Module 1 Venous Anatomy Flashcards
What is the circulatory system?
A network of blood vessels that the transport nutrients, hormones, etc. to and from the heart
What is the circulatory system comprised of? 5
- Heart
- Arteries and arterials
- Veins and venues
- Capillaries
- Blood
The right side of the (pulmonary) circulation has what kind of flow? As a result how did the walls seem?
Little resistance to flow, so the walls of the right ventricle are thinner
The left side of the (pulmonary) circulation has what level of resistance? What does this do to the walls?
Greater Peripheral resistance so the left ventricular walls are more muscular
What is the pressure system of the arteries and arterials? And what is the volume?
- High pressure system
- Low volume
What is the pressure system of the veins and venues ? What is the volume?
- Low pressure system
- High volume
What do the capillaries do?
Exchange between blood and tissue
Veins are capacitance vessels that hold how much blood volume?
2/3 of blood volume
What are considered a low pressure blood reservoir and what does it do?
Veins, and they return blood to the heart
What are vena combatants?
Veins are often paired in the extremities and accompany an artery
What two things controls the resistance of flow in the arteriole side? And what does it help regulate?
- Muscular arterioles
- Precapillary sphincters
- The helps regulate the pressure in the arterial tree
Lymph capillaries coexist with what? And what does it do?
- Blood capillaries
- They exchange anything from liquid to cells. They “mop up” or absorb excessive fluid like with interstitial edema
Single celled capillary walls help do what?
Exchange nutrients and gasses
Average total blood in the adult body?
5L
Blood is formed of what?
- Erythrocyte (red blood cell)
- Leukocytes (white blood cells)
- Platelets
What is the vasa vasorum?
Network of tiny vessels that supply the walls of large veins and arteries with nutrients and oxygen
Veins have 3 layers what are they?
- Tunica Intima
- Tunica media
- Tunica adventitia
The number of valves increase as what?
Distance from the heart increases
Valves allow for what? Where are there more valves?
One way flow and present with greater numbers in the upper and lower extremities
Valves in the Intimal layer usually consist of how many leaflets?
Bicuspid
What is reflux blood?
Fills the pockets behind the leaflets causing them to close and stop the reversed flow
Where are valves in the veins usually found?
Where a tributary joins a larger vein and at intervals along main veins
What are three different types of veins/
- Deep
- Superficial
- Perforators
Deep veins are surrounded by what? They are usually accompanied by what? Calf veins are special how?
- Surrounded by muscles
- Have an accompanying artery
- Calf veins are duplicated
What does the internal iliac veins drain?
Pelvic viscera and muscles
What does the external iliac veins drain?
Leg
Where is the Common iliac vein seen at? What is it formed by?
The level of the sacroiliac joints and are formed by the confluence internal and external iliac veins
External iliac vein becomes the common femoral vein where?
Inguinal ligament
Pop vein is formed by the confluence of what? 3
- Anterior tibial veins
- Tibioperoneal trunk
- Perineal veins
What is the anterior tibial vein (ATV)? Where is it located? What does it join?
- Pedal vein in foot
- Between the tibia and fibula
- Joins the tibial trunk
Where is the Tibioperoneal trunk found? What two things does it consist of?
Found along medial calf and consists of the
1. Posterior tibial veins
2. Medial and lateral plantar veins
What are the Peroneal veins (Peroneal veins)? Where is it found?
- Lateral Calf
- Behind fibula
What are the Soleal sinuses?
Thick walled venous reservoirs within the soleal muscle
What does the Soleal Sinuses empty into?
Posterior tibial veins and peroneal veins
Soleal sinuses do not contain what? What does this lead to?
Venous valves and are a frequent site of thrombosis
Where are Lower extremity superficial veins located? 2
- Near the skin surface
- Superficial to muscle
What does the Lower extremity superficial veins help the body to do?
Helps regulate body temperature
Does the Lower extremity superficial veins have a corresponding artery?
No
What structures are included in the Lower extremity superficial veins? 2
- GSV
- SSV
What is the GSV?
Longest vein in the body (long saphenous)
Where is the GSV located?
In the lower extremities medial malleolus to groin
What does the GSV insert into?
CFV and is 4 cm inferior to inguinal ligament
What is the vein system is GSV connected to?
It is a superficial system that is connected to the deep system via perforators
What is the small saphenous vein (SSV)?
Lesser saphenous/ short saphenous vein
What does the small saphenous vein empty into?
Popliteal vein posteriorly
Where is the small saphenous vein located? (Calf and lateral malleolus)
- Posterior calf
- Lateral and posterior to lateral malleolus
Does the small saphenous vein connect to the GSV?
Yes, through numerous tributaries
What is popliteal fossa variant?
High confluence of the Anterior tibial vein
What is the duplication variant in the lower extremity? 2
- Deep veins in the thigh are duplicated in up to 25% of patients.
- Duplication may be segmental or unilateral (femoral vein and popliteal vein)
What are perforators? How does it help the skin level?
- Connect deep and superficial system
- Keep blood from pooling at skin level
Perforators are assessed for what?
Chronic venous insufficiency (CVI)
What are perforating veins?
Veins connecting the superficial to deep vein system
What directions can perforating veins travel?
If functioning properly superficial to deep only!
What are major perforators in the lower extremity? 3
- Dodd’s
- Boyd’s
- Cockett’s
Where is Dodd’s perforators located? Distance from knee? What are they called normally?
- Medial thigh
- Hand width above knee
- “Thigh perforators”
Where is the Boyd’s perforating veins located? Distance from knee? What are they called?
- Medial calf
- Immediately below knee
- “knee perforators”
Where is Cockett’s perforating veins located? What are they called?
- Medial lower third of calf
- “Ankle perforators”
What is the largest vein in the head and neck?
Internal jugular vein
What are the dural sinuses?
- Chambers between the dura matter
What does the dural sinuses drain into?
Internal jugular veins
Are the deep veins in the upper extremities paired?
- Often paired
- Accompanied by an artery of the same name
What do the superficial veins of the upper extremities do? Do they have an accompanying artery?
- Join with deep veins
- Does not have an accompany artery
Where are the superficial veins of the upper extremity located?
Closer to the skin surface
The primary route of venous drainage of the upper extremities are what?
Through the superficial system
What are the UE deep veins? 8
- Superior vena cava
- Innominate (RT and LT)
- Internal Jugular (IJV)
- Subclavian (SCV)
- Axillary
- Brachial (2)
- Radial (2)
- Ulnar (2)
What is the cephalic vein? What does it join to form?
- Upper extremity superficial vein
- Joins the axillary veins and forms the Subclavian vein
What kind of vein is the median cubital vein? What is it a tributary of? What does it join? Where is it located?
- Upper extremity superficial vein
- Tributary of the cephalic vein
- Joins the basillic
- Located near the elbow
What does the basilic vein join? Where is it located?
- Joins the brachial vein to form the axillary vein
- Medial bicep and forearm
What does the basilic vein form in the hand?
The medial dorsal arch of the hand
What is the inferior vena cava?
1.Largest vein in the body
Where does the IVC taper off?
At the union of common iliac veins at the L5
How does the IVC course? Through what?
Superiorly through the retroperitoneum
What is the location of the IVC and the liver?
Posterior
What is the superior path of the IVC?
Passes through the diaphragm and enters the Right atrium
What is the renal veins?
Drain from the hilum of each kidney
Where is the Renal veins located in relation to the renal artery?
Anterior to the artery
Which renal vein is shorter?
Right renal vein is shorter and travels more inferiorly than the left
The Left renal vein travels how in relation to the SMA and the aorta?
Posterior to the SMA and anterior to aorta
What are the hepatic veins?
- Short veins (right, middle, and left ) that drains the liver
- Empties into the IVC just below the diaphragm
What does the right and left hepatics do?
Drain the right and left lobes of the liver
What does the middle hepatic vein do?
- Drains the middle segment of the left lobe
- Drains the anterior segment if the right lobe
What is the portal system?
- Venous system
- Returns blood for blood and spleen
Is the portal system part of the venous circulation?
No it is separate
What substances does the portal system contain?
Nutrients and oxygen
How much blood flow does the portal system deliver to the liver?
3/4
What structures are included in the portal system? 4
- Main portal vein (MPV)
- Superior mesenteric vein (SMV)
- Splenic vein (SV)
- Inferior mesenteric vein (IMV)
Where does the main portal vein form?
Posterior to the neck of the pancreas
Confluence of the superior mesenteric vein and the splenic vein
How long is the main portal vein?
- 5.5 - 8 cm in length
- 1 cm in diameter
Where is the Main portal vein located?
Posterior to the first portion of the duodenum to the porta hepatis
What does the main portal vein divide into?
Left and right branches
What vessels does the main portal vein receive?
LT and RT gastric veins
What does the left portal vein receive?
Paraumbilical vein
Where does the SMV originate?
Root of the mesentery
Where is the SMV located?
In front of the 3rd portion of the duodenum and uncinate process
Where is the SMV located in relation to the SMA?
Parallel and to the left
Where does the splenic vein border?
The posterior surface of the pancreatic body and tail
What veins empties into the splenic vein? 2
- Gastroepiploic vein
- Short gastric vein
What does the splenic vein join with?
The SMV to form the MPV
Where is the Splenic vein located in the abdomen?
Medial and superior in the abdomen
Where does the inferior mesenteric vein start?
Begins midway down the anal canal as the superior rectal vein
Where does the IMV run? What does it join?
Up the posterior abdominal wall on the left side and joins the splenic vein behind the pancreas
Is the IMV easy to recognize on U/S?
No, because of two things
1. Anatomic location
2. Small diameter
