Anatomy of the Vessels and Nerves of the Trunk (Angioneurology) - Chornokulskyi S. T. 2011

Veins of the Systemic Circulation. Veins of the Trunk
Superior Vena Cava

These comprise three venous systems: the Veins OF THE Heart, the SUPERIOR VENA CAVA, and the INFERIOR VENA CAVA.

(v. cava superior) Fig. 32

It is a thick, short, valveless venous trunk located on the right and slightly posterior to the ascending aorta in the anterior Mediastinum*. The vein is formed by the union of the right and left brachiocephalic veins (vv. brachiocephalicae dextra et sinistra) behind the junction of the first right costal Cartilage with the Sternum. From here, the v. cava superior runs vertically downward and, upon reaching the level of the third right costal cartilage's junction with the sternum, empties into the right atrium.

The superior vena cava lies posterior to the Thymus gland and the anterior part of the right lung, anterior to the ROOT of the right lung, to the left of the right lung and the right phrenic nerve, and to the right and posterior to the ascending aorta.

Tributaries of the superior vena cava

If both brachiocephalic veins are considered its roots, its tributaries are:

— the azygos vein (v. azygos);

— the pericardial veins (vv. pericardiacae);

— the mediastinal veins (vv. mediastinales).

The superior vena cava collects venous Blood from three main sources:

— the Veins of the HEAD and Neck;

— the veins of the upper limbs;

— the veins of the thoracic and, partially, abdominal walls and cavities.

Azygos vein (v. azygos) Figs. 32, 33

It is formed at the confluence of the right ascending lumbar vein (v. lumbalis ascendens dextra) and the right subcostal vein (v. subcostalis dextra). These serve as the roots of the azygos vein.

✶ According to the modern International Anatomical Nomenclature, in the superior mediastinum.

Class="center">

Fig. 32. The System of the superior vena cava (9), the azygos (10), hemiazygos (14), and accessory hemiazygos (12) veins, and the inferior vena cava (17):

1 — site of Termination of the Thoracic duct arch (arcus ductus thoracici) into the left venous angle;

2 — bifurcation of the Trachea (bifurcatio tracheae);

3 — suprarenal gland (glandula suprarenalis);

4 — Kidney (ren);

5 — Abdominal Aorta (aorta abdominalis) and its bifurcation; subclavian vein (v. subclavia);

7 — internal jugular vein (v. jugularis interna);

8 — brachiocephalic veins (right, left) (vv. brachiocephalicae dextra, sinistra);

9 - superior vena cava (v. cava superior);

10 - azygos vein (v. azygos);

11 - drainage of the hemiazygos veins into the v. azygos;

12 - accessory hemiazygos vein (v. hemiazygos accessoria);

13 - posterior intercostal veins (vv. intercostales posteriores);

14 - hemiazygos vein (v. hemiazygos);

15 - renal vein (v. rena lis);

16 - hepatic veins (vv. hepaticae);

17 - inferior vena cava (v. cava inferior);

18 - right testicular (ovarian) vein (v. testicularis (ovarica) dextra);

19 - lumbar veins (vv. lumbales);

20 - ascending lumbar vein (v. lumbalis ascendens);

21 - left testicular (ovarian) vein (v. testicularis (ovarica) sinistra);

22 - common iliac vein (v. iliaca communis);

23 - external iliac vein (v. iliaca externa);

24 - internal iliac vein (v. iliaca interna)

Brachiocephalic veins (right and left) (Fig. 32)

(vv. brachiocephalicae dextra et sinistra)

Each brachiocephalic vein is formed by the union of the subclavian and internal jugular veins. These are the tributaries that form the superior vena cava. The right brachiocephalic vein begins at the level of the right sternoclavicular joint, whereas the longer left one starts at the level of the corresponding left joint. They unite posterior to the first right costal cartilage, forming the trunk of the superior vena cava.

Tributaries of the brachiocephalic vein:

1. Internal thoracic veins (vv. thoracicae internere) (see above).

2. Vertebral vein (v. vertebralis), which accompanies the artery of the same name, running alongside it through the transverse foramina of the cervical vertebrae. It receives the anterior vertebral vein (v. vertebralis anterior) and the occipital vein (v. occipitalis).

3. Deep cervical vein (v. cervicalis profunda), which descends posterior to the transverse processes of the cervical vertebrae, accompanying the corresponding artery.

4. Supreme intercostal vein (v. intercostalis suprema) draining the 1st intercostal space.

5. Left superior intercostal vein (v. intercostalis superior sinistra) draining the posterior Regions of the 2nd and 3rd intercostal spaces and emptying into the left brachiocephalic vein.

6. The inferior thyroid vein (v. thyroidea inferior), which drains blood from the unpaired thyroid plexus, as well as numerous veins:

7. Mediastinal (vv. mediastinales), thymic (vv. thymicae), bronchial (vv. bronchiales), tracheal (vv. tracheales), esophageal (v. oesophageales), and pericardiacophrenic veins (vv. pericardiacophrenicae).