Great vessels (dave's notes)

Question 1

List the great vessels

Answer 1

Arch of the aorta
Brachiocephalic trunk
Left and right common carotid
Subclavian arteries
Brachiocephalic veins
Superior vena cava
Ligamentum arteriosum

Question 2

What is the course of the arch of the aorta?

Answer 2

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

Question 3

What does the arch of the aorta give off at its apex?

Answer 3

The brachicephalic trunk, left common carotid artery and the left subclavian artery

Question 4

What lies to the left of the arch of the aorta?

Answer 4

The phrenic (anteriorly)
The vagus nerves (posteriorly)
Sympathetic and vagus branches of the superficial cardiac plexus

Question 5

Describe the course of the left superior intercostal vein

Answer 5

Passes forwards, superficial to vagus, deep to phrenic and to the brachiocephalic vein

Question 6

Describe the course of the left recurrent laryngeal nerve

Answer 6

Hooks around the arch posterior to the left atrium, passing back up on the right hand side.

Question 7

What happens within the concavity of the aortic arch?

Answer 7

The pulmonary artery bifurcates into right and left pulmonary arteries

Question 8

What lies on the right hand side of the aortic arch?

Answer 8

The trachea and oesophagus

Question 9

What is in the adventitial layer? What supplies these?

Answer 9

Baroreceptors. Supplied by vagal fibres.

Question 10

What lies under the arch? What do these detect?

Answer 10

Aortic bodies. These detect hypoxia. Supplied by vagal fibres.

Question 11

Where does the brachiocephalic trunk arise? What is its course?

Answer 11

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.

Question 12

Other than the right common carotid, and the right subclavian artery, what branches does the brachiocephalic trunk have?

Answer 12

No other branches except for the rare thyroidea ima artery.

Question 13

Where does the left common carotid arise? What is its course?

Answer 13

The left common carotid arises just behind the brachiocephalic trunk and slopes in front of the trachea

Question 14

Where does the left subclavian artery arise? What is its course?

Answer 14

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.

Question 15

What is the ligamentum arteriosum?

Answer 15

The remnant of the ductus arteriosus from the left pulmonary artery to the concavity of the aortic arch.

Question 16

What are the relations of the ligamentum arteriosum?

Answer 16

The left recurrent laryngeal nerve hooks around it, and the superficial part of the cardiac plexus lies anterior to it.

Question 17

Where are the brachiocephalic veins formed? From what tributaries?

Answer 17

Behind the sternoclavicular joints, from the internal jugular veins and the subclavian veins.

Question 18

What are the relations of the internal jugular vein?

Answer 18

The IJV lies lateral to the common carotid artery and in front of scalenus anterior.

Question 19

What are the relations of the subclavian vein?

Answer 19

The SCV lies lateral to and then below scalenus anterior

Question 20

What is the course of the right brachiocephalic vein? What does it receive?

Answer 20

Runs vertically downwards (right anterior cardinal vein??), receiving the right lymphatic duct and right jugular and subclavian lymph trunks - enter independently of each other.

Question 21

What is the course of the left brachiocephalic vein?

Answer 21

Passes almost horizontally to form the SCV at the 1st right costal cartilage (??persistent anastomotic channel between the two anterior cardinal veins).

Question 22

What does the left brachiocephalic vein receive?

Answer 22

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.

Question 23

What happens to the SVC at the 1st right costal cartilage?

Answer 23

Commences at the border of the sternum

Question 24

What happens to the SVC at the 2nd right costal cartilage?

Answer 24

Pierces the pericardium and receives the azygous vein (T4)

Question 25

What happens to the SVC at the 3rd right costal cartilage?

Answer 25

Enters the upper border of the right atrium