Seminar topic:
“Venous drainage of thoracic wall”
LimKuan Yan, 0310445
Taylor’s University MBBS, Batch 5.
Veins that we going to discuss today
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Internal thoracic vein
Intercostal vein (Ant & Post.)
Azygos Vein
Hemiazygos vein
Accessory vein
Internal Thoracic Vein the (Internal Mammary Vein)
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Is a vessel that drains the chest wall and breasts.
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Bilaterally, it arises from the superior epigastric vein,
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Accompanies the internal thoracic artery along its course and terminates in the brachiocephalic vein.
Intercostal Vein
Intercostal Vein
• Anterior intercostal Vein
In each of the upper nine spaces
• Two anterior intercostal veins
• They accompany the corresponding
arteries
• Termination of Ant. Intercostal.V
• In upper 3 spaces, the veins end in the
internal thoracic vein
• In upper 4-6 spaces, the veins end in
vena comitantes accompanying internal
thoracic artery.
• In lower 7-9 spaces, the viens end in
vena comitantes accompanying
muculophrenic artery
Musculophrenic artery & Internal Thoracic artery
Intercostal Vein
• Posterior intercostal Vein
In each of upper nine spaces
• One posterior intercostal vein
• One collateral vein
V.A.N
• Each vein accompany the corresponding
artery and lies superiorly to the artery
Collateral branch of the posterior intercostal vein
Posterior intercostal Vein
Termination of Post. Intercostal Vein
Postrior intersotal Veins (P.I.V)
P.I.V on the right drain into
P.I.V on the left drain into
1st
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Right brachiocephalic.V
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Left Brachiocephalic.V
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Azygous.V
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Left Brachiocephalic.V
5-8th
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Azygous.V
Accesory hemiazygos .V
9-11th + subcostal V (12th)
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Azygous.V
Hemiazygos.V
2-4th
(Right side = Joined together and
form right sup. Intercostal vein)
(Left side = Joined together and form
left sup. intercostal vein)
Left sup. Int. costal vein
Right sup. Int. costal vein
Accesory hemizygous V.
Hemizygous V.
Right subcostal vein
Left subcostal vein
Azygos (Unpaired) Vein
General info
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Azygos vein drain the thoracic wall and the upper
lumbar region.
It forms and important channel connecting the sup. &
inf. Vanae cavae
The vein occupies the upper part of post. Abdominal
wall and post. Mediastinum
It connects portal venous system to caval venous
system.
Formation
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The azygos.V is formed by union of
• Lumbar azygos.V (Abdominal part of azygos.V)
 Lies to the right of lumbar vetebrae
 It’s lower end communicates with IVC
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Ascending lumbar.V (Formed by verticle anastomoses
that connect the lumbar vein)
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Right subcostal.V (Accompany by right subcostal artery)
Azygos (Unpaired) Vein
Course
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Ascends up
Pass through the aortic opening of the diaphragm
Enter throax
Continue ascend up to T4
Form arches forward over the root of the right lung
Joined the post aspect of sup.vena cava (just before
piercing into the pericardium)
THE END
Relation
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Ant = Oesophagus
Post = Lower 8 throcic vetebraes ( T5-T12)
= Right post. Intercostal arteries
Right = Right lung
= Pleura
Left = (lower part) => Thoracic duct + aorta
= (upper part) =>Oesophagus + trachea +
vagus nerve
Hemiazygos (Inferior hemiazygous) Vein
General info
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It is mirror immage of lower part of the
azgos vein.
Formation
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Hemiazyos vein is formed by union of
• Left lumbar azygos.V
• Left ascending lumbar.V
• Left subcostal.V
Hemiazygos (Inferior hemiazygous) Vein
Course
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Ascend upward
Pierce the left crura of the diaphragm
Go upward along with the left side of the vetebrae
Overlapped by aorta
At T9 go right side of the vetebrae
Passes behind oesophagus
Joins the azygos.V
THE END
Tributaries
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9th to 11th left post. Intercostal.V
Oesophagus.V
Accessory (Superior hemiazygos) Vein
General info
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It is the mirror image of upper part of
azygos vein.
Course
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Begin with medial end of 4th or 5th intercostal space
Descends downward on the left side of the vertebral
column
At the level of T8,it turns to the right side of vetebrae
Passes behind the aorta & thoracic duct
Join with azygos.V
THE END
Tributaries
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5th to 8th left post. Intercostal.V
References
Thank you !!!