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A large azygous occipital shield.
There are usually 1-20 accessory scales (azygous) that separate the internasals and the prefrontals.
Abnormal connections to the vena cava, azygous vein, or right atrium may occur.
It usually drains via the systemic venous system to the right atrium, vena cava, or azygous systems.
Most of the venous problems in MS patients have been reported to be truncular venous malformations, including azygous stenosis, defective jugular valves and jugular vein aneurysms.
It is worth noting that the lymphatic system does eventually drain into the systemic venous system via the azygous vein, and therefore these metastatic cells can eventually spread through the haematogenous route.
The contents of posterior mediastinum can be remembered using the mnemonic, "DATES", for Descending aorta, Azygous vein and hemiazygos vein, Thoracic duct, Esophagus, Sympathetic trunk/ganglia.
The mediastinal parietal pleura is lateral to the SVC, creating a confined space, and the SVC is adjacent to the right paratracheal, azygous, right hilar, and subcarinal lymph node groups.
If the obstruction is above the entry of the azygos vein, the syndrome is less pronounced because the azygous venous system can readily distend to accommodate the shunted blood with less venous pressure developing in the head, arms, and upper thorax.
If the lesion is above the azygous vein or if the onset of SVC occlusion is slow enough to allow sufficient collateral circulation, the symptoms and signs may stabilize and the patient may be comfortable enough to forego further therapy.
P. brachyrhyncha and P. carrancas are unique in lacking an adipose fin and azygous plates; in loricariids without an adipose fin, it is usually replaced by a series of azygous plates that form a ridge.