Quiz 2 Flashcards
T or F
Deep veins accompany deep arteries
true
Veins run _____, ________, __________
Central
Mid
peripheral
Venous Valves
Found in tunica intima
- Thin, paired structures consisting of
endothelial and connective tissue
- Normal valve allows blood flow in one direction
- Found in broadened area of vein called valve
sinus
Valve Competency
Valve is considered competent when it does not allow reversal of blood flow
With incompetent valves
DVT formation in valve sinus may cause injury to valve - Valve leaflets may be frozen open - Venous blood will flow retrograde when pressure on venous system is released
Valves in communicating system (perforators)
! Prevent flow from deep to superficial system
Valves in superficial system
Prevent flow from deep to superficial system ! Prevent retrograde flow in the superficial
system
amount of venous valves
Valves are more numerous in deep calf veins
- Decrease in number in popliteal and femoral
veins
- Located throughout the great and small saphenous veins
Anterior Tibial Veins
Paired veins that accompany ATA
- Ascend in the interosseous membrane between tibia and fibula to drain into popliteal vein
- Drains ankle joint, knee joint, tibiofibular joint and anterior portion of leg
Posterior Tibial Veins
Medial and lateral plantar veins form paired
PTVs
- Posterior to medial malleolus
-Accompany PTA
-Ascend deep in muscles of posterior leg
-Drain foot and posterior compartment muscles
peroneal veins
Paired peroneal v.
Drain lateral and posterior leg muscles
Gastrocnemius & Soleal Veins
Referred to as
Soleal Veins (sinsus)
- Venous sinuses located in the calf muscle
- Carry venous return from the muscle into the
PTV and peroneal vein
“Calf-muscle pump”
Popliteal Vein
Formed by confluence of Peroneal and PTV
- Found posterior to popliteal artery
- Continues to level of adductor canal to become FV
- SSV joins it posteriorly
- Drains knee joint and skin, muscles, and bones of portions of calf and thigh around knee joint
- Receives the gastrocnemius and small saphenous v.
Femoral Vein (formerly SFV)
Extends from adductor canal medially to upper thigh
- Accompanies femoral artery
- Joins DFV to form CFV ! THIS IS A DEEP VEIN
- It is part of the deep venous system and is NOT a superficial vein
- Blood clots in this vein are potentially LIFE THREATENING
Deep Femoral Vein
Also known as profunda femoris v.
- Brings venous flow from the thigh muscle and lower pelvis to common femoral vein
Common Femoral Vein
Lies medial to the artery in the groin
- Proximal limit is inguinal ligament, distal limit is division into FV and DFV
- GSV joins it at its medial aspect
- A valve is found in the saphenofemoral junction (SFJ)
External Iliac Vein
Brings venous blood from CFV to IVC via common iliac veins
- Joins with internal iliac vein to form common iliacs
Great Saphenous Vein
vein arises anterior to medial malleolus. travels superiorly along medial aspect of leg until joining the CFV. Longest vein in the body. originally called the “greater saphenous”. Also called “Long saphenous V.”
Great Saphenous Vein location
outside the muscular fascia. look for 2 fascial planes “winking eye”.
Caution1: most errors occur when the anterior saph. is scanned instead of the GSV. the GSV is more posterior then you think.
Caution 2: like all veins the superficial GSV compresses with the lightest of probe pressures.
Small Saphenous Vein
Originally called lesser or short saphenous vein
- Arises posteriorly from lateral malleolus
- Courses posteriorly up calf to enter popliteal vein behind the knee
- May have 9-12 valves
- Drain foot, posterior leg
- Often referred to as “stocking-seam” vein
Vein of Giacomini
Sometimes the SSV does not anastamose with the popliteal v., but continues proximally into the thigh
- Also called a thigh extension (TE) or intersaphenous anastamosis
- Typical TE = SSV terminates at pop v, but a branch continues up the thigh and enters the GSV
- Other variants: SSV itself does not terminate at pop but continues into thigh
- Problems with insufficiency
Communicating Veins
Veins provide a connection between the superficial and deep venous systems
- Contain valves that allow blood to flow from the superficial to deep system
Communicating Vein Locations
- Hunterian – prox thigh
- Dodd’s – distal thigh
- Boyd’s – proximal calf
- Highest anteromedial perforating v. in calf
- Cockett’s perforators
- Located 6, 12, and 18 cm above heel
3 ways blood fights gravity to get back to the heart
intrathoracic pressure changes
venous valves
calf0muscle pump
Intrathoracic pressure changes:
pressure inside the chest decreases with inhalation & increases with exhalation. Therefore, below the diaphragm, blood ceases to flow in inspiration & resumes flow in exhalation.
anything superior to the right atrium is _______ pressure
negative
anything inferior to the right atrium is _______ pressure
positive.
the proper name for the superficial femoral vein is the
femoral vein
the proper flow is from:
superficial to deep systems.
valves are the only thing keeping venous blood moving in a forward direction?
false
90% of PE come from ______ thrombi.
lower extremities.
Radial veins
- Begin at deep palmer venous arches
- Drain lateral aspects of forearms, pass alongside
of radial arteries - Unite with ulnar veins to form brachial veins
Ulnar Veins
Larger than radial veins
- Begin at superficial palmar venous arches
- Drain medial aspect of forearms, pass alongside
of ulnar arteries
- Join with radial veins to form brachial veins
Brachial Veins
At proximal radial and ulnar trunks are the paired brachial veins
- Drain forearms, elbow joints, arms and humerus
- Passes superiorly and joins axillary vein
- Almost always paired
- One on each side of artery
Axillary Veins
- Brachial veins unite and join axillary vein
- Drain arm, axilla, and superolateral chest wall
- Transition is at the lower border of the teres major muscle
Subclavian Vein
Axillary vein continues proximally to become subclavian vein
- Terminates at sternal end of clavicles
- Unite with IJV to form brachiocephalic veins
- Unlike arterial side, there are two brachiocephalic veins
- Drains arm, neck and thoracic wall
- Normally slightly larger than the artery
- Will be much larger with venous congestion,
suspended respiration, obstruction
Internal Jugular Vein
Subclavian vein joins IJV proximally to form the brachiocephalic vein
- Right and left brachiocephalic veins join in superior mediastinum to empty into SVC, then to the RA
- Brachiocephalic veins and SVC not easy to be seen by US
- Due to sternum, ribs, air filled lungs
- Use small footprint linear phased array or endovaginal probe in sternal notch
Superficial Veins
Cephalic and basilic veins and tributaries are the major superficial veins
Cephalic Veins
Originates at lateral portion of dorsal venous arch ! “snuffbox”
- Subcutaneous location along anterolateral aspect of arm
- At elbow, connects with medial cubital vein ! Crosses the antecubital fossa obliquely ! Connects to basilic v
- Continues along anterolateral aspect of arm, coursing over lateral aspect of deltoid muscle at shoulder
- Dives between upper deltoid and clavicular portion of pectoralis muscles to join proximal axillary vein
Basilic Vein
Originates at dorsal venous arch of hand
- Courses subcutaneously along medial forearm to
elbow
- At elbow, crosses medial side of anticubital fossa
- Continues cephalad, along medial border of biceps
muscle
- Becomes axillary vein at lower border of teres major muscle
- Very superficial when scanned from medial approach
Which vein joins with the brachial v. to form the axillary vein?
basilic vein
the 2 innominate veins join to form the
superior vena cava
the basilic vein lies on the
medial surface of the arm.
