Intercostal Vessels PDF

6 L.E  Internal thoracic (mammary) artery Begin: 1st part of subclavian artery Course: descend behind clavicle & upper 6 costal cartilage End: in 6th inter-costal space, it gives Superior epigastric &Musclo-phrenic arteries...

6 L.E  Internal thoracic (mammary) artery Begin: 1st part of subclavian artery Course: descend behind clavicle & upper 6 costal cartilage End: in 6th inter-costal space, it gives Superior epigastric &Musclo-phrenic arteries wy Branches:  Perforating: supplies medial side of breast  Pericardio-phrenic: supplies pleura, pericardium & diaphragm da  Upper 6 Anterior inter-costal arteries  Superior epigastric: pierces diaphragm through minor opening  Musclo-phrenic: Pierce diaphragm through minor opening to supply: en Pleura, pericardium, diaphragm & anterior abdominal wall Lower 3 anterior Inter-costal H Anterior intercostal arteries Number: (2) arteries in each of the upper (9) inter-costal spaces R. Origin: o Upper 6: from Internal thoracic artery o Lower 3: from Musclo-phrenic artery D Termination: Anastomose with posterior inter-costal artery & its collateral branch Anatomist “Intercostal vessels” 2  Posterior intercostal arteries Number: (1) artery in each of the (11) inter-costal spaces Origin: wy o Upper 2: from superior intercostal artery "branch from costo-cervical trunk of the 2nd part of da subclavian" o Lower 9: from descending thoracic aorta en Termination: Anastomose with anterior inter-costal artery Branches: H 1. Dorsal branches: to spinal cord & muscle of back 2. muscular to the surrounding muscles 3. right bronchial from right 3rd posterior ICA R. D Anatomist “Intercostal vessels” 3  Intercostal veins Anterior intercostal veins wy  Lower 3 anterior intercostal veins End in vena commitant of musclophrenic artery da  Upper 6 anterior intercostal veins: End in internal thoracic vein en N.B: Internal thoracic vein ends in brachiocephalic vein H R. D Anatomist “Intercostal vessels” 4  Posterior inter-costal veins st o 1 posterior intercostal vein : Ends in the corresponding brachiocephalic vein wy o 2nd & 3rd posterior intercostal veins: Forms superior intercostal vein which ends in: da  Arch of Azygous on the right side  Left brachiocephalic on the left side o Right 4th- 11th posterior intercostal veins: en End in the Azygous vein H o Left 4th- 8th posterior intercostal veins: End in superior hemiazygous R. o Left 9th-11th posterior intercostal veins: End in inferior hemiazygous vein D Anatomist “Intercostal vessels” 5 Superior hemiazygous Beginning: continuation of left 4th posterior ICV Course: Cross midline at level of T8 in posterior mediastinum Termination: in Azygous vein Tributaries:  left 4th -8th posterior ICV wy  left bronchial vein Inferior hemiazygous Beginning: union of left subcostal with left ascending lumbar veins da Course:  Ascend through minor opening of diaphragm  Cross midline at level of T8 in posterior mediastinum Termination: in Azygous vein en Tributaries:  left 9th -11th posterior ICV  left subcostal & ascending lumbar Azygous vein Beginning: H  back of IVC at renal vein level “L2”  union of right subcostal with right ascending lumbar R. Course:  Enter thorax through aortic orifice  Pass in posterior mediastinum then arch above root of Right lung in superior mediastinum D Termination: in SVC at sternal angle level Tributaries:  Right superior ICV  Right 4-11 posterior ICV  Right subcostal  Right ascending lumbar  Pericardial  Esophageal  Right bronchial  Hemiazygi Anatomist “Intercostal vessels” 6