Henry Gray (18251861). Anatomy of the Human Body. 1918.
lower down, the right internal mammary and right inferior thyroid veins, and sometimes the vein from the first intercostal space.
The Left Innominate Vein (v. anonyma sinistra), about 6 cm. in length, begins behind the sternal end of the clavicle and runs obliquely downward and to the right behind the upper half of the manubrium sterni to the sternal end of the first right costal cartilage, where it unites with the right innominate vein to form the superior vena cava. It is separated from the manubrium sterni by the Sternohyoideus and Sternothyreoideus, the thymus or its remains, and some loose areolar tissue. Behind it are the three large arteries, innominate, left common carotid, and left subclavian, arising from the aortic arch, together with the vagus and phrenic nerves. The left innominate vein may occupy a higher level, crossing the jugular notch and lying directly in front of the trachea.
Tributaries.Its tributaries are the left vertebral, left internal mammary, left inferior thyroid, and the left highest intercostal veins, and occasionally some thymic and pericardiac veins.
Peculiarities.Sometimes the innominate veins open separately into the right atrium; in such cases the right vein takes the ordinary course of the superior vena cava; the left veinleft superior vena cava, as it is then termedwhich may communicate by a small branch with the right one, passes in front of the root of the left lung, and, turning to the back of the heart, ends in the right atrium. This occasional condition in the adult is due to the persistence of the early fetal condition, and is the normal state of things in birds and some mammalia.
The internal mammary veins (vv. mammariæ internæ) are venæ comitantes to the lower half of the internal mammary artery, and receive tributaries corresponding to the branches of the artery. They then unite to form a single trunk, which runs up on the medial side of the artery and ends in the corresponding innominate vein. The superior phrenic vein,i.e., the vein accompanying the pericardiacophrenic artery, usually opens into the internal mammary vein.
The inferior thyroid veins (vv. thyreoideæ inferiores) two, frequently three or four, in number, arise in the venous plexus on the thyroid gland, communicating with the middle and superior thyroid veins. They form a plexus in front of the trachea, behind the Sternothyreoidei. From this plexus, a left vein descends and joins the left innominate trunk, and a right vein passes obliquely downward and to the right across the innominate artery to open into the right innominate vein, just at its junction with the superior vena cava; sometimes the right and left veins open by a common trunk in the latter situation. These veins receive esophageal tracheal, and inferior laryngeal veins, and are provided with valves at their terminations in the innominate veins.
The highest intercostal vein (v. intercostalis suprema; superior intercostal veins) (right and left) drain the blood from the upper three or four intercostal spaces. The right vein (v. intercostalis suprema dextra) passes downward and opens into the vena azygos; the left vein (v. intercostalis suprema sinistra) runs across the arch of the aorta and the origins of the left subclavian and left common carotid arteries and opens into the left innominate vein. It usually receives the left bronchial vein, and sometimes the left superior phrenic vein, and communicates below with the accessory hemiazygos vein.
The superior vena cava (v. cava superior) drains the blood from the upper half of the body. It measures about 7 cm. in length, and is formed by the junction of the two innominate veins. It begins immediately below the cartilage of the right first rib close to the sternum, and, descending vertically behind the first and second intercostal spaces, ends in the upper part of the right atrium opposite the upper border of the third right costal cartilage: the lower half of the vessel is within the pericardium. In its course it describes a slight curve, the convexity of which is to the right side.