Venous drainage of the thoracic wall

Changed by Daniel J Bell, 21 Jul 2021

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The venous drainage of the thoracic wall drains deoxygenated venous blood from the peripheriesperiphery of the thoracic cage back into the systemic circulation.

Gross anatomy

Anterior thoracic wall
Anterior intercostal veins

The anterior intercostal veins originate from the intercostal space just inferior to anterior aspects of their respective ribs and drain into the internal thoracic and musculophrenic veins.

Posterior thoracic wall
Posterior intercostal veins

The posterior intercostal veins originate from the intercostal space just inferior to posterior aspects of their respective ribs. In the right side, the 4th to 11th posterior intercostal veins and subcostal vein drain into the azygos vein. The 4th to 7th (sometimes 8th) left-sided posterior intercostal veins drain into the accessory hemiazygos vein. The 8th to 11th left-sided posterior intercostal and subcostal veins drain into the hemiazygos vein.

Supreme intercostal vein

The supreme intercostal vein drain drains the 1st intercostal space posteriorly opening into the vertebral or brachiocephalic veins.

Superior intercostal vein

The posterior 2nd and 3rd intercostal spaces are drained by their respective posterior intercostal veins into a single vessel, the superior intercostal vein, into the azygos and brachiocephalic veins in the right and left sides respectively.

Variant anatomy

  • the superior intercostal veins may additionally drain the 4th intercostal space
  • the accessory hemiazygos vein may drain the left 8th intercostal space posteriorly
  • -<p>The <strong>venous drainage of the thoracic wall</strong> drains deoxygenated venous blood from the peripheries of the thoracic cage back into systemic circulation.</p><h4>Gross anatomy</h4><h5>Anterior thoracic wall</h5><h6>Anterior intercostal veins</h6><p>The anterior intercostal veins originate from the intercostal space just inferior to anterior aspects of their respective ribs and drain into the internal thoracic and musculophrenic veins.</p><h5>Posterior thoracic wall</h5><h6>Posterior intercostal veins</h6><p>The posterior intercostal veins originate from the intercostal space just inferior to posterior aspects of their respective ribs. In the right side, the 4<sup>th</sup> to 11<sup>th</sup> posterior intercostal veins and subcostal vein drain into the <a href="/articles/azygos-vein">azygos vein</a>. The 4<sup>th</sup> to 7<sup>th</sup> (sometimes 8<sup>th</sup>) left-sided posterior intercostal veins drain into the <a href="/articles/accessory-hemiazygos-vein">accessory hemiazygos vein</a>. The 8<sup>th</sup> to 11<sup>th</sup> left-sided posterior intercostal and subcostal veins drain into the <a href="/articles/hemiazygos-vein">hemiazygos vein</a>.</p><h6>Supreme intercostal vein</h6><p>The supreme intercostal vein drain the 1<sup>st</sup> intercostal space posteriorly opening into the vertebral or <a href="/articles/brachiocephalic-vein">brachiocephalic veins</a>.</p><h6>Superior intercostal vein</h6><p>The posterior 2<sup>nd</sup> and 3<sup>rd</sup> intercostal spaces are drained by their respective posterior intercostal veins into a single vessel, the <a title="Left superior intercostal vein" href="/articles/left-superior-intercostal-vein">superior intercostal vein</a>, into the azygos and brachiocephalic veins in the right and left sides respectively.</p><h4>Variant anatomy</h4><ul>
  • +<p>The <strong>venous drainage of the thoracic wall</strong> drains deoxygenated venous blood from the periphery of the <a title="Thoracic cage" href="/articles/thoracic-cage">thoracic cage</a> back into the systemic circulation.</p><h4>Gross anatomy</h4><h5>Anterior thoracic wall</h5><h6>Anterior intercostal veins</h6><p>The <a title="anterior intercostal veins" href="/articles/anterior-intercostal-veins">anterior intercostal veins</a> originate from the <a title="Intercostal spaces" href="/articles/intercostal-spaces">intercostal space</a> just inferior to anterior aspects of their respective <a title="Ribs" href="/articles/ribs">ribs</a> and drain into the internal thoracic and musculophrenic veins.</p><h5>Posterior thoracic wall</h5><h6>Posterior intercostal veins</h6><p>The <a title="posterior intercostal veins" href="/articles/posterior-intercostal-veins">posterior intercostal veins</a> originate from the intercostal space just inferior to posterior aspects of their respective ribs. In the right side, the 4<sup>th</sup> to 11<sup>th</sup> posterior intercostal veins and <a title="subcostal vein" href="/articles/subcostal-vein">subcostal vein</a> drain into the <a href="/articles/azygos-vein">azygos vein</a>. The 4<sup>th</sup> to 7<sup>th</sup> (sometimes 8<sup>th</sup>) left-sided posterior intercostal veins drain into the <a href="/articles/accessory-hemiazygos-vein">accessory hemiazygos vein</a>. The 8<sup>th</sup> to 11<sup>th</sup> left-sided posterior intercostal and subcostal veins drain into the <a href="/articles/hemiazygos-vein">hemiazygos vein</a>.</p><h6>Supreme intercostal vein</h6><p>The <a title="supreme intercostal vein" href="/articles/supreme-intercostal-vein">supreme intercostal vein</a> drains the 1<sup>st</sup> intercostal space posteriorly opening into the <a title="vertebral veins" href="/articles/vertebral-veins">vertebral</a> or <a href="/articles/brachiocephalic-vein">brachiocephalic veins</a>.</p><h6>Superior intercostal vein</h6><p>The posterior 2<sup>nd</sup> and 3<sup>rd</sup> intercostal spaces are drained by their respective posterior intercostal veins into a single vessel, the <a href="/articles/left-superior-intercostal-vein">superior intercostal vein</a>, into the azygos and brachiocephalic veins in the right and left sides respectively.</p><h4>Variant anatomy</h4><ul>

References changed:

  • 1. Macéa, J. R., & Fregnani, J. H. T. G. (2006). Anatomy of the thoracic wall, axilla and breast. International Journal of Morphology, 24(4), 691-704. https://doi.org/10.4067/S0717-95022006000500030. <a href="https://doi.org/10.4067/S0717-95022006000500030">https://doi.org/10.4067/S0717-95022006000500030</a>
  • 2. Chummy S. Sinnatamby. Last's Anatomy. (2020) <a href="https://books.google.co.uk/books?vid=ISBN9780702033957">ISBN: 9780702033957</a><span class="ref_v4"></span>
  • 3. Susan Standring. Gray's Anatomy E-Book. (2015) <a href="https://books.google.co.uk/books?vid=ISBN9780702068515">ISBN: 9780702068515</a><span class="ref_v4"></span>
  • 1. de la Pared Torácica A, y Mama A. Anatomy of the thoracic wall, axilla and breast. Int. J. Morphol. 2006;24(4):691-704.
  • 2. McMinn RM. Last's anatomy: regional and applied. London: Churchill Livingstone, 1994; 1994 Sep 20.
  • 3. Gray H. Gray's Anatomy: With original illustrations by Henry Carter. Arcturus Publishing; 2009 Jul 15.

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