Superior Vena- Cava

SUPERIOR VENA- CAVA

Q. 1

Left sided superior vena cava drains into?

 A

Right Atrium

 B

Left Atrium

 C

Coronary Sinus

 D

Pericardial Space

Q. 1

Left sided superior vena cava drains into?

 A

Right Atrium

 B

Left Atrium

 C

Coronary Sinus

 D

Pericardial Space

Ans. C

Explanation:

Left Superior Vena Cava drains directly into the coronary sinus and by way of the coronary sinus into the right atrium. Left SVC thus, drains into both, the coronary sinus and the right atrium.


Q. 2

All of the following veins are formed from vitelline vein except

 A

Hepatic vein

 B

Superior vena cava

 C

Inferior vena cava

 D

Superior mesenteric vein

Q. 2

All of the following veins are formed from vitelline vein except

 A

Hepatic vein

 B

Superior vena cava

 C

Inferior vena cava

 D

Superior mesenteric vein

Ans. B

Explanation:

B i.e. Superior Vena Cava


Q. 3

Left sided superior vena cava drains into:

 A

Right Atrium

 B

Left Atrium

 C

Coronary sinus

 D

Pericardial space

Q. 3

Left sided superior vena cava drains into:

 A

Right Atrium

 B

Left Atrium

 C

Coronary sinus

 D

Pericardial space

Ans. C

Explanation:

C i.e. Coronary sinus


Q. 4

Which of the following tumor is most commonly associated with superior vena cava syndrome:

 A

Lymphoma

 B

Small cell carcinoma

 C

Non small cell carcinoma

 D

Metastasis

Q. 4

Which of the following tumor is most commonly associated with superior vena cava syndrome:

 A

Lymphoma

 B

Small cell carcinoma

 C

Non small cell carcinoma

 D

Metastasis

Ans. B

Explanation:

Answer is B (Small cell carcinoma):

Current Critical Care Diagnosis & Treatment 3ra /465

The incidence of superior vena caval syndrome is highest with small cell carcinoma.

Superior vena caval syndrome  (SVC syndrome)

  • SVC syndrome results from an impedance in outflow from superior vena cava due to external compression
  • The most common cause of SVC syndrome is external compression by a malignant tumoure
  • The most common malignant tumor causing SVC syndrome is bronchogenic carcinomas
  • The most common histological type of bronchogenic carcinoma causing SVC syndrome is small cell carcinomas

Etiologies of Superior Vena Cava Obstruction:

Malignancy

95%

Lung Cancer

65%

Lymphoma

15%

Breast cancer

5%

Germ-cell

2%

Thymic cancer

2%

Other cancer

4%

Benign

5%

Central venous device related

Mediastinal fibrosis

1%

3%


Q. 5

Azygos vein drains into:

 A

Left brachiocephalic vein

 B

Inferior vena cava

 C

Superior vena cava

 D

Right brachiocephalic vein

Q. 5

Azygos vein drains into:

 A

Left brachiocephalic vein

 B

Inferior vena cava

 C

Superior vena cava

 D

Right brachiocephalic vein

Ans. C

Explanation:

The azygos vein ends by joining the posterior aspect of the superior vena cava

The Azygos Vein

  • The azygos vein connects the superior and inferior venae cavae, either directly by joining the IVC or indirectly by the hemiazygos and accessory hemiazygos veins.
  • The azygos vein drains blood from the posterior walls of the thorax and abdomen.
  • It ascends in the posterior mediastinum, passing close to the right QA des of the bodies of the inferior eight thoracic vertebrae (T4-T12).
  • It is covered anteriorly by the oesophagus as it passes posterior to the root of the right lung.
  • It then arches over the superior aspect of this root to join the SVC.
  • In addition to the posterior intercostal veins, the azygos vein communicates with the vertebral venous plexuses.
  • This vein also receives the mediastinal, oesophageal, and bronchial veins.

Q. 6

Which of the following subtype of lung carcinoma produces superior vena cava syndrome:

September 2009

 A

Small cell carcinoma

 B

Adenocarcinoma

 C

Anaplastic carcinoma

 D

Squamous cell carcinoma

Q. 6

Which of the following subtype of lung carcinoma produces superior vena cava syndrome:

September 2009

 A

Small cell carcinoma

 B

Adenocarcinoma

 C

Anaplastic carcinoma

 D

Squamous cell carcinoma

Ans. A

Explanation:

Ans. A: Small cell carcinoma


Q. 7

Not true about superior vena cava 

 A

Opens into right ventricle

 B

Enters the heart at level of 3rd costal

 C

Pierces paricardium at 2nd costal cartilage

 D

Receives azygos vein behind sternal angle

Q. 7

Not true about superior vena cava 

 A

Opens into right ventricle

 B

Enters the heart at level of 3rd costal

 C

Pierces paricardium at 2nd costal cartilage

 D

Receives azygos vein behind sternal angle

Ans. A

Explanation:

SVC opens in to right atrium (not right ventricle).

Superior vena-cava

  • SVC collects blood from the upper half of the body and drains into the right atrium. It is formed by the union of two brachiocephalic veins at the level of lower border of 1″ right costal cartilage. It passes vertically downwards behind the right border of sternum and piercing the pericardium at the level of the second costal cartilage, enters the upper border of the right atrium to end in the upper and posterior part of sinus venorum at the lower border of third right costal cartilage (opposite Ts vertebra).
  • Behind the sternal angle (T4 vertebral level), SVC receives the azygos vein.
  • SVC is divided into two parts –

i) Upper half (extrapericardial) 

ii) Lower half (intrapericardial)



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