Thoracic Angiology

Question 1

Ligamentum Arteriosum

Answer 1

• Fibrous cord that connects the aortic arch to the L pulmonary artery
• Embryological remnant of ductus arteriosus

Question 2

Why is the Posterior Cusp of the Aorta called the non-coronary cusp?

Answer 2

Because there is no coronary artery arising from its sinus

Question 3

Where does the descending aorta begin?

Answer 3

At the lower edge of T4

Question 4

RCA Area of Distribution

Answer 4

• RA
• RV
• SA Node
• AV Node
• Interatrial Septum
• Partial LA
• Posteroinferior third of Interventricular Septum
• Portion of Posterior part of LV

Question 5

LCA Area of Distribution

Answer 5

• LA
• LV
• Most of Interventricular Septum
• AV Bundle and Branches

Question 6

Tributaries to the Coronary Sinus

Answer 6

• Great Cardiac Vein
• Small Cardiac Vein
• Middle Cardiac Vein
• Posterior Cardiac Vein

Question 7

Anterior Veins of Right Ventricle (Anterior Cardiac Veins)

Answer 7

• Arise on anterior surface of right ventricle
• Cross the coronary sulcus and enter anterior wall of right atrium

Question 8

Venae Cordis Minimae

Answer 8

Very small veins that drain directly into all chambers

Question 9

Thoracic Aorta

Answer 9

• Begins at lower edge of T4
• Ends anterior to the lower edge of T12 as it passes thru the aortic hiatus posterior to the diaphram
• Branches: bronchial (2 on L, 1 on R), esophageal, pericardial, mediastinal, posterior intercostal, superior phrenic

Question 10

Internal Thoracic Artery

Answer 10

• Paired arteries, deep to the ribs, on either side of the sternum
• Arise from the Subclavian A superiorly and ends inferiorly at the sixth intercostal space where it divides into Superior Epigastric and Musculophrenic arteries

Question 11

Branches of Internal Thoracic Artery

Answer 11

• Pericardiacophrenic
• Anterior Intercostal
• Anterior Perforating

Question 12

Arterial Supply of the Pericardium

Answer 12

Mainly from the Pericardiacophrenic, but does get smaller contributions from:
- Musculophrenic
- Bronchial
- Esophageal
- Superior Phrenic
- Coronary

Question 13

Important collateral channel capable of returning venous blood to the heart from lower part of body if the IVC is blocked:

Answer 13

Azygos system of Veins

Question 14

Azygos Vein is located on the __ side of the body

Answer 14

RIGHT

Question 15

Hemiazygos Veins located on the ___ side of the body

Answer 15

LEFT

Question 16

What two veins come together to form the Superior Vena Cava?

Answer 16

Right and Left Brachiocephalic Veins

Question 17

Thoracic Duct

Answer 17

• Largest lymphatic channel in the body
• Conveys most lymph of the body to the venous system: that from the lower limbs, pelvic cavity, abdominal cavity, L upper limb, L side of thorax/head/neck — essentially drains lymphatic system from below diaphragm and left side of thoracic wall

Question 18

Lymphatic Drainage of the Heart

Answer 18

• Lymphatic vessels follow the coronary arteries
• Drainage empties into the Brachiocephalic and Tracheobronchial Nodes

Question 19

Lymphatic Drainage of the Lungs

Answer 19

• Drain directly to the Bronchopulmonary Nodes then drain into the Tracheobronchial Nodes then drain into the Bronchomediastinal Trunks
• Bronchomediastinal Trunks continue superiorly and empty into the venous system at the junction of the internal jugular and subclavian veins

Question 20

What are the major lymph conduits draining thoracic viscera?

Answer 20

Right and Left bronchomediastinal lymph trunks

Question 21

Venous Angles

Answer 21

Junction of internal jugular and subclavian veins where lymph drains

Question 22

Lymph from Parietal Pleura drains into:

Answer 22

Lymph nodes of Thoracic Wall

Question 23

Lymph Nodes of Thoracic Wall

Answer 23

• Intercostal
• Parasternal
• Mediastinal
• Phrenic

Question 24

Subpleural Lymphatic Plexus

Answer 24

• Located deep to visceral pleura
• Drains lung parenchyma and visceral pleura
• Drain into bronchopulmonary lymph nodes