Download vascular-technology-lecture-22-venous-gross

 Lower
Extremity Veins
• Note: The anatomical relationship of the veins to
the heart is the same as for the arteries. Veins
located at the ankle are considered distal: while
veins located closer to the heart (e.g., Femoral)
are considered more proximal
• Note: Be sure to know the orientation of vessels
from medial to lateral and from lateral to medial
 Paired peroneal veins (PerV)
• Formed by confluence of venules
• Empties the lateral leg
• Paired veins may form common trunk and carry
blood cephalad into tibial-peroneal trunk
 Paired posterior tibial veins (PTV)
• Formed by confluence of venules
• Empties back of leg
• Paired veins may form common trunk and carry
blood cephalad into tibial-peroneal trunk
 Paired
anterior tibial veins (ATV)
• Formed by confluence of venules
• Empties front of leg
 Popliteal
vein (PopV)
• Formed by union of ATV and Tib-Peroneal Trunk
• Usually just below the knee
• Becomes femoral vein (previously called
superficial femoral vein) when passes through
adductor hiatus in lower thigh
The adductor hiatus is a hiatus (gap)
between the adductor magnus muscle and
the femur that allows the passage of the
femoral vessels from the anterior thigh to
the posterior thigh and then the popliteal
fossa.
 Femoral Vein
(FV)
• Popliteal vein becomes FV when vein passed
through adductor hiatus
 Common
Femoral Vein (CFV)
• Formed by joining of FV & Deep femoral vein
 External
iliac Vein (EIV)
• Common femoral vein becomes EIV when
passes through inguinal ligament
 Common
Iliac Vein (CIV)
• Formed by confluence of external and internal
iliac veins
 Because
the left common iliac vein
passes under the right common iliac
artery, extrinsic compression may be
evident.
 This pressure point may account for left
sided DVT; also known as May-Thurner
Syndrome
 Inferior Vena
Cava (IVC)
• Formed by confluence of common iliac veins
• Commonly at level of 5th lumbar vertebra
• Carries blood into right atrium of heart
 Small
saphenous (formally
lesser) vein (SSV)
• Ascends back of calf joining popliteal
vein
 Great
(formerly Greater) Saphenous Vein
(GSV)
• Longest vein in the body, originating on dorsum
of foot, traveling medially to saphenofemoral
junction in the groin (about level of CFA
bifurcation)
 Carry
blood from superficial veins into
deep veins
 Posterior arch vein
• Has three ankle perforators
• Plays major role in development of venous stasis
ulcers
 Intracranial:
• Spaces between dura mater and periosteum that
drain blood into the Internal Jugular Vein
 Lower
extremity:
• Dilated channels in soleal and gastrocnemius
muscles
• Drains blood into the posterior tibial vein and
Peroneal Vein
• Major part of calf muscle pump
 Deep Veins
• The paired deep veins of the arm follow the
corresponding arteries; called venae comitantes
(corresponding veins)
 Radial veins
 Ulnar veins
 Brachial veins
 Paired
radial veins (RadV)
• Formed by confluence of venules
• Empties lateral hand and forearm
 Paired
ulnar veins (UlnV)
• Formed by confluence of venules
• Empties medial hand and forearm
 Paired
brachial veins (BraV)
• Formed by confluence of radial and ulnar veins
 Axillary
veins (AxV)
• Formed by confluence of brachial vein and
basilic vein (basilic vein is in the superficial
system)
 Subclavian
vein (SubV)
• Formed by the confluence of axillary vein and
cephalic vein (cephalic vein is superficial
system
 Innominate
vein (InnV)
• Formed by confluence of subclavian vein and
internal jugular (Also called brachiocephalic)
 Superior
vena cava (SVC)
• Formed by confluence of right and left
innominate veins
• Carries blood into right atrium
 Basilic Vein:
• Formed by the digital veins
• Empties medial aspect of arm
• Joins brachial vein to form axillary vein
• Can be harvested for arterial bypass conduit
Cephalic vein
 Formed by digital veins
 Empties lateral aspect
 Joins axillary vein to form subclavian vein
 Can be harvested for arterial bypass
conduit
 Superior Vena
Cava (SVC)
• Formed by confluence of innominate veins
• Drains head and upper extremity veins
• Terminates in right atrium
 Inferior Vena
Cava (IVC)
• Formed by confluence of common iliac veins
• Drains lower half of body
• Terminates in right atrium
 Portal
vein
• Formed by superior mesenteric and splenic
veins
• Drains abdominal part of digestive tract,
pancreas, spleen, and gallbladder
• Carries blood into sinusoids of liver (hepatopetal flow)
• Carries approximately 80% of blood flow to the
liver
 Hepatic Veins
• Carries blood from the liver into IVC (flow away
from the liver called hepato-fugal)
 Renal
veins – empties into the IVC
 Function
• Thin walled, collapsible tubes that transport
blood from capillaries toward heart
• Carry away waste products of cellular activity
• Not completely passive structures; have some
element of reactivity, which may be referred to
as veno-motor tone; contraction of smooth
muscle cells can occur in response to stimulation
of sympathetic nervous system, i.e., temperature,
exercise, stress, traume
 Same
three layers as arteries, e.g., intima,
media, adventitia (Media layer very thin)
 Venous system starts at capillary level
with progressive increase in size (venules
smallest – vena cava – largest)
 Extensions
of intimal layer
 Bicuspid structures providing
unidirectional flow
 Valves of lower extremities more
susceptible to disease secondary to the
effects of venous thrombosis, increased
ambulatory venous pressure from gravity,
increased intraabdominal pressure and
or venous obstruction.
 Soleal
sinuses
 External iliac vein: contains valves
approximately 25% of the time
 Common Iliac and internal iliac
 Innominate
 Superior and Inferior vena cava
 Great
saphenous vein has approximately 12
valves: most are below the knee
 Small Saphenous: 6 -12 valves
 Perforators: each contains a valve
 Intrapopliteal (deep veins: 7 – 12 valves
each
 Popliteal and femoral: 1-3 valves each
 External iliac vein: contains valves
approximately 25% of the time
 Common femoral: 1 valve
 Jugular Vein: 1 valve
 Basilica and cephalic: 1 valve each
 Variable number of UE deep veins has
valves
Lower extremity venous
 Peroneal veins are paired
 Posterior tibial veins par paired
 Take note if May-Thurner Syndrome
Upper extremity veins
 Know medial to lateral and lateral to
medial
Hepatic blood flow direction
 Hepato-petal flow is blood flow into the liver
 Hepato-fugal flow is blood flow away from
the liver
Veins with valves
 Where the most of the valves are: the further
away from the heart!!
 The closer to the heart, the least likely for a
vein to have a valve.
 Textbook: Chapter
24
• Gross Anatomy of the Central Peripheral Venous
systems
 Pages 265 – 276
 SDMS
Assignments