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Neurovasculature of the thoracic wall: want to learn more about it?

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Neurovasculature of the thoracic wall

Learning objectives

After completing this study unit you will be able to:

  1. Identify the main arteries of the thoracic wall and their branches.
  2. Describe the venous drainage of the thoracic wall.
  3. List the main nerves of the thoracic wall.

Watch videos

The thoracic wall is a musculoskeletal framework consisting of the rib cage, muscles, fascias and skin that enclose the thoracic cavity. It has a rich arterial supply via branches that arise from three main sources: the subclavian artery, axillary artery and the thoracic aorta. The veins of the thoracic wall initially follow a similar course to that of their arterial counterparts, however most of them terminate by draining into the azygos venous system. Lastly, the nervous supply to the thoracic wall mainly stems from the anterior rami of the spinal nerves T1-T12 (a.k.a. intercostal/subcostal nerves). Additional supply to the thoracic wall stems from the preterminal branches of the brachial plexus, such as the medial and lateral pectoral nerves.

Watch this video to get an overview of the main arteries, veins and nerves of the thoracic wall.

Take a quiz

Test yourself with the following quiz to see how much information you’ve retained from your learning so far!

You can also customize your own quiz with our custom quiz creator. On this link, you’ll find the preset for a quiz about all the structures of the thoracic wall, including the muscles, bones, ligaments and neurovasculature.

Browse atlas

Here you can find 2 galleries with the arteries, veins and nerves of the thoracic wall seen from different views. You can move between the individual structures and take a closer look at each of them.

Anterior/posterior view

Lateral view

Summary

Key points about the arteries of the thoracic wall
Arteries Internal thoracic artery:
- Origin: Subclavian artery
- Branches: Musculophrenic artery, superior epigastric artery, upper 6 anterior intercostal arteries
Superior thoracic artery:

- Origin: Axillary artery
Lateral thoracic artery:

- Origin: Axillary artery
Anterior intercostal arteries:

- Origin: internal thoracic artery (upper 6), musculophrenic artery (lower 3)
Posterior intercostal arteries:

- Origin: Supreme intercostal artery (upper 2), thoracic aorta (lower 10)
Subcostal artery:

- Origin: thoracic aorta
Veins Anterior intercostal veins:
- Drain into: internal thoracic vein
Posterior intercostal veins:

- Supreme intercostal vein drains into: brachiocephalic vein
- Superior intercostal vein drains into: azygos/left brachiocephalic vein
- Right 4th-11th drain into: azygos vein
- Left 4th-7th drain into: accessory intercostal vein
- Left 8th-11th drain into: hemiazygos vein
Superior intercostal vein:

- Drains into: left brachiocephalic vein (left), azygos vein (right)
Subcostal vein:

- Drains into: azygos vein
Nerves Thoracic nerves:
- Anterior rami of spinal nerves T1-T11: intercostal nerves
- Anterior ramus of spinal nerve T12: subcostal nerve
Brachial plexus:

- Long thoracic nerve (C5, C6, C7)
- Lateral pectoral nerve (C5, C6, C7)
- Medial pectoral nerve (C8, T1)

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