Card Set Information
Unpaired (Visceral) Arteries
Aorta-Ductus arteriosus/ligamentum arteriosum
*come off front of aorta
Paired (Parietal) Arteries
Superior Intercostal-1 & 2 space via costocervical trunk
Posterior Intercostal-3-11 via Aorta
Subcostal-12 via Aorta
Anterior Intercostal-1-6 via Internal thoracic
at bottom of rib cage split into
-superior epigastric-6th space to rectus sheath
*back of aorta and run around posterior wall into intercostal spaces
System of 3 long vessels
Azygos (Rt.)-posterior intercostal drain into-only on right side
Hemiazygos (Lower Lt.)
Accessory Hemiazygos (Upper Lt.)
Continuation of ascending lumbar v.
connect SVC with IVC-important anastomotic channel
Azygos v. origin
Origin: 1) Rt. ascending lumbar and subcostal v., 2) Rt. renal v.
Route of Azygos v.
: 1) Rt. ascending lumbar and subcostal v., 2) Rt. renal v.
Enter thorax on rt. side of TD and aorta
Ascends on vertebral bodies to root of lung
Emerges under esophagus and arches forward above bronchus to SVC
Azygos v. valves
Imperfect valves: tributaries have numberous ones
Azygos v. recieves?
lower 8 post. intercostal & subcostal v.
Rt. superior intercostal (1 & 2)
Esophageal, pericardial, broncial, mediastinal
Hemiazygos v. origin and route
: left ascending lumbar and lt. renal v.
Enters thorax-lt crus of diaphragm on lt. side of vertebrae
8-9th vertebrae cross columb behind aorta, esophagus and TD
Hemiazygos v. recieves?
lower 4-5 posterior intercostals and occasionally accessory hemiazygos
Accessory hemiazygos v. origin and route
: variable-often continuous with lt. sup. intercostal
inversely proportional to sup. intercostal
decends on lt. side of column to hemiazygos
Accessory hemiazygos v. receives?
3-4 post. intercostals between lt. sup. and hemiazygos
Superior Intercostals drain and empty into?
Drain 1-5 intercostals (variable)
Empty into lt. brachiocephalic v.
Vertebral Plexus of Veins
Runs length of vertebral canal
Interconnections with SVC & IVC
can move up or down
Thoracic duct route
Begins with cisterna chyli (T12)
2 lumbar trunks and interstinal trunk
Ascends behind aorta through hiatus
Azygos v. (rt. ) and aorta (lt.)
T5-deviates to left behind esophagus
Ascends into neck behind carotid sheath and ant. to vertebral artery
Empties into union of internal Jugualar and Subclavian
*Main collecting duct-lower limbs, pelvis, GI tract, left upper limb and left head
*transparent-returns protein back into venous system-if cut during surgery can be fatal within days
Leave spinal n. as White Rami Communicantes (myelinated)-lateral part
Join thoracic chain at ganglia
Number of preganglionic fibers < Number of ganglion cells
What occurs once preganglionic fibers enter chain
ascend and then synapse
descend and then synapse
leave chain without synapse
Where do the areas of preganglionic fibers go to in the body?
T1-T5-head, neck, upper limb, thorax-ascend
Where is the Sympathetic Chain at?
Outside posterior mediastinum-behind costal pleura
Some rejoin spinal nerves as Gray Rami communicantes (unmyelinated)-medial aspect
Others leave trunk to thoracic viscera-synapse at point of exit
Superior, middle, inferior cervical (neck)
1st Thoracic-may be independent but often fused with inf. cervical
2-10 usually single, slightly below nerve
usually only 11 ganglia (11th and 12th often fused)
Gray Rami-to spinal nerves
Br. to Cardiac & pulmonary plexuses
Greater-T5-T9 (10)-Exit crura of diaphragm (aortic)
Lesser-T10-11-exit crura of diaphragm
angina-pain referral to left limb
pain fibers traveling with sympathetic system
synapse with sympathetic fibers-go out to blood vessels-vasocontricution to area of skin
area irritated-afferent pain fibers activated and back into spinal cord-somatic sources-into thalamus
perceive pain in arm rather than heart
sensory fibers-travel on gray then white back to spinal cord
Hemiazygos v.-behind everything-compress=no blood crossing over
vein (most superior) then artery, then nerve-connects to sympathetic chain with white and gray rami
azygos v. and thoracic duct parallel with each other-azygos v. more lateral-sympathetic trunk more lateral to azygos v.
Esophagus origin and termination
: cricoid cartilage (C6)
Termination-Cardiac opening of stomach
Esophagus Constrictions (3)
Cricoid cartilage (C6)-larynx can flatten out if constricted
Bifurcation of trachea (T4-broncho-aortic constriction-flatten out against vertebral column)
Esophageal hiatus of diaphragm (T 11)-spicter for esophagus-costal agents or foreign objects stuck here
Blood supply to esophagus
*small sized vessels*
*esophagus-thick and muscular*
Nerve supply to esophagus
Vagus-rotates 90 degrees to the right
: lf-ant.; rt.-posterior to esophagus
Sympathetic chain-greater splanchnic n.
Origin of Diaphragm
bony elements around circumference
Crura-2 bundles (lt.-3, rt.-2)
Arcuate lig.-med. and lat. ligament
Insertion points of Diaphragm
Crura-medial fibers arch around aorta
right also loop around esophagus
Arcuate lig.-med. over psoas mus. and lat. over quad. lumborum mus.
Nerve supply to Diaphragm
Phrenic-C3, 4, 5
Arteries supply of Diaphragm
Intercostals, musculophrenic, inf. phrenic, pericardiophrenic
Openings of Diaphragm
a, e, i-12, 10, 8
T 12-aorta between crura and TD, azygos v.
T 10-esophagus and rt and lt vagus n.
T8-IVC-central tendon and rt phrenic