Great vessels (dave's notes) Flashcards
List the great vessels
Arch of the aorta Brachiocephalic trunk Left and right common carotid Subclavian arteries Brachiocephalic veins Superior vena cava Ligamentum arteriosum
What is the course of the arch of the aorta?
Passes from manubriosternal angle (costal cartilage 2) to to T4, front to back, just to the left, over the left bronchus and the bifurcation of the pulmonary trunk
What does the arch of the aorta give off at its apex?
The brachicephalic trunk, left common carotid artery and the left subclavian artery
What lies to the left of the arch of the aorta?
The phrenic (anteriorly)
The vagus nerves (posteriorly)
Sympathetic and vagus branches of the superficial cardiac plexus
Describe the course of the left superior intercostal vein
Passes forwards, superficial to vagus, deep to phrenic and to the brachiocephalic vein
Describe the course of the left recurrent laryngeal nerve
Hooks around the arch posterior to the left atrium, passing back up on the right hand side.
What happens within the concavity of the aortic arch?
The pulmonary artery bifurcates into right and left pulmonary arteries
What lies on the right hand side of the aortic arch?
The trachea and oesophagus
What is in the adventitial layer? What supplies these?
Baroreceptors. Supplied by vagal fibres.
What lies under the arch? What do these detect?
Aortic bodies. These detect hypoxia. Supplied by vagal fibres.
Where does the brachiocephalic trunk arise? What is its course?
Arises a little to the left, but slopes up to the right across the trachea, to the right sternoclavicular joint where it divides into the right common carotid and the subclavian artery.
Other than the right common carotid, and the right subclavian artery, what branches does the brachiocephalic trunk have?
No other branches except for the rare thyroidea ima artery.
Where does the left common carotid arise? What is its course?
The left common carotid arises just behind the brachiocephalic trunk and slopes in front of the trachea
Where does the left subclavian artery arise? What is its course?
The left subclavian artery arises next after the left common carotid. It arches over the apex of the lung, leaving the common carotid artery just behind the sternoclavicular joint.
What is the ligamentum arteriosum?
The remnant of the ductus arteriosus from the left pulmonary artery to the concavity of the aortic arch.
What are the relations of the ligamentum arteriosum?
The left recurrent laryngeal nerve hooks around it, and the superficial part of the cardiac plexus lies anterior to it.
Where are the brachiocephalic veins formed? From what tributaries?
Behind the sternoclavicular joints, from the internal jugular veins and the subclavian veins.
What are the relations of the internal jugular vein?
The IJV lies lateral to the common carotid artery and in front of scalenus anterior.
What are the relations of the subclavian vein?
The SCV lies lateral to and then below scalenus anterior
What is the course of the right brachiocephalic vein? What does it receive?
Runs vertically downwards (right anterior cardinal vein??), receiving the right lymphatic duct and right jugular and subclavian lymph trunks - enter independently of each other.
What is the course of the left brachiocephalic vein?
Passes almost horizontally to form the SCV at the 1st right costal cartilage (??persistent anastomotic channel between the two anterior cardinal veins).
What does the left brachiocephalic vein receive?
At its commencement it receives the thoracic duct and the vertebral, internal thoracic, interior thyroid pleases of veins, the left superior intercostal veins and a large thymic vein.
What happens to the SVC at the 1st right costal cartilage?
Commences at the border of the sternum
What happens to the SVC at the 2nd right costal cartilage?
Pierces the pericardium and receives the azygous vein (T4)
What happens to the SVC at the 3rd right costal cartilage?
Enters the upper border of the right atrium
