C1&2: Anatomy & Venous Circulatory System Flashcards
Where is the majority of the body’s blood volume located?
In the veins (~2/3 of blood)
Describe the relationship between pressure and volume in arteries and veins.
Arteries are high pressure and low volume
Veins are low pressure and high volume
Which vessels control resistance to blood flow and pressure in the arterial tree?
Arterioles and precapillary sphincters (there also referred to as resistance vessels)
How should at BP in the ankle compare to a BP in the arm?
They should be the same, or the ankle should be a bit higher…. this shows that arterioles control blood flow
Where are lymph capillaries found and what are their function?
They’re found in capillary beds with blood capillaries.
They function to absorb excessive fluid in tissue which will eventually be returned to venous blood
What are capacitance vessels?
Veins
Describe venules
They’re tributaries of veins that collect blood from capillary beds
What are vena combatants?
Paired veins the often accompany arteries
What causes vein valves to close?
The reversal of blood
Where are valves found in veins?
Where a tributary joins a larger vein and at varying intervals along main veins (mostly at the widest section of a vein)
Where are the greatest number of valves found?
The number of valves increases as you move further away from the heart
Which layer of the veins form the valves?
Tunica intima
What is the tunica intima composed of?
A single layer of endothelial cells and some elastic cells
What is the tunica media composed of?
Smooth muscles cells, collagen fibers and elastic fibers
What is the tunica adventitia composed of?
Fibrous layers made of elastic tissue
What is a vasa vasorum and where is it found?
A network of tiny vessels that supply the walls of larger veins and arteries with O2 and nutrients.
Found in the tunica adventitia
Valves in veins usually have how many cusps?
Bicuspid
At what level do the internal and external iliacs join to form the common iliac veins?
The level of the sacroiliac joint
The internal and external iliac veins drain which structures?
IIV drains the pelvis organs and muscles
EIV drains the leg
At what point does the CIV become the CFV?
The level of the inguinal ligament
The CFV is located where in relation to the CFA?
Medial and posterior
Which landmark can you look for to know you’re at the level of the CFV?
The femoral head
Which two veins combine to form the CFV?
The deep femoral vein/profunda and the femoral vein/superficial femoral vein
What is bifid and how common is it with the femoral vein?
The duplication of a vein, found in 25% of the population for the FV
When we reach the distal portion of the FV, how is it coursing in the leg?
Coursing very deeply as it passes through the adductor canal/hiatus
What is another word for the adductor canal?
Hunters canal
What is one way to distinguish FV distal from Pop vein?
FV distal, the vein and artery will be coursing side by side
Pop V, the vein will be more superficial to the artery
Is the gastrocnemius/sural vein single or pairs? And what vessel does it empty into?
It is paired
Emptied into the Pop vein
The Pop vein in formed by the confluence of which veins?
Anterior tibial veins (2)
And
Tibioperoneal trunk
Where do the anterior tibial veins originate? And how do they course in the body?
Pedal vein in the foot
They course between the tibia and the fibula to join the tibioperoneal trunk
Which veins combine to form the tibioperoneal trunk?
The posterior tibial veins and the peroneal veins
Where do the posterior tibial veins originate and how to they course in the calf?
Originate from the confluence of the medial and lateral planter veins and travel up the medial aspect of the calf
(Think that tibia in more medial and fibula)
Where do the peroneal veins original and how do they course in the leg?
Originate from the foot and travel up the lateral aspect of the calf (posterior to the fibula)
Do we ever assess the anterior tibial veins?
No
What are the soleal sinuses?
What frequent pathology is found here?
Thick walled venous reservoirs in the soleal muscle.
Frequent site of thrombosis
The soleal sinuses empty into which vessel?
The PTV and the peroneal veins
What is the most important function of the soleal sinuses?
They divert blood into deep veins
What are some distinguishing feature of superficial veins?
They are superficial to muscle and they do not have a corresponding artery
What’s ones main function of superficial veins?
Help regulate body temp
What are perforator?
Veins the connect deep and superficial veins
Does the GSV join the CFV superior or inferior to the inguinal ligament?
Inferior
Where does the GSV originate?
Posterior to the medial malleolus
Is the GSV connected in any other way to the deep venous system? (Other than with the CFV)
Yes, through perforating veins
Which vein does the SSV empty into and where specifically along that vein?
Empties into the posterior aspect of the Pop vein above the popliteal fossa
How does the SSV course in the calf?
Along the posterior calf between the gastroc muscle and lateral and posterior to the lateral malleolus
Does the SSV connect to the GSV?
Yes
If a vein is more than 2 times the size of the artery and doesn’t change with respiration, then likely pathology is….?
Thrombus
What are the four key assessments when performing nervous Doppler?
1) spontaneous flow
(vein signals should be seen/heard without any compressions… indicated patency)
2) phasicity
(Signals vary with breathing)
3) augmentation
(Singalong increases with distal compression)
4) non pulsitility
If we get an augmented signal with proximal compression, what does this indicate?
Valvular incompetence because the valves aren’t closing properly, allowing blood to flow backwards
When might a vein show pulsatility?
If it is a larger vein near the heart
OR
if the individual is very hydrated, pulsatility may occur in the LE veins
SVC if formed by the junction of which veins?
The brachiocephalic or innominate veins
The innominate veins are formed by the junction of which veins?
The internal jugular vein and subclavian veins
What areas do the EJV drain?
The superficial areas of the scalp and face
What do the vertebral arteries drain?
The vertebrae, spinal cord and neck muscles
what do the IJV drain?
Most of the blood from the brain and deep areas of the face and neck
What are the dural sinuses?
Large chambers found between the dura mater layers that collect blood from the brain and drain it into the IJV
What are the major dural sinuses?
Superior and Inferior Sagittal sinuses, straight, trans, cavernous, signed and petrosal sinuses
What segments of the liver does the MHV drain?
The anterior segment of the R lobe, the medial segment of the L lobe and the caudate lobe
Is the portal venous system separate from venous circulation?
Yes
What is the approximate length and diameter of the MPV?
Length: 5.5-8cm
Diameter: 1-1.1cm
Does the MPV run anterior or posterior to the first part of the duodenum?
posterior
Which 2 veins drain into the MPV and which 1 vein drains into the LPV?
Draining into MPV: L and R Gastric veins
Draining into LPV: Paraumbilical vein
The SMV originates from where and from which veins?
The root of the mesentery and from the middle colic, right colic and ileocolic veins
How does the SMV course compared to the third part of the duodenum?
Anteriorly
Which 2 veins empty into the SV?
The left gastroepiploic vein and the short gastric veins
Where does the IMV originate?
The anal canal
Which veins are the primary route of drainage for the upper extremities?
The superficial venous system
The axillary vein is formed by which 2 veins?
The brachial veins (2) and the basilic vein
Where to the ulnar veins course in the arm? Where do the radial veins course?
Ulnar: medially
Radial: Laterally
Which 2 veins form the subclavian vein?
The cephalic and axillary
Where does the cephalic empty into the axillary to become the subclavian vein?
media to the humeral head
How does the cephalic vein course in the arm?
Up the lateral aspect
Which muscles does the cephalic vein course through?
Between the deltoid and pectoralis muscle
The medial cubital vein is a branch of what vein
The cephalic
The cephalic vein forms which veins in the hand? The basilica vein forms which veins in the hand?
C: The lateral Dorsal arch of the hand
L: the medial dorsal arch of the hand
What are the 3 main perforating veins and where are they located?
1) Dodd’s - located in medial thigh
2) Boyd’s - located in medial calf
3) Cockett’s - Located in the medial lower 1/3 of the calf
From which organs does the portal venous system gather blood?
The bowel and the spleen
Do the soleal sinuses contain values?
No
Which vein empties more superiorly into the popliteal vein? The gastroc, or the SSV?
SSV
The medial cubital vein connects which two veins in the arm?
The cephalic and basilic veins
What vessels are referred to as exchange vessels
Capillaries
What’s the avg total blood volume of an adult?
What’s the most common blood cells in blood?
5L
RBCs
What are the 2 tributaries of the subclavian veins?
Vertebral veins
EJVs
Which veins are the largest veins in the neck and head
IJV
What is the longest vein in the body
GSV
Which veins in the upper extremities are paired
Brachial
Ulnar
Radial
What % of the population has a duplicated femoral or popliteal vein
25%
What is a popliteal fossa variant
High confluence of the ATV
