Venous drainage of the chest wall

Venous drainage of intercostal spaces
On the outflow of venous blood from the chest wall participate:
 * vv.intercostales anteriores dx. et sin;
 * vv.intercostales posteriores dx. et sin. for 2. to 11. intercostal space;
 * v.intercostalis superior dx. et sin. - one on each side; blood is poured into them from 2. to 4. v.intercostalis posterior;
 * v.intercostalis suprema dx. et sin. - from 1. intercostal space on both sides ;
 * v.subcostalis dx. et sin. - under the 12. rib.

Most of these veins flows into the v.azygos or v.hemiazygos in detail to v.hemiazygos accessoria.

In the mediastinum posterius, to the right on the sides of the thoracic vertebrae runsv.azygos, from left below v.hemiazygos and from left above v.hemiazygos accessoria. Vena azygos arises by confluence of v.lumbalis ascendens dextra and v.subcostalis dextra (v.hemiazygos arises by confluence of veins of the same name on the left).

Vena azygos is located dorsally from the esophagus, to the right of the thoracic duct and aorta thoracica, receives 5. to 11. right intercostal vein and orifices like arcus venae azygos to vena cava superior just before its entry into pericardium. Vena hemiazygos is situated dorsally from the thoracic aorta, blood is poured into it from 9. to 11. intercostal vein on the left and together with v.hemiazygos accessoria flows into v.azygos most often at the vertebral level of Th8. Vena hemiazygos accesoria drains blood from 5. - 8. intercostal space on the right.

First intercostal space drains on both sides v.intercostalis suprema, which flows into the v.brachiocephalica on its side. Veins from '''2. to 4. intercostal space merge on both sides into v.intercostalis superior dx. et sin.'''. This vein on the right side opens into arcus venae azygos and on the left into v.brachiocephalica sin. '''Vena subcostalis dx. et sin. connects with the relevant v.lumbalis ascendens, and so on the right side arises v.azygos or v.hemiazygos''' on the left.

Outflow of chest veins

 * vv.intercostales anteriores -> vv.thoracicae internae

Right side
 * 1. v.intercostalis posterior dx. = v.intercostalis suprema dx. → v.brachiocephalica dx.
 * 2. - 4. vv.intercostales posteriores dx. → v.intercostalis superior dx. → arcus venae azygos
 * 5. - 11. vv.intercostales posteriores dx. → v.&azygos

V. subcostalis dx. after connection with v.lumbalis ascendens dx. creates v.azygos, which flows into the v.cava superior

Left side
 * 1. v.intercostalis posterior sin. = v.intercostalis suprema sin. → v.brachiocephalica sin.
 * 2. - 4. vv.intercostales posteriores sin. → v.intercostalis superior sin. → v.brachiocephalica sin.
 * 5. - 8. vv.intercostales posteriores sin. → v.hemiazygos accessoria → at the vertebral level of Th8 together with v.hemiazygos flows into the v.azygos
 * 9. - 11. vv.intercostales posteriores sin. → v.hemiazygos → v.azygos

V. subcostalis sin. after connection with v.lumbalis ascendens sin. creates v.hemiazygos.

Related articles

 * Arterial supply of the chest wall
 * Chest wall innervation
 * Vídeňská klasifikace gastrointestinálních neoplazií https://www.wikiskripta.eu/w/Soubor:Azyg_final.png

Literature

 * ČIHÁK, Radomír. Anatomie III. 2., upr. a dopl vydání. Praha : Grada Publishing, spol. s. r. o., 2004. 673 s. ISBN 80-247-1132-X