أسئلة الـ IC vessels (ريتين ثانية أناتومي)
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Questions and Answers

What is the endpoint of the upper 6 anterior intercostal veins?

They end in the internal thoracic vein.

How do the 2nd and 3rd posterior intercostal veins drain?

They form the superior intercostal vein, which drains into the arch of Azygous on the right side and the left brachiocephalic on the left side.

What is the fate of the right 4th to 11th posterior intercostal veins?

They end in the Azygous vein.

Which veins do the lower 3 anterior intercostal veins terminate in?

<p>They end in the vena commitant of the musclophrenic artery.</p> Signup and view all the answers

What drains the left 4th to 8th posterior intercostal veins?

<p>They end in the superior hemiazygous vein.</p> Signup and view all the answers

What veins contribute to the formation of the superior hemiazygous vein?

<p>The left 4th to 8th posterior intercostal veins contribute to the formation of the superior hemiazygous vein.</p> Signup and view all the answers

At which level does the inferior hemiazygous vein cross the midline?

<p>The inferior hemiazygous vein crosses the midline at the level of T8.</p> Signup and view all the answers

Where does the azygous vein originate?

<p>The azygous vein originates from the back of the inferior vena cava at the renal vein level (L2).</p> Signup and view all the answers

Identify two tributaries of the azygous vein.

<p>The right superior intercostal vein and the esophageal veins are tributaries of the azygous vein.</p> Signup and view all the answers

What is the termination point of the inferior hemiazygous vein?

<p>The inferior hemiazygous vein terminates in the azygous vein.</p> Signup and view all the answers

What artery gives rise to the superior epigastric and musclo-phrenic arteries?

<p>The internal thoracic artery.</p> Signup and view all the answers

Which arteries supply the medial side of the breast?

<p>The perforating branches of the internal thoracic artery.</p> Signup and view all the answers

How many anterior intercostal arteries are there in the upper 6 intercostal spaces?

<p>There are 2 anterior intercostal arteries in each of the upper 6 intercostal spaces.</p> Signup and view all the answers

What is the origin of the lower 3 anterior intercostal arteries?

<p>They arise from the musclo-phrenic artery.</p> Signup and view all the answers

From where do the upper 2 posterior intercostal arteries originate?

<p>They originate from the superior intercostal artery, a branch of the costo-cervical trunk.</p> Signup and view all the answers

What main artery supplies the lower 9 posterior intercostal arteries?

<p>The descending thoracic aorta.</p> Signup and view all the answers

What is the termination point of the internal thoracic artery?

<p>It terminates in the 6th intercostal space.</p> Signup and view all the answers

Which arteries anastomose with the anterior intercostal arteries?

<p>The posterior intercostal arteries and their collateral branches.</p> Signup and view all the answers

What is the beginning point of the superior hemiazygous vein?

<p>It begins as a continuation of the left 4th posterior intercostal vein.</p> Signup and view all the answers

Which veins contribute to the formation of the inferior hemiazygous vein?

<p>The inferior hemiazygous vein forms from the union of the left subcostal and left ascending lumbar veins.</p> Signup and view all the answers

How does the azygous vein enter the thorax?

<p>It enters through the aortic orifice.</p> Signup and view all the answers

What is the primary termination point of the azygous vein?

<p>It terminates in the superior vena cava at the level of the sternal angle.</p> Signup and view all the answers

What distinction exists between the drainage of the 1st posterior intercostal vein and the 2nd and 3rd posterior intercostal veins?

<p>The 1st posterior intercostal vein drains directly into the corresponding brachiocephalic vein, while the 2nd and 3rd posterior intercostal veins form the superior intercostal vein.</p> Signup and view all the answers

How do the 2nd and 3rd posterior intercostal veins contribute to venous drainage on the left side?

<p>They end in the left brachiocephalic vein via the superior intercostal vein.</p> Signup and view all the answers

Explain the termination of the internal thoracic vein and its significance.

<p>The internal thoracic vein ends in the brachiocephalic vein, which is significant for returning blood from the anterior thoracic wall to the heart.</p> Signup and view all the answers

What is unique about the drainage of the upper 6 anterior intercostal veins compared to the lower 3?

<p>The upper 6 anterior intercostal veins drain into the internal thoracic vein, while the lower 3 anterior intercostal veins terminate in the venae comitantes of the musclophrenic artery.</p> Signup and view all the answers

What structures does the pericardio-phrenic artery specifically supply?

<p>Pleura, pericardium, and diaphragm.</p> Signup and view all the answers

How many branches does the posterior intercostal arteries have, and what are their functions?

<p>They have three branches: dorsal branches to the spinal cord and back muscles, muscular branches to surrounding muscles, and right bronchial to the right bronchus.</p> Signup and view all the answers

From which part of the subclavian artery does the internal thoracic artery arise?

<p>It arises from the 1st part of the subclavian artery.</p> Signup and view all the answers

What is the significance of the superior epigastric artery in relation to the diaphragm?

<p>It pierces the diaphragm through a minor opening to supply blood to the upper abdominal wall.</p> Signup and view all the answers

Describe the origin of the lower three anterior intercostal arteries.

<p>They originate from the musclo-phrenic artery.</p> Signup and view all the answers

What role do perforating branches of the internal thoracic artery serve?

<p>They supply the medial side of the breast.</p> Signup and view all the answers

In which intercostal spaces do the anterior intercostal arteries originate from the internal thoracic artery?

<p>They originate from the upper 6 intercostal spaces.</p> Signup and view all the answers

How do the anterior and posterior intercostal arteries communicate?

<p>They anastomose with each other.</p> Signup and view all the answers

Flashcards

Where do the lower 3 anterior intercostal veins drain?

The lower 3 anterior intercostal veins drain into the vena commitant of the musculophrenic artery.

Where do the upper 6 anterior intercostal veins drain?

The upper 6 anterior intercostal veins drain into the internal thoracic vein.

Where does the 1st posterior intercostal vein drain?

The first posterior intercostal vein drains directly into the corresponding brachiocephalic vein.

Where does the superior intercostal vein drain?

The second and third posterior intercostal veins join to form the superior intercostal vein, which drains into the arch of the azygous vein on the right side and into the left brachiocephalic vein on the left side.

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Where do the right 4th to 11th posterior intercostal veins drain?

The right 4th to 11th posterior intercostal veins drain into the azygous vein on the right. The left 4th to 8th posterior intercostal veins drain into the superior hemiazygous vein on the left.

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What is the Internal Thoracic Artery?

The Internal thoracic artery is a major blood vessel that runs down the chest, supplying vital structures like the breast muscles and the heart.

It arises from the subclavian artery and descends behind the clavicle, branching into several arteries that serve the chest wall, diaphragm, and even the abdominal wall.

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What are the branches of the Internal Thoracic Artery?

The internal thoracic artery gives off several branches that supply various tissues and organs. These branches include:

  • Perforating branches: Supply the medial side of the breast
  • Pericardiophrenic artery: Supplies the pleura (lining of the lungs), pericardium (sac surrounding the heart), and diaphragm.
  • Anterior intercostal arteries (upper 6): Supply the upper 6 intercostal spaces (spaces between the ribs)
  • Superior epigastric artery: Supplies the upper abdominal wall
  • Musculophrenic artery: Supplies the lower 3 intercostal spaces, diaphragm, and abdominal wall.
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Identify the anterior intercostal arteries.

The anterior intercostal arteries are a pair of arteries that run between the ribs. They ensure adequate blood flow to the intercostal spaces.

These arteries originate from either the internal thoracic artery or the musculophrenic artery, depending on their position within the chest.

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What are the posterior intercostal arteries?

The posterior intercostal arteries are a series of arteries that course along the back, supplying the muscles and structures of the dorsal region. They originate from the superior intercostal artery for the upper two spaces, while the lower 9 receive their blood supply from the descending thoracic aorta.

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How do anterior and posterior intercostal arteries connect?

The anterior and posterior intercostal arteries connect with each other, creating a network that ensures a continuous supply of blood to the chest wall.

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What are the branches of the posterior intercostal arteries?

The posterior intercostal arteries have several branches that distribute blood to different locations in the back. These branches include:

  • Dorsal branches: Supply the spinal cord and muscles of the back
  • Muscular branches: Supply the surrounding muscles
  • Right bronchial branch (from the right 3rd posterior intercostal artery): Supplies the right lung.
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What is the superior intercostal artery?

The superior intercostal artery is a small artery that arises from the costo-cervical trunk of the subclavian artery. It mainly provides blood to the first and second intercostal spaces.

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What is the descending thoracic aorta's role in the intercostal circulation?

The descending thoracic aorta is a large artery that provides blood to various structures in the chest and abdomen.

The descending thoracic aorta gives rise to the lower 9 posterior intercostal arteries, ensuring adequate blood supply to the lower intercostal spaces.

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What is the formation and course of the inferior hemiazygous vein?

The inferior hemiazygous vein is formed by the union of the left subcostal vein and the left ascending lumbar vein. It then ascends through the minor opening of the diaphragm and crosses the midline at the level of T8 in the posterior mediastinum. Finally, it terminates in the azygous vein.

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What is the formation of the superior hemiazygous vein and its tributaries?

The superior hemiazygous vein is a continuation of the left 4th posterior intercostal vein. It crosses the midline at the level of T8 in the posterior mediastinum and terminates in the azygous vein. It receives tributaries from the left 4th to 8th posterior intercostal veins and the left bronchial vein.

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Describe the origin, course, and termination of the azygous vein.

The azygous vein originates from the union of the right subcostal vein and the right ascending lumbar vein. It enters the thorax through the aortic orifice and moves through the posterior mediastinum before arching above the right lung root in the superior mediastinum. Finally, it terminates in the superior vena cava at the sternal angle level.

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What are the tributaries of the inferior hemiazygous vein?

The inferior hemiazygous vein receives blood from the left 9th to 11th posterior intercostal veins, as well as the left subcostal vein and the left ascending lumbar vein.

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What are the tributaries of the azygous vein?

The azygous vein receives blood from the right superior intercostal veins, right 4th to 11th posterior intercostal veins, right subcostal vein, right ascending lumbar vein, pericardial vein, esophageal vein, right bronchial vein, and the hemiazygous veins (both superior and inferior).

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Where do the upper six anterior intercostal veins drain?

The upper six anterior intercostal veins drain into the internal thoracic vein, which then merges with the brachiocephalic vein.

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Where do the lower three anterior intercostal veins drain?

The lower three anterior intercostal veins drain into the vena commitant of the musculophrenic artery.

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Where does the first posterior intercostal vein drain?

The first posterior intercostal vein drains directly into the corresponding brachiocephalic vein on the same side.

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Where do the right 4th to 11th and left 4th to 8th posterior intercostal veins drain?

The right 4th to 11th posterior intercostal veins drain into the azygous vein, while the left 4th to 8th posterior intercostal veins drain into the superior hemiazygous vein.

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Origin and Course of the Internal Thoracic Artery

The internal thoracic artery arises from the first part of the subclavian artery and descends behind the clavicle, supplying structures like the breast muscles and the heart.

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Branches of the Internal Thoracic Artery

The internal thoracic artery gives off branches to the mediastinum (space around the heart), anterior chest wall, and upper abdominal region. These include the perforating, pericardiophrenic, anterior intercostal, superior epigastric, and musculophrenic arteries.

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Anterior Intercostal Arteries

The anterior intercostal arteries supply blood to the intercostal spaces (spaces between the ribs), running along the inside of the rib cage. They are crucial for providing oxygen and nutrients to the muscles and structures of the chest wall.

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Posterior Intercostal Arteries

The posterior intercostal arteries are located on the back of the rib cage, supplying blood to the muscles and structures of the back. They originate from different sources depending on their location. The upper two originate from the superior intercostal artery, while the lower nine arise from the descending thoracic aorta.

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Anastomosis of Intercostal Arteries

The anterior and posterior intercostal arteries anastomose (connect) with each other, forming a network that ensures a continuous supply of blood to the chest wall. This interconnected circulation provides redundancy and helps maintain proper oxygen and nutrient delivery.

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Superior Intercostal Artery

The superior intercostal artery originates from the costo-cervical trunk of the subclavian artery and supplies blood to the first and second intercostal spaces.

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Descending Thoracic Aorta and Intercostal Circulation

The descending thoracic aorta is the major blood vessel in the chest, providing blood to various structures, including the intercostal spaces. The lower nine posterior intercostal arteries branch off from the descending thoracic aorta, ensuring a consistent blood supply to the lower ribs.

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Branches of the Posterior Intercostal Arteries

The posterior intercostal arteries have several branches that supply the spinal cord, back muscles, and surrounding tissues. These include dorsal branches, muscular branches, and a right bronchial branch.

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Where does the Inferior Hemiazygous vein end?

The "inferior" hemiazygous vein is formed by the union of the left subcostal vein and the left ascending lumbar vein. It travels upwards through the diaphragm and crosses the midline at the level of T8 in the posterior mediastinum before it empties into the azygous vein.

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Describe the course of the Azygous vein

The azygous vein arises from the union of the right subcostal vein and the right ascending lumbar vein. It enters the chest through the aortic opening, passes through the posterior mediastinum, arches over the right lung root, and finally drains into the superior vena cava at the sternal angle.

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Where does the Superior Hemiazygous vein drain?

The superior hemiazygous vein descends from the left 4th posterior intercostal vein, crosses the midline at the level of T8 in the posterior mediastinum, and joins the azygous vein.

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What drains into the Inferior Hemiazygous vein?

The inferior hemiazygous vein receives drainage from the left 9th, 10th, and 11th posterior intercostal veins, the left subcostal vein, and the left ascending lumbar vein.

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Study Notes

Intercostal Vessels

  • Intercostal vessels are a network of arteries, veins, and nerves that supply the intercostal muscles and spaces between the ribs. They are crucial for the function of the chest cavity.

Internal Thoracic (Mammary) Artery

  • Originates from the first part of the subclavian artery.
  • Descend behind the clavicle and superior 6 costal cartilages.
  • Ends in the 6th intercostal space, providing branches to the superior epigastric and musculophrenic arteries.
  • Branches of the internal thoracic artery include perforating arteries that supply the medial side of the breast.
  • Also supplies the pleura, pericardium, and diaphragm via pericardiophrenic arteries.
  • Upper 6 anterior intercostal arteries branch directly off the internal thoracic artery.
  • Lower 3 anterior intercostal arteries branch from the musculophrenic artery.
  • The artery supplies the muscles, pleura, pericardium, and anterior abdominal wall in the upper chest.
  • Important anastomosis (connection) with posterior intercostal arteries.

Anterior Intercostal Arteries

  • Two arteries in each of the upper 9 intercostal spaces.
  • Originate from the internal thoracic artery (upper 6) and musculophrenic artery (lower 3).
  • Supply blood to the intercostal muscles and tissues of the chest wall.

Posterior Intercostal Arteries

  • One artery in each of the 11 intercostal spaces.
  • Upper 2 arteries branch from the superior intercostal artery (part of the costocervical trunk, which arises from the subclavian artery).
  • Lower 9 arteries arise from the descending thoracic aorta.
  • They supply the intercostal muscles, spinal cord, surrounding muscles, and back.
  • Anastomose with anterior intercostal arteries for blood supply.

Intercostal Veins (Anterior)

  • Lower 3 anterior intercostal veins drain into the companion vein of the musculophrenic artery.
  • Upper 6 drain into the internal thoracic vein.
  • The internal thoracic vein empties into the brachiocephalic vein.

Intercostal Veins (Posterior)

  • 1st posterior intercostal vein drains into the brachiocephalic vein.
  • 2nd and 3rd posterior intercostal veins empty into the superior intercostal vein.
  • The superior intercostal vein connects to either the right or left brachiocephalic vein, or the arch of the azygos vein.
  • Right 4th-11th posterior intercostal veins drain into the azygos vein.
  • Left 4th-8th posterior intercostal veins empty into the superior hemiazygous.
  • Left 9th-11th posterior intercostal veins drain into the inferior hemiazygous vein.

Superior/Inferior Hemiazygous Veins

  • These are important in connecting various intercostal veins on the right and left sides of the body.
  • Draining blood from posterior intercostal veins to the superior vena cava.

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