Inferior vena cava (dave's notes)

Question 1

At what thoracic levels does the IVC originate and terminate? How does this compare to the aorta?

Answer 1

IVC L5-T8, Aorta T12-T4

Question 2

How does the IVC lie relative to the aorta?

Answer 2

The IVC runs to the right of the aorta, lying on the lumbar vertebral bodies.

Question 3

What are the other significant other anatomical relations of the IVC?

Answer 3

The IVC overlaps the sympathetic trunk and crosses the right renal artery. It lies 2.5cm to the right of the midline of the inter tubercular line???? to t.5cm right of xiphisternum??

Question 4

How do tributaries approach the aorta?

Answer 4

Lower down the tributaries lie posterior, more superiorly the tributaries lie anterior

Question 5

How is the IVC placed in the infracolic compartment?

Answer 5

It lies behind the peritoneum, crossed by the root of the mesentery and D3

Question 6

How is the IVC placed in the supracolic compartment?

Answer 6

In the supracolic compartment the IVC lies behind the portal vain, head of pancreas, bile duct and posterior slit of EF??? to the bare area of the liver.

Question 7

How to tributaries relate to aortic branches?

Answer 7

They are not analogous. Blood from the GI track, pancreas, and spleen is collected into the portal venous system.

Question 8

Describe the common iliac vein and its immediate tributaries

Answer 8

The common iliac vein is formed infront of the sacroiliac joint by the external and internal iliac veins. These travel up behind the arteries. The left CI is longer than the right C iliac.

Question 9

Other than external and internal iliac veins, what other tributaries does the common iliac receive?

Answer 9

Iliolumbar +/- lateral sacral. The left usually receives the median sacral artery.

Question 10

What accompanies the 4th and 3rd lumbar veins?

Answer 10

Arteries draining the lateral and posterior abdominal wall (behind the sympathetic trunks).

Question 11

What do the 2nd and 1st lumbar arteries drain into?

Answer 11

The ascending lumbar vein. “each unites common iliac vein and iliolumbar vein passing upwards behind psoas in front of the lumbar transverse processes

Question 12

Describe the course of the ??ascending lumbar vein

Answer 12

Each unites CIV and ILV passing upwards behind psoas in front of the lumbar transverse processes. The right side passes through the aortic opening. The left perforates the left crus.

Question 13

What joins the ascending lumbar vein? What do they become?

Answer 13

The subcostal veins, to form the azygous (right) and hemiazygous (left) veins.

Question 14

List the tributaries of the IVC

Answer 14

External iliac
Internal iliac
4th and 3rd lumbar veins
Gonadal veins
Renal veins
Right lumbar azygous vein
Right suprarenal vein
Inferior phrenic veins 
Hepatic veins

Question 15

Describe the course of the gonadal veins

Answer 15

These are usually paired, then later unite. On the right the vein usually enters the IVC but may enter the renal vein. On the left, the left gonadal joins the left renal vein

Question 16

Which renal vein is the longest? By how much?

Answer 16

The left renal vein is three times as long as the right

Question 17

What does the left renal vein cross? What tributaries does it have?

Answer 17

The left renal vein crosses the aorta. It receives suprarenal and gonadal veins, +/- the inferior phrenic artery.

Question 18

What and where is the right lumbar azygous vein?

Answer 18

The right lumbar azygous vein is a small vessel (+/- obliterated) that connects the posterior IVC with the azygous vein. It lies at renal vein level, behind psoas.

Question 19

What and where is the right suprarenal vein?

Answer 19

The right suprarenal vein is a short stout vessel entering the IVC behind the bare area of the liver - here the gland lies in contact with the liver and the IVC.

Question 20

Where are the inferior phrenic veins found?

Answer 20

The inferior phrenic veins accompany their arteries and join the IVC just below the diaphragm.

Question 21

Name the hepatic veins. What do they drain? Where do they enter the IVC?

Answer 21

Left, central and right hepatic veins enter the vena cava as it grooves the back of the liver. The central vein drains both halves.