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Internal thoracic artery anatomy
------------------------------------

The internal thoracic artery (previously called the internal mammary artery) supplies the anterior body wall and its associated structures from the clavicles to the umbilicus.

Gross anatomy
Origin
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The internal thoracic artery arises from the first part of the subclavian artery in the base of the neck.

Course
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It then passes from the neck to the thorax posterior to the subclavian vein and first rib. It has a vertical course and runs inferiorly within a few centimetres laterally of the sternum in a neurovascular plane between the transversus thoracus muscle posteriorly and the costal cartilages and internal intercostal muscles anteriorly. At the sixth-to-seventh costal cartilages the internal thoracic artery bifurcates into two terminal branches - musculophrenic artery and superior epigastric artery.

Along its course, the internal thoracic artery gives off perforating branches which pass superficially towards the skin. At the second-to-fourth intercostal spaces these perforating branches are larger (and become even more enlarged during pregnancy) to supply to the breasts.

The internal thoracic artery, via its superior epigastric branches anastomoses with the inferior epigastric arteries, provides an important alternate blood supply if the aorta becomes occluded between the arch of the aorta and descending aorta (see: coarctation of the aorta).

Branches
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anterior intercostal arteries within each intercostal space
pericardiophrenic artery (runs with the phrenic nerve)
perforating cutaneous branches
musculophrenic artery (terminal branch)
superior epigastric artery (terminal branch)

Supply
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The internal thoracic artery supplies the anterior body wall from clavicle to umbilicus including the sternum and the breasts. In addition, via the pericardiophrenic artery it supplies the mediastinum, thymus, phrenic nerves, and pericardium.

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