c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Tracheobronchial Relationships: 7

A D V E R T I S E M E N T

   
 

The aortic valve at the outlet of the left ventricle (see heart anatomy, coronal sections) has right, left and posterior leaflets beneath the dilated sinuses of Valsalva. The coronary sinuses normally (see coronary arteries anatomy) lie above the right and left leaflets. The left main coronary artery lies beneath the pulmonary trunk initially before dividing into anterior descending and circumflex.     

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Tracheobronchial Relationships: 8

A D V E R T I S E M E N T

   
 

The pulmonic valve lies anterior to the aortic valve, and its cusps are right, left and anterior. An easy way to remember the leaflet orientation is to associate the third cusp with the relative position of the parent vessel, i.e. the anterior pulmonary valve has an anterior cusp, and the posterior aortic valve has a posterior cusp.      

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Tracheobronchial Relationships: 9

A D V E R T I S E M E N T

   
 

The superior vena cava is formed by the confluence of the right and left brachiocephalic veins behind the right side of the manubrium. Note how the left brachiocephalic vein bows anteriorly around the arch vessels and must be retracted to expose the roots of those vessels. The right brachiocephalic vein must be retracted to expose the brachiocephalic artery and the origins of the left common carotid and subclavian (see subclavian artery injury). The azygous vein drains into the mid-portion of the superior vena cava about the level of the second costal cartilage (see subclavian vein access). The junction of the superior vena cava with the right atrium is at the level of the third costal cartilage.    

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This page was last modified on 11/21/2001.