Ch 3-Thorax: Vasculature

Question 1

-Arteries: post/ant intercostal arteries:

Answer 1

-Post: Upper 2, from supreme intercostal artery → costocervical trunk
Remaining 9, from post thoracic aorta

-Ant: From internal thoracic arteries → superior epigastric artery/musculophrenic artery → ( intercostal spaces) → 2 Anterior Intercostal arteries

Question 2

-Arterial supply from: (internal thoracic arteries → subclavian arteries → intercostal arteries)

Answer 2

• Laterally: axillary artery
• Medially: internal thoracic artery *arise from subclavian arteries in root of neck
• 2nd-4th intercostal arteries

Question 3

-Venous drainage (going backward):

Answer 3

• Parallel arteries,
• into axillary, internal thoracicveins/ brachiocephalic veins, intercostal veins
• Upper Post Veins on left form left superior intercostal vein → left brachiocephalic vein.
• Upper Post Veins on Right form right superior intercostal vein → azygous vein

Question 4

-Lymphatic drainage of thoracic wall:

Answer 4

• remaining into parasternal nodes, associated with internal thoracic artery
• follows post intercostal arteries connecting with intercostal nodes
• Upper thorax: R/L bronchomediastinal trunks
• Lower thorax: thoracic duct
• With diaphragm nodes
• brachiocephalic, lateral aortic nodes
• axillary lymph nodes
• Laterally, they drain into axillary region

Question 5

• Innervation of thoracic wall:

- **2nd-4th intercostal space branches supply antermedial breast parts

Answer 5

• Intercostal nerves: Anterior rami of spinal nerves T1 to T11
  
  • Begins at Lateral cutaneous branchh and ends at anterior cutaneous branches
  • Carry motor/sensory info and postgang sympathetic fibers to periphery

           -Also  anterior ramus T1
    
           - Intercostobrachial nerve

  • Muscles, skins, and abs

-**In men, 4th/5th intercostal space

Question 6

-Lymphatic vessels from medial breast drain into parasternal nodes on deep surface of thoracic wall.

Answer 6

• 75% drain laterally/superiorly into axillary nodes
• remaining into parasternal nodes, associated with internal thoracic artery
• follows post intercostal arteries connecting with intercostal nodes
• Upper thorax: R/L bronchomediastinal trunks
• Lower thorax: thoracic duct
• With diaphragm nodes
• brachiocephalic, lateral aortic nodes
• axillary lymph nodes
• Laterally, they drain into axillary region

Question 7

-4th-6th intercostal nerves carry sensation away from breast

Answer 7

• Innervation
  
  • Breast via anterior/lateral 2nd to 6th intercostal nerves
  • Nipple by 4th intercostal nerve.