🥇 VASOS SANGUÍNEOS DE LA PARED TORÁCICA, (Arterias y Venas), Fácil, Rápido y Sencillo.

Summary

En este video, el Dr. Juan José Sánchez explica la irrigación de la pared torácica, detallando las arterias principales: mamaria interna, intercostales superiores, intercostales posteriores y subcostales. Además, describe el drenaje venoso del tórax y sus conexiones con las arterias. Explica la relación de la arteria mamaria interna con el nervio frénico y su recorrido, junto con las ramas terminales como la arteria epigástrica superior y la musculofrénica. Finaliza describiendo las venas intercostales y la complejidad del drenaje venoso posterior del tórax. ¡No olvides suscribirte y seguirlo en Instagram!

Takeaways

• 😀 La irrigación de la pared torácica se realiza a través de cuatro grandes grupos de arterias: mamarias internas, intercostales superiores, intercostales posteriores y subcostales.
• 👍 La arteria mamaria interna, también llamada arteria torácica interna, es una rama de la arteria subclavia.
• 💡 La arteria mamaria interna se encuentra inicialmente cruzada por el nervio frénico y se ubica sobre la cúpula pleural antes de llegar al sexto espacio intercostal.
• 👨‍⚕️ En cada espacio intercostal, la arteria mamaria interna da ramas intercostales anteriores superiores e inferiores, además de ramas perforantes anteriores.
• 🫀 Las ramas terminales de la arteria mamaria interna son la arteria epigástrica superior y la arteria musculofrénica.
• 🔍 Las arterias intercostales posteriores son ramas directas de la aorta torácica a partir del tercer espacio intercostal.
• 🔧 Las arterias subcostales se encuentran debajo de la doceava costilla y no pueden llamarse intercostales, debido a que no están entre costillas.
• 🩸 La irrigación posterior del tórax es más compleja, involucrando arterias intercostales posteriores que se subdividen en ramas dorsales y ventrales.
• 🏥 El drenaje venoso sigue el mismo patrón que el arterial, con venas intercostales anteriores y posteriores, aunque con algunas variaciones entre el lado derecho e izquierdo del cuerpo.
• 🚨 Las venas subcostales contribuyen a la formación de la vena ácigos en el lado derecho y de la vena hemiácigos en el lado izquierdo.

Q & A

¿Cuáles son las principales arterias que irrigan la pared torácica?

Las principales arterias que irrigan la pared torácica son las arterias mamarias internas, las arterias intercostales superiores, las arterias intercostales posteriores y las arterias subcostales.

¿Qué nervio cruza inicialmente la arteria mamaria interna?

El nervio que cruza inicialmente la arteria mamaria interna es el nervio frénico.

¿En qué espacio intercostal se divide en sus ramas terminales la arteria mamaria interna?

La arteria mamaria interna se divide en sus ramas terminales en el sexto espacio intercostal.

¿Cuáles son las ramas terminales de la arteria mamaria interna?

Las ramas terminales de la arteria mamaria interna son la arteria epigástrica superior y la arteria musculofrénica.

¿Qué estructuras irriga la arteria pericardiofrénica?

La arteria pericardiofrénica irriga el pericardio, la pleura parietal y el diafragma.

¿Cómo se diferencian las arterias intercostales anteriores de las posteriores?

Las arterias intercostales anteriores provienen de la arteria mamaria interna y se encuentran en los espacios intercostales anteriores, mientras que las arterias intercostales posteriores provienen de la aorta torácica y se encuentran en los espacios intercostales posteriores.

¿Cuál es la importancia de la arteria musculofrénica según algunos autores?

Según algunos autores, la arteria musculofrénica es importante porque consideran que es una continuación de la arteria mamaria interna, ya que irriga las mismas áreas.

¿De dónde provienen las primeras dos arterias intercostales posteriores?

Las primeras dos arterias intercostales posteriores provienen de la arteria intercostal superior, que a su vez es una rama del tronco costocervical.

¿Cuál es la diferencia en el drenaje venoso de la pared torácica entre el lado derecho e izquierdo del cuerpo?

En el lado derecho, las venas intercostales superiores drenan en la vena ácigos, mientras que en el lado izquierdo, las venas intercostales superiores drenan en las venas braquiocefálicas.

¿Cómo se forman las venas hemiácigos y hemiácigos accesorias?

Las venas hemiácigos accesorias se forman a partir de las venas de los espacios intercostales cuarto a séptimo del lado izquierdo, y las venas hemiácigos se forman a partir de los espacios intercostales octavo a undécimo del lado izquierdo.

Outlines

00:00

💉 Irrigación y drenaje de la pared torácica: arterias principales

El video comienza con una introducción sobre la irrigación de la pared torácica, destacando las cuatro arterias principales: la mamaria interna, la intercostal superior, las intercostales posteriores y la subcostal. El autor también invita a los espectadores a suscribirse al canal antes de entrar en detalles sobre la arteria mamaria interna, que también se conoce como arteria torácica interna. Esta arteria es una rama de la arteria subclavia, que baja desde el tronco tirobicervicoescapular y se cruza con el nervio frénico. El recorrido de la arteria mamaria interna incluye ramas como la pericardiofrénica, que irriga el pericardio, la pleura parietal y el diafragma. Además, se menciona que la arteria mamaria interna se divide en ramas terminales: la epigástrica superior y la musculofrénica, que se anastomosan con ramas de la arteria ilíaca externa.

05:02

🔍 Arteria musculofrénica y su relación con la irrigación intercostal

Este párrafo detalla la función de la arteria musculofrénica, que se considera por algunos autores como la continuación de la arteria mamaria interna. Esta arteria proporciona ramas intercostales anteriores en los espacios intercostales séptimo, octavo y noveno, así como ramas perforantes anteriores. También se muestra en una imagen cómo la arteria mamaria interna y sus ramas contribuyen a la irrigación de la pared torácica anterior. Las ramas perforantes anteriores, especialmente en los espacios intercostales segundo, tercero y cuarto, suministran sangre a las glándulas mamarias, independientemente del género.

10:05

🔄 Irrigación posterior del tórax: arterias intercostales posteriores

El autor pasa a describir la irrigación de la parte posterior del tórax, comenzando con las arterias intercostales posteriores. Las dos primeras son ramas de la arteria intercostal superior, que a su vez es una rama del tronco costocervical de la arteria subclavia. Desde el tercer espacio intercostal hasta el undécimo, las arterias intercostales posteriores son ramas directas de la aorta torácica. Se explica cómo estas arterias se dividen en ramas dorsales y ventrales, y las dorsales se subdividen en ramas espinales y musculares, con una rama cutánea interna y otra externa. Se enfatiza la importancia de las anastomosis entre las arterias intercostales anteriores y posteriores.

15:08

🩸 Venas intercostales y el sistema ácigos

Este párrafo se enfoca en el drenaje venoso de la pared torácica posterior. Las venas intercostales anteriores drenan en la vena mamaria interna, que a su vez desemboca en los troncos venosos braquiocefálicos. En la parte posterior, el drenaje es más complejo, con diferencias entre el lado derecho y el izquierdo del cuerpo. En el lado derecho, la vena intercostal superior derecha drena en la vena ácigos, mientras que en el lado izquierdo, la vena intercostal superior izquierda drena en el tronco venoso braquiocefálico. Además, se describe la formación de las venas hemiazygos y hemiazygos accesorias, responsables del drenaje de los espacios intercostales inferiores en el lado izquierdo.

Keywords

💡Irrigación de la pared torácica

Se refiere al suministro de sangre a la pared del tórax a través de diversas arterias. En el video se explican cuatro grupos principales de arterias encargadas de esta irrigación: la arteria mamaria interna, las arterias intercostales superiores y posteriores, y la arteria subcostal. La irrigación es crucial para el funcionamiento adecuado de los músculos y órganos en esta región.

💡Arteria mamaria interna

También conocida como arteria torácica interna, es una rama de la arteria subclavia que desciende a lo largo del tórax. Se describe como la arteria que cruza el nervio frénico y que, a nivel del sexto espacio intercostal, se divide en dos ramas terminales: la arteria epigástrica superior y la arteria musculofrénica. Es clave en la irrigación de la pared torácica anterior.

💡Arteria pericardiofrénica

Es una rama de la arteria mamaria interna que acompaña al nervio frénico y proporciona irrigación al pericardio y la pleura parietal. Su relevancia radica en su papel en la irrigación de estructuras vitales del tórax, incluyendo el diafragma.

💡Arterias intercostales anteriores

Son ramas de la arteria mamaria interna que se distribuyen en cada espacio intercostal, proporcionando sangre a la parte anterior de los espacios intercostales. Se dividen en ramas superior e inferior, y son importantes porque se anastomosan con las arterias intercostales posteriores, permitiendo una red de suministro sanguíneo en el tórax.

💡Arterias intercostales posteriores

Son las arterias que irrigan la parte posterior del tórax. Las primeras dos arterias intercostales posteriores provienen de la arteria intercostal superior, mientras que el resto (de la tercera a la undécima) son ramas directas de la aorta torácica. Son cruciales para la irrigación de la parte posterior de la pared torácica y de los músculos dorsales.

💡Vena ácigos

Es una vena importante en el drenaje venoso de la pared torácica posterior en el lado derecho del cuerpo. Recoge la sangre de las venas intercostales posteriores y drena en la vena cava superior. El video explica su papel fundamental en el sistema venoso del tórax y cómo varía entre el lado derecho e izquierdo del cuerpo.

💡Arteria subcostal

Es una rama de la aorta que irriga la región debajo de la duodécima costilla. Aunque anatómicamente no se le denomina 'intercostal' debido a que no pasa entre costillas, su función es similar a la de las arterias intercostales. Juega un papel importante en la irrigación de la parte inferior del tórax.

💡Vena hemiazigos accesoria

Es una vena que drena los espacios intercostales superiores en el lado izquierdo del cuerpo. Esta vena a menudo cruza la línea media para unirse a la vena ácigos en el lado derecho, formando una vía importante de drenaje venoso. Es crucial para entender el sistema venoso posterior del tórax en el lado izquierdo.

💡Anastomosis

Es el término que se refiere a la conexión entre dos estructuras tubulares, como vasos sanguíneos. En el video, se explica cómo las arterias intercostales anteriores y posteriores se anastomosan para asegurar el suministro continuo de sangre en los espacios intercostales.

💡Nervio frénico

Es un nervio que inerva el diafragma y que cruza la arteria mamaria interna en su recorrido. Juega un papel esencial en la respiración, ya que controla el movimiento del diafragma. Su relación con las arterias torácicas, especialmente la pericardiofrénica, es clave en el contexto del video.

Highlights

La pared torácica está irrigada por cuatro grandes grupos de arterias: las mamarias internas, las intercostales superiores, las intercostales posteriores y las subcostales.

Las venas del tórax tienen los mismos nombres que las arterias, facilitando su identificación en el drenaje venoso.

La arteria mamaria interna también es conocida como arteria torácica interna, y se origina de la arteria subclavia.

La arteria mamaria interna se divide en dos ramas terminales: la arteria epigástrica superior y la arteria musculofrénica.

La arteria musculofrénica se considera una continuación de la arteria mamaria interna debido a las zonas que irriga.

Las arterias intercostales anteriores son ramas importantes que irrigan los espacios intercostales.

Las ramas perforantes anteriores del segundo, tercer y cuarto espacio intercostal irrigan las glándulas mamarias en ambos géneros.

Las primeras dos arterias intercostales posteriores se originan de la arteria intercostal superior, una rama del tronco intercostal-cervical.

Las arterias intercostales posteriores del tercer al undécimo espacio intercostal son ramas directas de la aorta torácica.

Las arterias intercostales posteriores derechas son más largas debido a la posición de la aorta torácica en el lado izquierdo del cuerpo.

Cada arteria intercostal posterior da una rama ventral y una rama dorsal, esta última se subdivide en una rama espinal y una rama muscular.

La arteria subcostal es la equivalente a la duodécima arteria intercostal, pero al no pasar entre un espacio intercostal, se llama subcostal.

El drenaje venoso posterior es más complejo; en el lado derecho, las venas intercostales posteriores drenan en la vena ácigos.

En el lado izquierdo, las venas intercostales superiores drenan en el tronco venoso braquiocefálico, mientras que las inferiores forman la vena hemiácigos.

Las venas intercostales accesorias hemiácigos drenan entre el cuarto y séptimo espacio intercostal en el lado izquierdo y se conectan con la vena ácigos.

Transcripts

It's a pleasure to greet you friends, this is Juan José Sánchez and today we will talk about irrigation

of the chest wall, okay? The chest wall is irrigated by four large arteries

that are four large groups of arteries that are the internal mammary arteries, the

superior intercostal arteries, the posterior intercostal arteries and the subcostal arteries

. After talking about irrigation we will go to the venous drainage that The thorax is drained

by veins that actually have the same names as the arteries, so first of all

I invite you to subscribe to my channel, it is very fast here in the lower right corner

click and click to subscribe. okay? so that you can have access to the rest of my videos,

then the relationship of the thorax we are going to start first with one of the very important arteries

which is the internal mammary artery and then the dorsal of the other group of three arteries, then

this internal mammary artery You will find in many texts with the name

internal thoracic artery, it is the same thing, so I remind you that the internal breast artery was a branch of the

subclavian artery, specifically of the first portion of the subclavian artery, in fact it was the only branch of

the subclavian artery that It grabbed downwards because the rest of the subclavian branch either grabbed

posteriorly or grabbed upwards, so you see that it arises at the same level of the

thyrobicervico-scapular trunk only that the trunk, as I say, grabbed upwards and the

internal mammary artery grabs downwards. , the artery at its beginning is crossed by this great nerve that in

the famous phrenic nerve that crosses it anteriorly, then this internal mammary artery

in its descent rests on the pleural dome and then is placed in front of the

costal parietal pleura and between what is the costal cartilages, it reaches a level where it is placed in front

of the transverse muscle of the thorax, also called triangular of the sternum, and at this point it is

separated from the parietal pleura precisely by this muscle until it reaches the sixth,

some Authors say that you reach the seventh but most agree that it reaches the sixth

intercostal space and is divided into its terminal branches, a medial branch called the

superior epigastric artery or superior abdominal artery and a lateral branch that would be the musculophrenic artery or

diaphragmatic artery but In the clearest man, that phrenic muscle artery is the most

anatomical name, so this internal mammary artery will give several branches during its journey, one of the

first that it will give is the phrenic pericardium artery if by giving it the name phrenic pericardium

and You can imagine what the route of that artery is, because this artery

accompanies the pericardium, the route is easy because it accompanies the phrenic nerve branch of the deep cervical plexus

during its route and is then responsible for providing irrigation to what is the pericardium, ok ?

and what the parietal pleura is because it goes between the pleura and the pericardium until it

reaches the diaphragm, which it also irrigates, which is why we call the pericardial phrenic artery,

it is the first branch that we are going to see of the internal mammary artery; then it comes and in each of the

intercostal spaces, as I told you, it ends in the sixth intercostal space, then it is supposed

that it is going to cover me. If there are intercostal spaces in each of those intercostal spaces, I am going

to give myself two branches, an upper branch and another inferior branch, then we are going to call this branch

the anterior intercostal arteries, the surname anterior is very important to

differentiate it from other arteries that look very similar, so you know each intercostal space

gives a superior anterior intercostal artery and an anterior intercostal artery -inferior,

in addition to that, we are going to see that in each of those intercostal spaces it gives branches that instead of

grabbing towards the intercostal spaces, it grabs and pierces forward, those are the famous

anterior perforating branches, also as it is already not bad in six intercostal spaces will

only give six anterior perforating branches, okay? and finally its terminal branches, terminal

because that's where you just reach the artery and that's where it ends. I already told you that they are the

superior epigastric artery, which is more medial and that anastomoses with the inferior epigastric artery.

which is a branch of the external iliac and its last terminal is the one that you grab and external is to go to

the lateral which is the musculophrenic artery, which is also anastomosed with the

superficial circumflex iliac artery which is also a branch of the external iliac, so that the two branches

of the internal breast anastomose with branches of the external iliac artery, now this

musculophrenic artery is very important because many authors consider that it is a continuation of the

internal mammary artery because the places it supplies are the same that irrigates the internal mammary gland,

if I have just told you that the internal mammary gland reaches up to the sixth intercostal space and from then on

who is going to give me the anterior intercostal branches and the anterior perforating branches is going

to be the phrenic muscle, then they are going to give the anterior intercostals of the seventh,

eighth and ninth intercostal space and he is going to give me the anterior perforators of the seventh,

eighth and ninth intercostal space and very easily to this muscular phrenic artery that does the same thing

that the internal mammary artery does. Now let's see in this image here the

internal mammary artery is sectioned and this artery whose first branch that accompanies the

phrenic nerve, you see well, would then be the pericardium phrenic artery, as I told you right now this

posterior view of the anterior wall of the thorax we see here The muscle was the phrenic pericardium cut

accompanied by the phrenic nerve and see how in each of the intercostal spaces,

it gives a superior anterior intercostal and an antero-inferior intercostal until

the sixth arrives and who replaces that function of giving the anterior intercostals It is the phrenic muscle whose

most external branch is this one that you see here would be the superior epigastric artery, so this would be

the irrigation of the anterior part of the thorax, now let's go with the posterior part something that

I forgot to tell you that these anterior perforators specifically the The second,

third and fourth intercostal spaces give branches for the breast, regardless of whether it is a woman or a man. The

mammary branches are from these second, third and fourth anterior perforators, okay? Now let's go

now with irrigation of the posterior part of the thorax, which is becoming a little more complex.

We first see that in each intercostal space there will be a posterior intercostal artery

to differentiate it from the previous ones that were the internal mammary artery, but what happens? The first

two posterior intercostal arteries, see the first and the second are branches of this artery that

is the superior intercostal artery, now you will say, where does that

superior intercostal artery come from? You have to quickly remember, I invite you to my video of the subclavian artery,

that the subclavian artery and its second portion gave the intercostal cervix trunk, which is this one, and this

intercostal cervix trunk is subdivided into a branch, a branch that grabbed towards the neck,

which was the artery. deep cervical and a branch that came towards the thorax which was the

superior intercostal and that superior intercostal artery is subdivided into two, some authors say three

but most say two which are the first two posterior intercostal arteries,

ok? The first and the second occur on both the right side of the body and the left side.

Now from the third intercostal space down, remember that there are 11

intercostal spaces, they are 11 because there are 11 spaces between the two ribs, even though there are 12 ribs,

there are 11 intercostal spaces, these would then be from the third intercostal space to the 11th

that It is the last one, all the posterior intercostal arteries, which are 9 in total, are counted from the

third to the 11th, there are 9. They are direct branches of who? of the thoracic aorta on both the

right and left sides. Now, what is the anatomy of those

posterior intercostal arteries like? Notice how the thoracic aorta is more on the left side of the

body, so it is easy to infer that the posterior intercostal arteries on the right side have

to be longer and they have to be longer because they have to travel a longer route,

so notice indifferently the side of the body that are posterior intercostal character

will give a dorsal branch and a ventral branch, listen carefully, the ventral branch will be its own

posterior intercostal artery but the dorsal branch is in turn subdivided into two: a branch that goes

to the spinal cord, which we will call the spinal branch, and a branch that goes to the muscles

of the back, which we will call the muscular branch, now in turn It gets a little more complicated because this

muscular branch is a medial cutaneous or internal cutaneous branch that is and an external branch,

I repeat, each posterior intercostal gives a ventral and a dorsal, the dorsal in turn gives

to the spinal and the muscular and The muscular branch is in turn divided into the internal cutaneous branch and the external branch,

which is a muscular branch, the external one is not cutaneous, the internal branch is the one that is cutaneous. Now,

each of these posterior intercostal arteries, specifically the ventral branch that I told you

is the posterior intercostal artery itself, is going to give you a collateral branch, you will tell you

this the hell if you make up a joke, well, but look carefully, this collateral branch is this one that It goes

downwards because that lateral branch is important because you remember that the

anterior intercostal gives a superior branch and an inferior branch, the anterior intercostal well, the superior branch of

the anterior intercostal artery anastomoses, well, with the posterior intercostal artery itself

, see How is it anastomosed with a single unit, but the artery, excuse me, there the

inferior branch anterior intercostal artery is anastomosed with whom? with the collateral of the

posterior intercostal, then you already know the collateral of the posterior intercostal, which is the one that grabs

downwards and anastomoses with the inferior of the anterior intercostal, okay? This is done in a single

unit along the entire intercostal space. In addition to this, the

posterior intercostal artery itself, which remember that it is the superior branch, gives a lateral cutaneous branch that supplies the skin and

muscles of the lateral part of the chest wall. very important. Now there is another artery which

is the subcostal artery, the subcostal artery is the same twelfth posterior intercostal artery

only that we cannot call it intercostal because below the twelfth rib the

artery comes out, which is the one you see here, but it does not pass between a intercostal space,

then theoretically anatomically we cannot call it intercostal, we are going to call it subcostal,

the same happens for the twelfth nerve and for the eleventh nerve and for the twelfth vein,

sorry we call it subcostal vein, subcostal nerve and in this case it would be subcostal artery,

it is nothing more than the twelfth itself, now something very important that I have to return here

happens with the bronchial arteries, quickly anyway this is a type of bronchi

but I have to remind you of this at once, there are three bronchial arteries,

two left bronchial arteries, listen well there are three, two of those three are left and are

direct branches of the thoracic aorta and there is only one right bronchial artery, you will say:

but why are you telling me that right now in irrigation of the chest? Because that

right bronchial artery, which is unique, is a branch of the third right posterior intercostal artery, do not

forget the third right posterior intercostal artery, a branch of the aorta, as I told you, the third

and from that artery, the third right posterior intercostal artery, comes the right bronchial branch,

so it is important not to forget it. With venous drainage it is much easier because the

veins have the same names as the arteries, it gets a little complicated in the posterior part

but in the anterior part it is basically the same, we have the anterior intercostal veins that

join and form satellite veins, The satellite veins conform to the internal mammary vein. Where will

that internal mammary vein drain? which you can also call it the internal thoracic vein, it drains

directly into the brachiocephalic venous trunks, which are also called innominate veins but

they are the same brachiocephalic venous trunk, there it drains into the internal mammary vein, okay? Now let's go to

the back part, which is a little more complicated and here I do need you to pay

attention because the right side of the body varies a little from the left side, we are going to start

with the right side of the body, on the right side of the body we are also going to have they remember that

There were superior intercostal arteries, there are also superior intercostal veins, what is the

difference? that the right superior intercostal vein can see well, the

right superior intercostal vein drains the three or four but most books say that they are the three

superior intercostal spaces on the right side, even though the artery occupies two spaces the

vein drains three spaces or up to four and they form those four intercostal veins or three

more superior intercostal veins, on the right side they conform to the right superior intercostal vein

that was in the right superior intercostal where it is draining into the famous azygos vein,

that happens on the right side. but what happens on the left side? Likewise, the

left upper intercostal spaces, the first three or the first four, will conform to

this vein, which is the left upper intercostal vein. The difference will be that the

left upper intercostal vein drains directly into the brachiocephalic veins, unlike the

right one, which drains into the azygos vein, so that difference between drainage is important but

the variations still continue, we are going to call the rest of the veins posterior intercostal veins,

which are going to be the intercostal spaces that are further down, now those

posterior intercostal veins Those on the right side of the body also drain directly into

the azygos vein, directly there, but the one on the left side is different because the one on the fourth,

assuming that it reaches the third, the one on the fourth, fifth, sixth and even seventh

left intercostal space forms This large vein that you see here, which is the accessory hemiazygos vein,

in any case in the other image you will understand it better, while the

lower internal spaces on the left side we talk about from the eighth down to the eleventh, remember

that there are 11 intercostal space conforms to the hemiazygos vein, so you know the one above is

accessory hemiazygos, the one below is hemiazygos, so see this image on the right side here

is the right upper intercostal vein draining into the acids and the azygos draining in turn in the

superior vena cava, in another video I will explain the azygous vein, while the rest of the

intercostal spaces on the right side drain directly into the azygous, while on the left side see

that all the superior intercostal spaces form the left superior intercostal vein and

that left superior intercostal vein drains into the left brachiocephalic vein, while the

rest conforms to the accessory hemiazygos vein and the most inferior ones to the hemiazygos vein,

so see in this image here you can see the two superior intercostals, I already explained that The one

on the right side drains into the azygos and the one on the left side a brachiocephalic vein. See

that the middle intercostal spaces we speak of from the fourth to the seventh more or less make up the

accessory hemiazygos vein and that accessory hemiazygos vein can do two things or cross the midline and

drains into the azygos or simply joins the one below, which is the hemiazygos vein, but

the most common thing is that they cross the midline and drain directly into the azygos, while the

lower intercostal spaces make up the hemiazygos vein and It always crosses the midline

to drain into the azygos, so you see that the venous drainage of the back of the thorax

is a little complicated and finally this last vein, as I told you, is below the tenth

rib, we call it the subcostal veins. okay? It helps to form the right side, it helps me

to form the azygos vein and the left side helps me to form the hemiazygos vein. So friend

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