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Angiology4
Department of Anatomy
Luzhou Medical College
Edited by professor Xiao
The veins

Concept

Characteristics

Specially veins
Larger cavity
Thinner wall
Lower pressure
Slower flow
Superficial veins
Deep veins
Venous valves
Numerous anastomoses
Diploic veins
Sinus of dura mater
Systemic veins

Division
(Coronary veins)
Pulmonary veins
Ⅰ. The pulmonary veins

They carry oxygenated blood from the lungs to the left atrium.
The pulmonary veins are two in number from each lung,
superior and inferior, that all of them originate from the
capillary network in the oveolar wall and devoid of valves. By
repeating junctions tributary veins finally form a single trunk in
each lobe (left two and right three). In the pulmonary hilum,
the tributaries of each lung form the superior and inferior
pulmonary veins draining into the left atrium.
Left superiuor
pulmonary vein
Left inferior
pulmonary vein
Right superior
pulmonary vein
Right inferior
pulmonary vein
Pulmonary artery
Ⅱ.the systemic veins
Superior vena cava
systemic
veins
The vein of the heart
The head, neck,
upper limb, thorax,
upper part of the
abdominal wall
Greater cardiac vein
middle cardiac vein
lesser cardiac vein
Lower limbs
Inferior vena cava pelvis
abdomen
1. Superior vena cava

It is a short venous trunk and
is formed by the junction of
the two brachiocephalic veins.
It begins behind the lower
border of the first right costal
cartilage, close to the
sternum, descends on the
right of the ascending aorta
and ends in the upper part of
the right atrium opposite the
lower border of the third
sternocostal joint. It receives
the azygos vein before
superior vena cava joins the
right atrium
2. The brachiacephalic veins

Also called innominate vein,
each is formed behind the
stenoclavicular joint by the
union of the internal
jugular and the subclavian
veins of the same side.
The angle of the union is
termed the venous angle.
The left brachiacephalic
vein runs obliquely
downwards to the right
across the three main
branches of the aortic arch,
so the left is much longer
than the right.
Besides the internal jugular and the subclavian veins, its
tributaries also include vertebral , internal thoracic and
inferior thyroid veins
(1) Internal jugular
vein

Collects the blood from
the skull, the brain, the
superficial parts of face
and much of the neck. It
begins as a continuation
of the sigmoid sinus in the
jugular foramen at the
skull base. Then the vein
runs downwards through
the neck with the internal
artery, common carotid
artery and vagus nerve
within the carotid sheath
in which the position of
the vein is on lateral, the
artery on medial, and the
vagus nerve lies
posteriorly between them.
Clinic note
Deep facial vein
The internal jugular vein has thin wall which is united
with the carotid sheath to provide beneficial condition
for blood return. But when the internal jugular vein
is ruptured, it may lead to air embolus.
Facial vein It begins at the medial angle of the eye.
superior ophthalmic vein
Tributaries
Internal jugular vein
Pterygoid venous
Plexus is located
The temporalis
and The lateral
pterygoid muscles
Cavernous sinus
Angular vein
Facial vein
Facial vein
No valves
Dangerous area
Superficial temporal vein
Retromandibular
Maxillary vein
vein
emissary foramen
Pterygoid plexus and its communications
Superior vena cava
Internal jugular vein
Sternoclavicular joint
Subclavian vein
Brachiocephalic vein
External jugular vein
Posterior division of
retromandibular vein
Posterior auricular vein
Outer border
of the first rib
Axillary vein
Clinic note
The wall of the subclavian vein is tightly fastened by
the fascia around it . When the vein is hurt in clinic
operation, the air can go into the vessel through the
aperture, and then could result in the air embolus.
Posterior auricular vein
Posterior division of
retromandibular vein
Anterior division of
retromandibular vein
External jugular vein
The veins of upper limb
Superficial veins
Deep vein
Cephalic vein
Median cubital vein
Basilic vein
Dorsal venous rete hand
Dorsal digital veins
Superior vena cava
Azygos
Subclavian vein
Accessory hemiazygos vein
Hemiazygos vein
Left ascending lumbar vein
Right ascending lumbar vein
Inferior vena cava
And its tributaries
Right atrium
Vena cava foramen
Inferior vena cava
Common iliac vein
Fifth lumbar vertebra
The tributaries of the inferior vena cava
Inferior
Parietal
tributaries
Inferior phrenic vein
Lumbar vein
vena
Hepatic vein
cava
Visceral
tributaries
Pampiniform plexus
Right suprarenal vein
Renal vein
Right testicular vein
(Right ovarian vein)
Internal vein of the
Spermatic cord
Common iliac vein
Internal iliac vein
External iliac vein
Parietal tributaries
Femoral vein
Inferior epigastric vein
Receive the blood from the
regions which the corresponding
Arteries supply.
Visceral tributaries
Superior rectal vein
Inferior rectal vein
Internal pudendal vein
(rectal venous plexus)
Internal and external
rectal plexuses
The veins of the lower limb
Deep vein
Superficial veins
Superficial iliac circumflex v.
Superficial epigastric v.
Superficial lateral femoral v.
superficial medial femoral v.
External pudendal v.
Femoral vein
Popliteal vein
Small saphenous vein
Great saphenous vein
Dorsal venous arch of foot
In front of the medial
malleolus is superficial and
its location is almost no
variability, so it often used
to transfuse and inject in
clinic.

Inferior mesenteric vein
Superior mesenteric vein
Splenic vein
form
The hepatic portal vein
Characteristics
Between two sets
of capillaries
No valves
High pressure in
portal vein the
blood can flow
adversely
It is a functional
vessel of liver
Collects the blood from the
abdominal part of the
digestive canal, except the
anal canal, and from the
pancreas, the spleen and
the gallbladder and the
liver.
Hepatoduodenal ligament
Tributaries
Superior mesenteric vein
Splenic vein
Inferior mesenteric vein
Left gastric vein
Right gastric vein
Paraumbilical vein
Cystic vein
The anastomoses between the hepatic portal
venous system and vena cava system
 1. anastonoses through the esophageal
venous plexus

Hepatic v.
left gastric v.
esophageal venous plexus
v.
superior vena cava.
esophagus v.
esophageal v.
azygos

2. the anastomoses through the rectal
venous plexus

Hepatic v.
Splenic v.
Inferior mesenteric v.
Superior rectal v.
Rectal venous plexus
inferior
rectal v. and anal v.
Internal iliac v.
Common
iliac v.
Inferior vena cava.
3. The anastomoses through periumbilical
venous rete
Hepatic portal v.
paraumbilical v.
periumbilical venous rete
The following routes
 ①Superficial epigastric v.
Great saphenous v.
Femoral v.
External iliac v.
Common iliac v.

Inferior vena cava
 ②Thracoepigastric v.
Lateral thoracic v.
Axillary
v.
Subclavian v.
Brachiocephalic v.

Superior v.
 ③ Superior epigastric v.
Internal thoracic v.
Brachiocephalic v.
Superior vena cava


4. vertebral veins, lumbar veins and anastomose with the
veins of the posterior wall of the abdomen and the posterior
wall of the thorax.
4.
vertebral veins, lumbar veins
and anastomose with the veins of
the posterior wall of the abdomen
and the posterior wall of the thorax.
5. Anastomoses through the
union between small veins
posterior wall, the small
tributaries of the superior and
inferior mesenteric veins
anastomose with the small
divisions of the posterior
intercostal vein, the inferior
diaphragm vein, the renal vein
and testicular vein.
Paraumbilical veins
Cystic vein
Left gastric vein
Right gastric vein
Splenic vein
Superior mesenteric v.
Inferior mesenteric v.
Hepatic portal vein
T
y
p
e
s
The types of the hepatic portal vein
Great saphenous vein
Small saphenous v.
The dorsal venous
arch of the foot
Superior rectal vein
External rectal plexus
Internal rectal plexus
The lymphatic system

The lymphatic system is an accessory system of the
cardiovascular system.

The blood— blood capillaries—certain fluid elements filter through the
wall of the capillaries into the tissue spaces and become the tissue fluid.

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The tissue fluid is mostly taken up by the blood capillaries, partly by the
lymphatic capillaries.
Composition
Lymphatic system consists of the lymph conducting channels, lymphoid
tissues and lymphoid organs.
Lymph tissues: contain lymphocytes. Diffused lymphoid tissues and
lymph nodules. Such as aggregated lymphatic follicles.
Lymphoid organs: lymph nodes, tonsils, thymus and spleen.
Lymphoid vessels: lymphatic capillaries, lymphatic vessels, lymphatic
trunks and the lymphatic ducts
The lymph conducting vessels
1. The lymphatic capillaries
Dilated blind ends and form network in the tissue spaces. The
wall of lymphatic capillaries consists of a single layer of
verlapping endothelial cells attached by anchoring filaments to
surrounding connective Tissue. The basal lamina is often lacking
and the pericytes are absent.
The absent of the lymphatic capillaries
Specialized lymphatic capillaries
Epidermis. Hair. Nails.
Cornea. Lens. Vitreous body.
Articular cartilage. Splenic
pulp. Bone marrow.
Enament. Central N.S.
Intestinal villi
Absorb the fat from the small intestine
2. Lymphatic vessels
Superficial lymphatic vessels
valves
Deep lymphatic vessels
3. Lymphatic trunks
Left and right jugular trunks
Left and right subclavian trunks
Left and right bronchomediastinal trunks
Left and right lumbar trunks
Intestinal trunk
Thoracic duct
4. The lymphatic ducts
Right lymphatic duct
The lymph nodes
Lying in the course of lymphatic vessels
Arranged in groups in certain place
position
Oval or bean-shaped bodies
A slightly depression—hilum
Efferent lymphatic vessels at hilum
Afferent lymphatic vessels at periphery
form
Regional lymph nodes
Clinic note
One feature of lymphatic system
Is significance is the spread of tumor
Cancer usually produces a secondary
Growth (metastases).
Lymph from an area of
body is drained into the
local corresponding lymph
nodes. These nodes
termed regional lymph
nodes
The lymphatic ducts
Left venous angle
Right venous angle
The thoracic duct
Posterior mediastinum
Right lymphatic duct
Left cervical trunk
Left subclavian trunk
Left bronchomediastinal trunk
Aortic hiatus
Right cervical trunk
Right subclavian trunk
Right bronchomediastinal trunk
Cisterna chyli
Left and right lumbar trunks
Intestinal trunk
Lymphatic
Drainage
The lymphatic
drainage of
the head and
neck
The lymph nodes of
the head lie in the
boundary between
the head and neck
they consist of the
occipital, mastoid,
parotid, submandibular
and submental lymph
nodes
Deep lateral cervical lymph nodes
Lymphatic
Drainage
The lymphatic
drainage of
the head and
neck
The lymph nodes of the neck
Anterior cervical lymph nodes
Superficial group
Deep group
Lateral cervical lymph nodes
Superficial group
Deep group
Deep Lateral
Cervical Lymph
nodes
Superior group
Inferior group
Inferior deep
lateral cervical
lymph nodes
Transverse
cervical chain
of nodes
Supraclavicular
nodes
Deep Lateral
Cervical Lymph
nodes
Inferior group
Inferior deep
lateral cervical
lymph nodes
Transverse
cervical chain
of nodes
Supraclavicular
nodes
Virchow’s lymph node
The lymphatic efferents of the
head and neck unite to form
the left and right trunk.
The lymphatic drainage of the upper limb
All of the vessels of the
upper limbs drain into the
terminal roup of lymph nodes,
the axillary lymph nodes. The
superficial tissues are drained
by vessels which accompany
the superficial veins to pass
to the axillary nodes either
directly, or indirectly. The
deep lymph nodes follow the
principal neurovascular
bundle and end in the lateral
group of the axillary lymph
nodes.
 1. Cubital lymph nodes
 They are superficial to the
deep fascia above the medial
epicondyle of the humerus
and near the deep blood
vessels of the cubital fossa.

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2. The Axillary Lymph

which are in the loose
connective tissue of the
axillary fossa and arranged
along the blood vessels.
They vary from twenty to
thirty in number, and are
divided into five groups.
①. Anterior group or
pectoral lymph nodes
②. Lateral lymph nodes
③. Posterior lymph nodes or
subscapular lymph nodes
④. Central lymph nodes
⑤. apical lymph nodes
The efferents of this
group unite to form the
subclavian trunk.
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The lymphatic drainage of the thorax
Lymph of anterior
wall of thorax
The parasternal
lymph nodes
The intercostal
lymph nodes
The superior phrenic
lymph nodes
Posterior wall
of the
Thoracic
Cavity

The intercostal lymph
nodes
The
superior
phrenic lymph
nodes
The lymph nodes of
the thoracic Contents
Anterior mediastinal lymph nodes
Posterior mediastinal lymph nodes
The lymph nodes of the
trachea, bronchi and lungs
The lymph nodes of the trachea,
bronchi and lungs
The pulmonary lymph nodes
 The broncheopulmonary hilar lymph nodes
 The tracheobronchial lymph nodes
 The paratracheal lymph nodes
 The efferents of the contents of the thorax
to form left and right bronchomediatinal
trunks

Lymphatic drainage of the abdomen
The lymph nodes of
the abdominal wall
The superficial lymphatic
vessels
from the anterior abdominal wall
above the umbilicus follow the
superficial blood vessels to the
axillary nodes; the part below
umbilicus is drained to the
superficial linguinal lymph nodes.
The deep lymphatic vessels from
the posterior abdominal wall pass
directly, along the course of the
lumbar arteries, to lumbar lymph
nodes. Those from the upper part of
the anterior wall run with the
superior epigastric vessels to reach
the parasternal lymph nodes; those
of the lower part end in the external
iliac lymph nodes.
The lymph of the posterior abdominal wall
The lymph of the abdominal paired viscera
Lumbar lymph nodes
Common iliac nodes
Internal lymph nodes
External lymph nodes
The lymph nodes of the lower limb

The lumbar lymph
nodes lies
alongside the
abdominal aorta
and inferior vena
cava. They
receive afferents
from the posterior
abdominal wall,
the abdominal
paired viscera and
from the common
iliac nodes. Their
effrents unite to
form the right and
left lumbar trunks.
The lymph nodes of the abdominal viscera
The lymphatic drainage of the
unpaired viscera of the
abdominal cavity
Celiac lymph nodes
Superior mesenteric
lymph nodes
Inferior mesenteric
lymph nodes
The celiac lymph nodes They lie on the front of the abdominal aorta close to
the origin of the celiac artery. They are the terminal group for the stomach,
deodenum, liver, gallbladder, pancreas and spleen, and their afferents are derived
from the outlying lymph nodes which are placed along branches of the celiac artery.
①. Right and left gastric lymph nodes
②. Right and left gastroepiploic
lymph nodes
③. Pyloric lymph nodes
④. Hepatic lymph nodes
⑤. Pancreaticosplenic lymph nodes
The superior mesenteric lymph nodes
Inferior mesenteric lymph nodes
The lymphatic drainage of the pelvis
①. Sacral lymph nodes
③. External iliac lymph nodes
②. Internal iliac lymph nodes
④. Common iliac lymph nodes
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The lymphatic drainage of the
lower limbs
Most superficial lymphatic vessels follow the
great saphenous vein to end the lower
group of the superficial inguinal lymph
nodes; others run with the small saphenous
vein to the popliteal lymph nodes. The deep
lymphatic vessels accompany the main
blood vessels of the limb. The deep
lymphatic vessels of the foot and leg are
interrupted by the popliteal lymph nodes,
but those from the thigh pass direct to the
deep inguinal lymph nodes.
The popliteal lymph nodes
They are imbedded in the fat if the popliteal
fossa. The nodes are near the end of the
small saphenous vein and arranged along
the popliteal blood vessels. They receive
afferents from the deep lymphatic vessels
which accompany the anterior and posterior
tibial vessels, and superficial lymphatic
vessels from the lateral border of the foot,
and the back lateral side of the calf of the
leg. Their efferents pass to the deep
inguinal lymph nodes

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The inguinal lymph
nodes
①.The superficial inguinal
lymph nodes
They are arranged in two groups.
The upper group forms the a chain
immediately below the inguinal
ligament. The lymphatic vessels from
the lower part the abdominal wall,
external genitalia, gluteal region and
perineum pass this group. The lower
group is disposed vertically along the
terminal part of the great saphenous
vein. It receive all the superficial
lymphatic vessels of the lower limb,
with the exceptionof those from the
lateral border of the foot, and the
back and lateral side of the calf of
the leg. All the superficial inguinal
lymph nodes send their efferents to
the deep inguinal lymph nodes and
the external iliac nodes.
②. The deep inguinal lymph nodes
They are situated medial to the femoral vein and in the femoral canal.
They receive lymph from the deep structures of the lower limb and
perineum, and the afferents from the superficial inguinal and popliteal
lymph nodes. The efferents pass to the external iliac lymph nodes.
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The lymphatic drainage of
the mammary gland
Efferents vessels of the
mammary gland mainly drain to
the axillary lymph nodes. There
are 3drainage directions:
①. Efferents vessels of the
lateral and central part drain to
the pectoral lymph nodes.
②. Efferents vessels of the
superior part to the apical lymph
nodes and subclavicular lymph
nodes.
③. Efferents vessels of the
medial part to the parasternal
lymph nodes. Superficial
lymphatic vessels of the medial
part of the organ communicate
with the vessels of the opposite
side.
④. Lymphatic vessels of the
medioinferior part communicate
with the hepatic lymphatic
vessels by the epigastric
lymphatic vessels and inferior
phrenic lymphatic vessels.
The spleen
It is the largest lymphoid organ in
The body. and is surrounded by
Peritoneum
Function
Main functions are erythrocyte
Storage, phagocytosis, cytopoiesis
and immune responses.
Position
Lies in the left hypochondriac region of the abdomen. It is situated between
The fundus of stomach and diaphragm and deep to the 11th left ribs. Its
long axis corresponds to the 10th ribs. The normal spleen is not palpable
below the left costal margin unless it is enlarged or markedly dislocated.
Form
Soft, fragile, dark purplish color.
Has two surfaces (diaphragmatic and visceral), two borders (superior and
inferior) and two extremities (anterior and posterior).
Diaphragmatic surface is convex, smooth and faces upwards. It is in
relation with the abdominal surface of the diaphragm.
Visceral surface is directed towards the abdominal cavity, and
presents gastric, renal, pancreatic and colic impressions.
The hilum of spleen
It has a long fissure near
The center of its visceral
Surface. It is for the exit
And entrance of blood
Vessels and nerves.
Splenic notch
Superior border is sharper
And marked, near its lateral
End, by two or three splenic
Notches of variable depth,
Which can be recognized
When the spleen is enlarged
Splenic notch
Hilum of spleen
Visceral surface
Test for Angiology
1. The entrances of the left and right atria?
 2. The boundary between the inflow and outflow in the

right ventricle?
 3. Describe the fibrous skeleton of the heart?
 4. The conduction system of the heart includes?
 5. Define the systemic circulation.
 6. Describe the arterial supply of the thyroid gland.
 7. Describe the arterial supply of the stomach.
 8. Describe the hepatic portal vein and its tributaries.
 9. Describe the cubital arterial network.
 10. Describe the dangerous triangle of the face and the

communications of the facial vein.
