclusive rights to use the material transferred to editorial office. Editors are not responsible to third parties for contraventions of warranty given by the Authors. The considered rights are transferred to the editorial office since the moment when the current issue is signed for publishing. Reproduction of materials published in the Journal by other individuals and legal entities is possible only with the consent of Editorial office, with the obligatory indication of the full bibliographic reference of the primary publication. The Authors reserve the right to use the published material, its fragments and parts for teaching materials, oral presentations, dissertation thesis prepararion with obligatory bibliographic citation of the original paper. Electron copy of the published article, downloaded from official journal web-site in .pdf format may be put by authors on the official web-site of their institutions, any other official resources with open access.