Thoracic Veins and Lymphatics

Question 1

Answer 1

Question 2

Brachiocephalic (BC) Veins are formed __________ to the sternoclavicular joints by union of _________ and _______________. They lie __________ to arteries and the ___________ is twices as long as the _____________. They unite to form the _____________

Answer 2

Brachiocephalic (BC) Veins are formed posterior to the sternoclavicular joints by union of internal jugular** and **subclavian veins

• Lie anterior to arteries
• Left is more than twice as long as right
• Both unite at the level of 1stcostal cartilage on right (about halfway up the manubrium) to form the superior vena cava (SVC)

Question 3

Superior Vena Cava (SVC) is separated from pleura by ______________ laterally

Answer 3

Superior Vena Cava (SVC) is separated from pleura by right phrenic nerve laterally

Question 4

In superior mediastinum:

• _______ lie in front of _________
• Pass downward and to the ______ of the arteries
• Continue posteriorly so that exit of arteries from ventricles lies ________ to entry of veins into atria
• Related to?

Answer 4

In superior mediastinum:

• Veins lie in front of arteries
• Pass downward and to the right of the arteries
• Continue posteriorly so that exit of arteries from ventricles lies anterior to entry of veins into atria
• Related to the way in which the heart folds in the embryo

Question 5

Azygos System of Veins forms an important collateral pathway between?

Major Veins in System?

Answer 5

Inferior vena cava

Superior vena cava

Major veins in system:

• Azygosvein (right)
• Hemiazygos& accessory hemiazygosveins (left)

Question 6

______________ equivalent to azygos, but on left

Answer 6

Hemiazygos system: equivalent to azygos, but on left

Question 7

Answer 7

Question 8

At ______ the Hemiazygos veins cross ________ to: Aorta, Thoracic duct. Oesophagus joining the azygos vein at _____ level

Answer 8

At T9** the Hemiazygos veins cross **right posterior** to: Aorta, Thoracic duct. Oesophagus joining the azygos vein at **T9 level

Question 9

_______________ returns blood from all structures below diaphram

Answer 9

Inferior Vena Cava returns blood from all structures below diaphragm

Question 10

The inferior Vena Cava passes through:

__________: T8

__________: T10

__________: T12

Answer 10

The inferior Vena Cava passes through:

Diaphragm: T8

Oesophagus: T10)

Aortic hiatus: T12

Question 11

Answer 11

Question 12

Functions of Lymphatics?

Answer 12

• Drainage of tissue fluid from interstitial spaces (≈8 litre/day) –helps maintain appropriate fluid balance in the body
• Recovery of plasma proteins, hormones, enzymes (~200g/day) that leak into interstitial space
• Absorption of fat from the intestine → transport of chyle (rich in triglycerides, good energy source) to the venous system
• Immunological defense (at lymph nodes –masses of B-lymphocytes, T-lymphocytes and macrophages)

Question 13

Mechanisms for Lymphatic Flow?

Answer 13

Mechanisms for Lymphatic Flow

• Contraction of lymphatic vessels
• Contraction of skeletal muscles
• Thoracic pressure changes

Question 14

Superficial Collecting Vessels Drain to?

Answer 14

Superficial drain to the pectoral and central groups of axillary nodes

Question 15

Deep Lymphatic collecting vessel drainage:

• Parasternal: drain to ___________
• Intercostal: lie in intercostal spaces; drain to ____________ and _____________
• Diaphragmatic: on the thoracic surface, drain to ______________ and _______________

Answer 15

Deep Lymphatic collecting vessel drainage:

• Parasternal: drain to bronchomediastinal lymph trunk
• Intercostal: lie in intercostal spaces; drain to right lymphatic duct and thoracic duct
• Diaphragmatic: on the thoracic surface, drain to parasternal and posterior mediastinal nodes

Question 16

Tracheobronchial nodes:

Run alongside _______ & __________

Drain ______, _____ and _______; efferents join those of anterior mediastinal nodes to form ______________

Answer 16

Tracheobronchial nodes:

Run alongside trachea & main bronchi

Drain lungs, trachea and heart; efferents join those of anterior mediastinal nodes to form BRONCHOMEDIASTINAL TRUNK

Question 17

Principal channel through which lymph from most of the body is returned to venous system?

Answer 17

Thoracic Duct

Question 18

The Thoracic Duct

• Commences at the cisterna chyli at ______ level
• Passes from abdomen through _________________

Answer 18

The Thoracic Duct

• Commences at the cisterna chyli at T12 level
• Passes from abdomen through aortic hiatus of diaphragm

Question 19

The Thoracic Trunk drains all __________ of body, and:

• Left head & neck (_____________)
• Left thorax* (________________)
• Left upper limb (______________)

Answer 19

The Thoracic Trunk drains all lower half of body, and:

• Left head & neck (L. jugular trunk)
• Left thorax* (L. bronchomediastinaltrunk)
• Left upper limb (L. subclaviantrunk)

Question 20

__________ + ___________+ __________ trunks unite to drain into Right brachiocephalic vein via the ______________

Answer 20

Jugular + Subclavian+ Bronchmediastinal trunks unite to drain into Right brachiocephalic vein via the right lymphatic duct

Question 21

Accumulation of chyle in pleural cavity due to obstruction of/or leak from thoracic duct (or tributary)?

Answer 21

Chylothorax