椎动脉椎前部的形态特点及临床意义

目的 :探讨影响椎动脉椎前部供血的解剖学基础。方法 :5 1例成人尸体标本 ,解剖观察椎动脉椎前部的主要毗邻结构 ,测量椎动脉椎前部两端管腔外径、长度及其与锁骨下动脉形成的角度。结果 :①椎动脉椎前部可分为正常型和先天异常型 ,其中正常型左侧椎动脉外径大于右侧 ,左侧椎动脉与同侧锁骨下动脉形成角度小于右侧 ,两者均具有统计学的显著性差异 (P <0 .0 5 ) ,但左右两侧椎动脉椎前部长度无显著性差异。②椎动脉椎前部前方有胸锁乳突肌 ;后方有第 7颈椎横突、颈交感干等结构 ,其中颈中、下神经节发出分支形成椎动脉丛并支配该动脉 ,后内侧邻接胸膜顶、颈长肌、头长肌、外侧为前斜角肌。结论 :正常成人左侧椎动脉椎前部较右侧为优势供血动脉 ,但是血管本身或毗邻结构改变有时可致椎动脉管腔狭窄 ,发生供血不足

Morphological characteristics of prevertebral part of vertebral artery and its clinical significance

Objective: To clarify the anatomical basis of blood supply of prevertebral part of vertebral artery.Methods: Fifty one adult cadaver specimens were dissected.The main structures adjacent to prevertebral part of vertebral arteries were observed.The outer diameters, the lengths of two ends of prevertebral parts and the angles between subclavian arteries and prevertebral parts were measured.Results: There were two types of prevertebral parts of vertebral arteries: normality and abnormality.Normality: The outer diameter of left vertebral artery was larger than that of the right one.The left angle between vertbral arteries and subclavian arteries was smaller than the right one.All have statistically significant difference ( P <0.05). Howerver, there is no significant difference between the length of the left and right artery.The sternocleidomastoid lay to the anterior of prevertebral part.The transverse process of the seventh cervical vertebral and the cervical sympathetic trunk lay to the posterior of prevertebral part.The vertebral aoritic plaxus originated from the branches of middle and inferior cervical ganglion to control vertberal artery.Cupula of pleura, longus colli, longus capitis lay to the posterointerior of this artery.Scalenus anterior lay to its lateral part.Conclusion: In adult the left prevertebral part of vertebral artery is more dominant than the right one.But the variation of artery itself or adjacent structures may lead to the stricture of vertebral arteries and the blood supply shortage of the brain.