AORTIC ARCH

 Runs upwards, backwards and to the left, initially anterior then to the left of the trachea

Branches

 Brachiocephalic artery which divides into the right common carotid and right subclavian arteries
 Left common carotid artery
 Left subclavian artery

DESCENDING THORACIC AORTA

 Begins on the left side of the lower border of T4

 Descends in the posterior mediastinum and ends at the aortic opening of the diaphragm at the level of T12
where it continues as the abdominal aorta

Branches

 Posterior intercostal arteries

 Subcostal artery
 Pericardial, oesophageal and bronchial arteries

THE PULMONARY TRUNK

 5cm long begins at the pulmonary valve, runs upwards, backwards and to the left, terminating in the
concavity of the aortic arch by dividing into the left and right pulmonary arteries. Lies anterior to the trachea
 Connected to the aortic arch by the ligamentum arteriosum (remnant of the ductus arteriosus)
 The left recurrent laryngeal nerve hooks around the ligamentun arteriosum

INTERNAL THORACIC ARTERY

 Branch of the first part of the subclavian artery

 Supplies the anterior wall of the body from the clavicle to the umbilicus
 Descends on the pleura deep to the costal cartilages
 Ends at the 6th intercostal space dividing into the superior epigastric and musculophrenic arteries
 Gives off two anterior intercostal arteries to the upper 6 intercostal spaces
 Pericardiophrenic artery to the pericardium
 Mediastinal arteries to the anterior mediastinum including the thymus
 Perforating arteries to thoracic and anterior abdominal wall
 The internal thoracic vein drains into the brachiocephalic vein

SUPERIOR VENA CAVA

 Formed from the left and right brachioceplalic veins (which are formed from the subclavian and internal
jugular veins)
 Receives the azygos vein just before piercing the pericardium
 Lies anterior to the trachea and aorta in the superior mediastinum

THORACIC DUCT
 Begins in the abdomen as the cysterna chyli
 Enters thorax through aortic opening of the diaphragm on the right side of the descending aorta
 Crosses the mid-line posterior to the oesophagus
 Ascends on the left side of the oesophagus within the superior mediastinum
 Drains into the left brachiocephalic vein
 Receives the LEFT bronchomediastinal, jugular and subclavian lymph trunks
 Conveys lymph from the lower limbs, pelvis, abdomen, left side of the thorax, left side of the head and neck
and left upper limb into the blood stream
 Lymph from the right side of the head and neck, right upper limb and right side of the thorax is drained by
the right jugular, subclavian and bronchomediastinal trunks respectively. These may unite to form the right
thoracic duct which drains into the right brachiocephalic vein or drain independently in to the vain