Superior vena cava

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Superior vena cava
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The superior vena cava drains from the left and right brachiocephalic veins into the right atrium
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Details
Precursor Common cardinal veins
Drains fromLeft and right brachiocephalic veins
Source Brachiocephalic vein, azygos vein
Drains to Right atrium
Identifiers
Latin vena cava superior, vena maxima
MeSH D014683
TA98 A12.3.03.001
TA2 4745
FMA 4720
Anatomical terminology

The superior vena cava (SVC) is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. It is a large-diameter (24 mm) short length vein that receives venous return from the upper half of the body, above the diaphragm. Venous return from the lower half, below the diaphragm, flows through the inferior vena cava. The SVC is located in the anterior right superior mediastinum. [1] It is the typical site of central venous access via a central venous catheter or a peripherally inserted central catheter. Mentions of "the cava" without further specification usually refer to the SVC.[ citation needed ]

Contents

Structure

The superior vena cava is formed by the left and right brachiocephalic veins, which receive blood from the upper limbs, head and neck, behind the lower border of the first right costal cartilage. It passes vertically downwards behind the first intercostal space and receives the azygos vein just before it pierces the fibrous pericardium opposite the right second costal cartilage and its lower part is intrapericardial. It then terminates in the upper and posterior part of the sinus venarum of the right atrium, at the upper right front portion of the heart. It is also known as the cranial vena cava in other animals. No valve divides the superior vena cava from the right atrium.

The superior vena cava is made up of three layers, starting with the innermost endothelial tunica intima. The middle layer is the tunica media, composed of smooth muscle tissue, and the outermost and thickest layer is the tunica adventitia, composed of collagen and elastic connective tissue that allow for flexibility. [2] [3] The tunica adventitia contains three zones, with the middle zone consisting of few smooth muscle fibers; this differs from the longitudinal bundles of smooth muscle found in the same zone of the inferior vena cava. [4]

Anatomical variation

The most common anatomical variation is a persistent left superior vena cava. In persons with a persistent left superior vena cava, the right superior vena cava may be normal, small or absent, with or without an anterior communicating vein. This variation is present in less than 0.5% of the general population, but in up to 10% in patients with congenital heart disease. [5]

Clinical significance

Superior vena cava obstruction refers to a partial or complete obstruction of the superior vena cava, typically in the context of cancer such as a cancer of the lung, metastatic cancer, or lymphoma. Obstruction can lead to enlarged veins in the head and neck, and may also cause breathlessness, cough, chest pain, and difficulty swallowing. Pemberton's sign may be positive. Tumours causing obstruction may be treated with chemotherapy and/or radiotherapy to reduce their effects, and corticosteroids may also be given. [6]

In tricuspid valve regurgitation, these pulsations are very strong. [ clarification needed ]

No valve divides the superior vena cava from the right atrium. As a result, the (right) atrial and (right) ventricular contractions are conducted up into the internal jugular vein and, through the sternocleidomastoid muscle, can be seen as the jugular venous pressure.

Additional images

See also

Related Research Articles

<span class="mw-page-title-main">Vein</span> Blood vessels that carry blood towards the heart

Veins are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation, arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins. If you want to remember the functions of veins and arteries, then no need to remember both, you can remember one i.e., either veins or arteries because both are totally opposite, completely opposite.

<span class="mw-page-title-main">Inferior vena cava</span> One of two veinous trunks bringing deoxygenated blood back to the heart

The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of the fifth lumbar vertebra.

<span class="mw-page-title-main">Azygos vein</span> Human blood vessel by the spine

The azygos vein is a vein running up the right side of the thoracic vertebral column draining itself towards the superior vena cava. It connects the systems of superior vena cava and inferior vena cava and can provide an alternative path for blood to the right atrium when either of the venae cavae is blocked.

<span class="mw-page-title-main">Fontan procedure</span> Surgical procedure used in children with univentricular hearts

The Fontan procedure or Fontan–Kreutzer procedure is a palliative surgical procedure used in children with univentricular hearts. It involves diverting the venous blood from the inferior vena cava (IVC) and superior vena cava (SVC) to the pulmonary arteries. The procedure varies for differing congenital heart pathologies. For example in tricuspid atresia, the procedure can be done where the blood does not pass through the morphologic right ventricle; i.e., the systemic and pulmonary circulations are placed in series with the functional single ventricle. Whereas in hypoplastic left heart syndrome, the heart is more reliant on the more functional right ventricle to provide blood flow to the systemic circulation. The procedure was initially performed in 1968 by Francis Fontan and Eugene Baudet from Bordeaux, France, published in 1971, simultaneously described in July 1971 by Guillermo Kreutzer from Buenos Aires, Argentina, presented at the Argentinean National Cardilogy meeting of that year and finally published in 1973.

<span class="mw-page-title-main">Dialysis catheter</span>

A dialysis catheter is a catheter used for exchanging blood to and from a hemodialysis machine and a patient.

<span class="mw-page-title-main">Cardiac catheterization</span> Insertion of a catheter into a chamber or vessel of the heart

Cardiac catheterization is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes.

<span class="mw-page-title-main">Jugular vein</span> Veins that bring deoxygenated blood from the head back to the heart

The jugular veins are veins that take blood from the head back to the heart via the superior vena cava. The internal jugular vein descends next to the internal carotid artery and continues posteriorly to the sternocleidomastoid muscle.

<span class="mw-page-title-main">Atrium (heart)</span> Part of the human heart

The atrium is one of the two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular mitral and tricuspid heart valves.

<span class="mw-page-title-main">Superior vena cava syndrome</span> Group of symptoms caused by obstruction of the superior vena cava

Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the superior vena cava ("SVC"), a short, wide vessel carrying circulating blood into the heart. The majority of cases are caused by malignant tumors within the mediastinum, most commonly lung cancer and non-Hodgkin's lymphoma, directly compressing or invading the SVC wall. Non-malignant causes are increasing in prevalence due to expanding use of intravascular devices, which can result in thrombosis. Other non-malignant causes include benign mediastinal tumors, aortic aneurysm, infections, and fibrosing mediastinitis.

<span class="mw-page-title-main">Internal jugular vein</span> Blood vessel that drains the head

The internal jugular vein is a paired jugular vein that collects blood from the brain and the superficial parts of the face and neck. This vein runs in the carotid sheath with the common carotid artery and vagus nerve.

<span class="mw-page-title-main">Coronary sinus</span> Set of veins which drain blood from the myocardium (heart muscle)

The coronary sinus is the largest vein of the heart. It drains over half of the deoxygenated blood from the heart muscle into the right atrium. It begins on the backside of the heart, in between the left atrium, and left ventricle; it begins at the junction of the great cardiac vein, and oblique vein of the left atrium. It receives multiple tributaries. It passes across the backside of the heart along a groove between left atrium and left ventricle, then drains into the right atrium at the orifice of the coronary sinus.

The term Great veins can refer to either —

<span class="mw-page-title-main">Valve of inferior vena cava</span>

The valve of the inferior vena cava is a venous valve that lies at the junction of the inferior vena cava and right atrium.

<span class="mw-page-title-main">Vena caval foramen</span> Part of the diaphragm

The caval opening of diaphragm is an opening in the central tendon of diaphragm giving passage to the inferior vena cava as well as to some terminal branches of the right phrenic nerve, and some lymphatic vessels en route to middle phrenic and mediastinal lymph nodes. The foramen occurs between the middle leaf and the right leaf of the central tendon of diaphragm, with the fibres of the central tendon uniting vigorously with the adventitia of the inferior vena cava.

<span class="mw-page-title-main">Lumbar veins</span> Veins that drain the posterior abdominal wall

The lumbar veins are four pairs of veins running along the inside of the posterior abdominal wall, and drain venous blood from parts of the abdominal wall. Each lumbar vein accompanies a single lumbar artery. The lower two pairs of lumbar veins all drain directly into the inferior vena cava, whereas the fate of the upper two pairs is more variable.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Cavoatrial junction</span> Place where a major vein joins the heart

The cavoatrial junction (CAJ) is the point at which the superior vena cava meets and melds into the superior wall of the cardiac right atrium. Both the superior and inferior vena cavae enter the right atrium, but only the superior entry is called the cavoatrial junction. This junction marks the inferior end of the superior vena cava, the continuation below that point being considered part of the heart.

<span class="mw-page-title-main">Venae cavae</span> Large veins which return blood from the body into the heart

In anatomy, the venae cavae are two large veins that return deoxygenated blood from the body into the heart. In humans they are the superior vena cava and the inferior vena cava, and both empty into the right atrium. They are located slightly off-center, toward the right side of the body.

The heart is a muscular organ situated in the mediastinum. It consists of four chambers, four valves, two main arteries, and the conduction system. The left and right sides of the heart have different functions: the right side receives de-oxygenated blood through the superior and inferior venae cavae and pumps blood to the lungs through the pulmonary artery, and the left side receives saturated blood from the lungs.

Raghib syndrome is rare a congenital heart defect where the left superior vena cava (LSVC) is draining into the left atrium in addition to an absent coronary sinus and an atrial septal defect. This can be considered a dangerous heart condition because it puts the individual at a high risk of stroke. Other defects that are often associated with Raghib syndrome can include ventricular septal defects, enlargement of the tricuspid annulus, and pulmonary stenosis. While this is considered an extremely rare developmental complex, cases regarding a persistent left superior vena cava (PLSVC) are relatively common among congenital heart defects. It is also important to note that the PLSVC often drains into the right atrium, and only drains into the left atrium in approximately 10 to 20% of individuals with the defect.

References

  1. "General Practice Notebook". www.gpnotebook.co.uk. Retrieved April 6, 2018.
  2. White, Hunter J.; Soos, Michael P. (2021), "Anatomy, Thorax, Superior Vena Cava", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   31424839 , retrieved November 24, 2021
  3. Hashizume, H.; Ushiki, T.; Abe, K. (1995). "A histological study of the cardiac muscle of the human superior and inferior venae cavae". Archives of Histology and Cytology. 58 (4): 457–464. doi: 10.1679/aohc.58.457 . ISSN   0914-9465. PMID   8562136.
  4. Zhang, Shu-Xin (1999). An Atlas of Histology. New York: Springer. pp. 131–133.
  5. Sonavane, Sushilkumar K.; Milner, Desmin M.; Singh, Satinder P.; Abdel Aal, Ahmed Kamel; Shahir, Kaushik S.; Chaturvedi, Abhishek (October 9, 2015). "Comprehensive Imaging Review of the Superior Vena Cava". RadioGraphics. 35 (7): 1873–1892. doi: 10.1148/rg.2015150056 . ISSN   0271-5333. PMID   26452112.
  6. Britton, the editors Nicki R. Colledge, Brian R. Walker, Stuart H. Ralston ; illustrated by Robert (2010). Davidson's principles and practice of medicine (21st ed.). Edinburgh: Churchill Livingstone/Elsevier. p. 268. ISBN   978-0-7020-3085-7.{{cite book}}: |first= has generic name (help)CS1 maint: multiple names: authors list (link)