Download Need to Know Leg venous Anatomy

NEED TO KNOW LEG VENOUS
ANATOMY
Competency 1- Demonstrate appropriate
examination technique
http://1.bp.blogspot.com/_FYzmMSSuvWc/TEHOq8vipI/AAAAAAAAFeg/SplD_bhoS60/s1600/nic_k20_999.jpg
INTRODUCTION



In order to competently complete a DVT leg
examination it is important that the Sonographer
understands the normal anatomy of the venous
system as well as the common variations involved.
The venous system is divided into the
superficial and deep system. The superficial
includes the Great Saphenous vein and Short
saphenous vein and the deep involves the; common
femoral,femoral,profunda, popliteal, gastrocnemius,
soleal , anterior tibial, posterior tibial and peroneal
veins (Rumack, Wilson, Charboneau, & Levine,
2011).
The deep veins are located beneath the muscle
fascia and their role is to drain the muscles of the
lower extremity (Meissner, 2005).
The following slides demonstrate step by step
location and normal lower leg venous anatomy
 There are some variations involved in the venous
anatomy, the most common involves the
duplicating veins particularly the femoral and
popliteal (Thrush & Hartshorne, 2010).

LEFT COMMON FEMORAL VEIN

The common femoral vein continues from the
external iliac vessel in the inguinal region. It then
bifurcates into the femoral and profunda vein
(Rumack, Wilson, Charboneau, & Levine, 2011).
LEFT SAPHENOFEMORAL JUNCTION

The saphenofemoral junction involves the
common femoral vein and great saphenous
vein and lies immediately below the
beginning of the common femoral vein.
LEFT COMMON FEMORAL VEIN

The above image demonstrates the common
femoral vein just before its bifurcation
LEFT PROFUNDA VEIN (DEEP FEMORAL
VEIN)

The profunda vein can only be assessed at its
proximal portion as it dives deep within the
muscle. It is positioned just superior to the
bifurcation (Rumack, Wilson, Charboneau, &
Levine, 2011).
LEFT FEMORAL VEIN

The femoral vein continues from the common femoral
vein. It lies medial to the quadriceps muscles and extends
from the proximal femur to distal joining the popliteal
vein (Rumack, Wilson, Charboneau, & Levine, 2011).
LEFT PROXIMAL FEMORAL VEIN
LEFT MID FEMORAL VEIN
LEFT DISTAL FEMORAL VEIN

As the femoral vein continues it
travels distally through the adductor
canal. This canal provides an
intermuscular passage for the
femoral vessels (Moore, Agur, &
Dalley, 2010).
LEFT GREAT SAPHENOUS VEIN

The great saphenous vein begins medially
at the proximal portion of the common
femoral vein and continues to the foot
located within the superficial subcutaneous
tissue (Rumack, Wilson, Charboneau, &
Levine, 2011).
MID GREAT SAPHENOUS VEIN
LEFT POPLITEAL VEIN

The popliteal vein extends from the distal femoral
vein in the posterior aspect of the knee and lies
anterior to the popliteal artery. The first branch is
the anterior tibial veins (Rumack, Wilson,
Charboneau, & Levine, 2011).
LEFT TIBIOPERONEAL TRUNK VEINS

The tibioperoneal trunk bifurcates into the
paired peroneal and posterior tibial veins.
(Rumack, Wilson, Charboneau, & Levine,
2011)
LEFT SHORT SAPHENOUS VEIN

The short saphenous vein or (small) can insert into
the popliteal vein in a number of locations. It travels
down the mid posterior calf within the subcutaneous
tissue extending to the ankle (Rumack, Wilson,
Charboneau, & Levine, 2011).
MID SHORT SAPHENOUS VEIN
LEFT LATERAL GASTROCNEMIUS VEINS

The Gastrocnemius veins are located within the
medial and lateral gastrocnemius muscles. The veins
drain into the popliteal vein. The lateral
gastrocnemius veins usually appear smaller than the
medial (Arger, 2004).
LEFT MEDIAL GASTROCNEMIUS VEINS
LEFT SOLEAL VEINS

The soleal veins and sinuses drain the veins of
the soleal muscle directly into the posterior
tibial and peroneal veins. The are not
accompanied with arteries and vary in size
(Arger, 2004).
LEFT POSTERIOR TIBIAL AND PERONEAL
VEINS DISTAL

The paired peroneal veins travel with the artery
and sit medial to the fibula. The paired posterior
tibial veins also follow the artery and are situated
posterior to the tibia (Arger, 2004).
LEFT POSTERIOR TIBIAL AND PERONEAL
PROXIMAL VEINS
LEFT POPLITEAL FOSSA

The popliteal fossa is a diamond shaped space located
at the posterior aspect of the knee. A common
pathology seen within this region is a Bakers cyst
which appears between the gastrocnemius muscle
and semimembranous (Moore, Agur, & Dalley, 2010).
CONCLUSION

Through an understanding of the venous
anatomy the Sonographer will be able to
competently detect abnormal pathology, such as
Deep vein thrombosis. They will be able to
describe its location, extent and position in
relation to other vessels.
BIBLIOGRAPHY





Arger, P. (2004). The Complete Guide to Vascular
Ultrasound. Philadelphia: Lippincott Williams &
Wilkins.
Meissner, M. (2005). Lower Extremity Venous
Anatomy. Seminars in Interventional Radiology , 14156.
Moore, Agur, & Dalley. (2010). Essential Clinical
Anatomy 4th ed. Lippincott, Williams & Wilkins.
Rumack, C., Wilson, S., Charboneau, J., & Levine, D.
(2011). Diagnostic Ultrasound 4th edn. Philadelphia:
Elsevier Mosby.
Thrush, A., & Hartshorne, T. (2010). Vascular
Ultrasound- How, Why and When. London: Churchill
Livingstone.