Internal Thoracic aa.
-anterior intercostal aa brach from the internal thoracic aa.
-originates from subclavian aa.
-splits into the superior epigastric & musculophrenic aa @ the 6th intercostal
-used in CABG.
-originates from 2nd part of axillary aa (which comes from the subclavian aa)
-branches include pectoral, clavicular, acromial, deltoid
Posterior Intercostal aa
-branches off the descending thoracic aorta (laterally)
Anterior Intercostal aa
-originate from internal thoracic aa & musculophrenic aa
-supplies intercostal muscles
-two to each intercostal space, b/w internal & innermost intercostal muscles
-drain intercostal muscles/spaces
-on underside of ribs, superior to artery (VAN)
-drains into azygous (right), hemiazygous & accessory hemiazygous (left, lower & upper respectively), -superior intercostal vein & brachiocephalic vein (superiorly)
-thoracocentesis done above rib in order to avoid VAN
-accompanies phrenic nn
-originates from internal thoracic aa, supplies pericardium and diaphragm, ends w/ musculophrenic aa
phrenic front, travels anterior to hilum
in middle mediastinum
Superior Intercostal vv
-drain 2, 3, 4th posterior intercostal vv
-rt drains into azygous just prior to the SVC
-lft drains into L brachiocephalic, also sometimes has connection w/ accessory hemiazygous vv
party in the back, runs posterior to hilum
-gives rise to esophageal, cardiac, pulmonary plexuses
-supplies 90% of parasympathetic preganglionic fibers
Recurrent Larygneal nn
-originates from vagus nn.
-right: loops around subclavian aa
-left: loops around aortic arch (longer, more susceptible
-drops down in tracheoesophageal groove, supplies larynx
Sympathetic chain/trunk & ganglia (cell bodies)
Grey & White Rami communicans:
white carries preganglionic fibers to ganglia (more lateral, visible),
grey carries postganglionic fibers & nonsynapsed preganglionic fibers out of ganglia
sympathetic & parasympathetic innervation of heart
Thoracic Splanchnic nn
-arise from sympathetic chain in thorax and head anterior and inferior from sympathetic chain to supply sympathetic innervation to abdomen.
-carry preganglionic sympathetic & visceral afferent sensory fibers
supplied by sympathetic & parasympathetics (like cardiac plexus)
Greater Occipital nn
mixed, C2 dermatome back of the head,
semispinalis capitis (motor)
-from subclavian aa, goes up thru C1 transverse foramen, travels medially, passes thru posterior membrane and into vertebral canal
-ends in the basilar aa, supplies the brain