The upper hollow Vienna
The upper vena Vienna - Vienna short thin-walled with a diameter of 20 mm to 25 mm, located in the anterior mediastinum.
Its length varies from an average of five to eight centimeters. The upper hollow Vienna refers to the veins of the systemic circulation, and formed by the confluence of two (left and right) brachiocephalic veins. It collects the venous blood from the head, the upper parts of the chest, neck and hands and empties into the right atrium. The only tributary of the superior vena cava is unpaired Vienna. Unlike many other veins, the vessel has no valves.
The upper hollow Vienna is directed downward and comes into pericardial cavity at the second rib and slightly lower flows into the right atrium.
The superior vena cava is surrounded by:
- On the left - the aorta (ascending part);
- Right - mediastinal pleura;
- Ahead - the thymus (thymus) and the right lung (mediastinal part covered pleura);
- Behind - the root of the right lung (front surface).
The system of the superior vena cava
All vessels entering in the superior vena cava, close enough to the heart, and during relaxation are affected by the suction action of its cameras. Also, they are subjected to during the respiratory movements of the chest. Due to these factors in the superior vena cava is created quite strong negative pressure.
The main tributaries of the superior vena cava are valveless brachiocephalic vein. They also always very low pressure, so there is the risk of getting air in their wounds.
The system of the superior vena cava vein up:
- Head and neck;
- Chest wall, as well as some walls of the veins of the abdomen;
- Upper shoulder girdle and upper extremities.
Venous blood from the chest wall goes to the influx of the superior vena cava - the azygos vein, which absorbs blood from the intercostal veins. In azygos two valves located in its mouths.
External jugular Vienna located at a corner of the lower jaw pinna. In this vein, blood is collected from tissues and organs located in the head and neck. The external jugular vein flow back ear, occipital, suprascapular and anterior jugular veins.
The internal jugular Vienna originates near the jugular foramen of the skull. This Vienna together with the vagus nerve and carotid arteries form a bundle of nerves and blood vessels of the neck and includes a vein cord meningeal, eye and diploic vein.
Vertebral venous plexus included in superior vena cava, divided into domestic (pass inside the spinal canal) and external (located on the surface of the vertebral body).
Compartment syndrome of the superior vena cava
Compartment syndrome of the superior vena cava, which manifests itself as a violation of its permeability, can develop for several reasons:
- With the progression of cancer. When lung cancer and lymphoma often affects the lymph nodes in the vicinity of the upper extending hollow Vienna. There is also a violation of patency can cause metastasis of breast cancer, soft tissue sarcoma, melanoma;
- Against the background of cardiovascular disease;
- With the development of retrosternal goiter on the background of thyroid disease;
- With the progression of some infectious diseases, such as syphilis, tuberculosis and gistioplazmoz;
- If there is iatrogenic factors;
- When idiopathic fibrous mediastinitis.
Compartment syndrome of the superior vena cava, depending on its cause can progress slowly or grow fast enough. The main symptoms of this syndrome include:
- Swelling of the face;
- Change facial features;
- Shortness of breath;
- Chest pain;
- The swelling of veins of the chest, and in some cases - of the neck and upper extremities;
- Cyanosis, and hyperemia of upper parts of the chest and face.
For the diagnosis of compartment syndrome of the superior vena cava, as a rule, carried out X-rays, allowing to identify the pathological focus, as well as to define the boundaries and extent of its spread. Furthermore, in some cases, carried out by:
- Computed tomography - to obtain more accurate data on the location of the mediastinum;
- Venography - to assess the extent of the violation and the source of the differential diagnosis of vascular and extravascular lesions.
After studies with the rate of progression of the pathological process, decide to conduct drug treatment, chemotherapy or radiation therapy or surgery.
In cases where the reason for the change is the vein thrombosis, thrombolytic therapy is performed, followed by the appointment of anticoagulant drugs (eg, sodium heparin or therapeutic doses of warfarin).