Venous.1. Anatomy Flashcards
Drainage of the lower limb
- Superficial venous system
- Deep venous system
- perforating veins
- FACTORS THAT HELP THE VENOUS RETURN
- The most significant factors in the pathology of ankle ulceration
- Oral questions
Superficial venous system in Drainage of the lower limb
- Site
- Components
- CRITERIA
Site of Superficial venous system in Drainage of the lower limb
outside the deep fascia unsupported in the subcutaneous tissues.
Components of Superficial venous system in Drainage of the lower limb
A. Long saphenous vein “LSV”
B. Short (small) saphenous vein “SSV” :
Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Number of valves
- Course
- TRIBUTARIES
Number of valves of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
12-20 most of them in the leg
Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Origin
- Ascending
- Ending
- The sapheno-femoral junction
- A nerve closely related
Origin in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
Arises from medial part of dorsal venous arch of foot.
Ascending in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
It ascends in front of Medial malleolus in the medial side of the L.L.
Ending in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
It passes through the saphenous opening to end in the common femoral vein.
site of saphenous opening in Ending in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
4 cm below & lateral to pubic tubercle
The sapheno-femoral junction in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
Controlled by a valve which prevents regurgitation of blood from femoral to saphenous vein.
A nerve closely related in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
The saphenous nerve
The saphenous nerve in A nerve closely related in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Course
2. Area of supply
Course of The saphenous nerve in A nerve closely related in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Origin
- Crossing the femoral artery
- Leaving subsartorial canal
- Descending
Origin in Course of The saphenous nerve in A nerve closely related in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
it’s a branch of femoral nerve in the femoral triangle.
Crossing the femoral artery in Course of The saphenous nerve in A nerve closely related in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- It crosses the femoral artery from lateral to medial
2. in the femoral triangle & the upper part of the subsartorial canal.
Leaving subsartorial canal in Course of The saphenous nerve in A nerve closely related in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
It leaves the subsartorial canal by piercing the deep fascia between the tendons of sartorius & gracilis
Descending in Course of The saphenous nerve in A nerve closely related in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
It descends along the medial side of the leg accompanying the LSV.
Area of supply of The saphenous nerve in A nerve closely related in Course of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- The skin of the medial side of the leg
2. The skin of the medial side of the dorsum of the foot as far as the metacarpo-phalangeal joint of the big toe
TRIBUTARIES of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
4 - 2 - 2
A) 4 veins near the saphenous opening
B) 2 veins in the thigh
C) 2 veins in the leg
4 veins near the saphenous opening in TRIBUTARIES of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Superficial epigastric vein.
- Superficial circumflex iliac vein.
- Superficial external pudendal veins
- Deep external pudendal veins.
2 veins in the thigh in TRIBUTARIES of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Anterolateral vein of the thigh.
2. Posteromedial vein of the thigh.
Alternative name for Anterolateral vein of the thigh in 2 veins in the thigh in TRIBUTARIES of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
Lateral accessory saphenous vein
Alternative name for Posteromedial vein of the thigh in 2 veins in the thigh in TRIBUTARIES of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
Medial accessory saphenous vein
2 veins in the leg in TRIBUTARIES of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Posterior arch vein
2. Anterior arch veins of the leg.
alternative name for Posterior arch vein in 2 veins in the leg in TRIBUTARIES of Long saphenous vein in Components of Superficial venous system in Drainage of the lower limb
Vein of Leonardo
Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Number of valves
2. Course
Number of valves of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
9 - 12 valves
Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Origin
- Ascending
- Ending
- The sapheno-popliteal junction
- A nerve closely related
Origin in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
It arises from the lateral side of dorsal venous arch.
Ascending in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- It passes below & behind the lateral malleolus,
- runs along the outer edge of the Achilles tendon
- Ascends in the middle line of the back of the leg until the middle of the popliteal fossa
Ending in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
in the middle of the popliteal fossa where it pierces the deep fascia to join the popliteal vein
The sapheno-popliteal junction in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- The sapheno-popliteal junction is controlled by a valve.
2. The site of sapheno-popliteal junction in the popliteal fossa is not constant
A nerve closely related in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- The sural nerve
2. lies just lateral to the vein in the lower 1/3 of the leg.
The sural nerve in A nerve closely related in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Course
2. Area of supply
Course of The sural nerve in A nerve closely related in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- Origin
- Descending
- Course in the lower 1/3 of the leg
Origin in Course of The sural nerve in A nerve closely related in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
It’s a branch of the medial popliteal “tibial” nerve in the popliteal fossa.
Descending in Course of The sural nerve in A nerve closely related in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- It descends on the back of the calf
- in a groove between the 2 heads of gastrocnemius
- accompanying the SSV.
Course in the lower 1/3 of the leg in Course of The sural nerve in A nerve closely related in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
It is joined by the sural communicating nerve “branch of the lateral popliteal : common peroneal nerve
Area of supply of The sural nerve in A nerve closely related in Course of Short saphenous vein in Components of Superficial venous system in Drainage of the lower limb
- The skin of the posterior aspect of the lower 1/3 of the leg
- The lateral border of the foot
CRITERIA of Superficial venous system in Drainage of the lower limb
- There are numerous valves along the course of the superficial veins.
- The valves direct the blood flow from distal to proximal & From superficial to deep veins
- They drain 10% of the venous blood of the L.L.
- They have a thick muscle layer i.e well developed media.
Applied anatomy of thick muscle layer in CRITERIA of Superficial venous system in Drainage of the lower limb
can be used as a graft in bypass surgery
Deep venous system in Drainage of the lower limb
- Components
2. Criteria
Components of Deep venous system in Drainage of the lower limb
- Soleal venous sinuses.
- vena comitans accompanying tibial & peroneal arteries.
- Popliteal vein.
- Superficial & deep femoral veins.
- Common femoral vein.
site of the soleal venous sinuses in Components of Deep venous system in Drainage of the lower limb
In soleus muscle ( culf muscle)
Criteria of Deep venous system in Drainage of the lower limb
- The deep veins are inside the musculo-fascial compartment.
- They are valved except those in the soleus muscle, which are of nature of venous sinuses; they are unvalved & empty segmentally into the posterior tibial & peroneal veins.
- They drain 90% of the venous blood of the L.L.
- They have a thin muscle layer.
Perforating veins in Drainage of the lower limb
- Alternative name
- Definition
- Function
- Site
- Types
Alternative name for Perforating veins in Drainage of the lower limb
PERFORATORS
Definition of Perforating veins in Drainage of the lower limb
These are communicating vessels between the superficial & deep veins
Function of Perforating veins in Drainage of the lower limb
They transmit blood from the superficial to the deep system, via valves allowing unidirectional flow.
Site of Perforating veins in Drainage of the lower limb
Very important
a. Mid thigh perforator
b. Above knee perforator
c. Below knee perforator
d. Three medial ankle-perforators
e. A constant lateral direct ankle perforators
f. The LSV & SSV are considered as direct perforators.
Mid thigh perforator in Site of Perforating veins in Drainage of the lower limb
- Alternative name
- Site
- Connection
Alternative name for Mid thigh perforator in Site of Perforating veins in Drainage of the lower limb
Hunter’s perforator
Site in Mid thigh perforator in Site of Perforating veins in Drainage of the lower limb
Subsartorial canal below sartorius muscle
Connection in Mid thigh perforator in Site of Perforating veins in Drainage of the lower limb
Connecting between
- The LSV or one of its tributaries
- The femoral vein in Hunter’s canal.
Above knee perforator in Site of Perforating veins in Drainage of the lower limb
- Alternative name
- Site
- Connection
Alternative name for Above knee perforator in Site of Perforating veins in Drainage of the lower limb
Dodd’s perforator
Site of Above knee perforator in Site of Perforating veins in Drainage of the lower limb
At junction between lower third and upper two thirds of thigh
Connection of Above knee perforator in Site of Perforating veins in Drainage of the lower limb
Connecting between
- The LSV or one of its tributaries
- The superficial femoral vein
Below knee perforator in Site of Perforating veins in Drainage of the lower limb
- Alternative name
- Site
- Connection
Alternative name for Below knee perforator in Site of Perforating veins in Drainage of the lower limb
Boyd’s perforator
Site of Below knee perforator in Site of Perforating veins in Drainage of the lower limb
At Junction between upper third and lower two third of leg
Connection of Below knee perforator in Site of Perforating veins in Drainage of the lower limb
Connecting between
- The LSV or posterior arch vein
- The posterior tibial vein.
Three medial ankle-perforators in Site of Perforating veins in Drainage of the lower limb
- Alternative name
- Site
- Connection
Alternative name for Three medial ankle-perforators in Site of Perforating veins in Drainage of the lower limb
Cockett I,II,III
Site of Three medial ankle-perforators in Site of Perforating veins in Drainage of the lower limb
2,4 & 6 inches above the medial malleolus
Connection of Three medial ankle-perforators in Site of Perforating veins in Drainage of the lower limb
Connecting between
- The posterior arch vein
- The posterior tibial vein.
A constant lateral direct ankle perforators in Site of Perforating veins in Drainage of the lower limb
- Alternative name
- Site
- Connection
Alternative name for A constant lateral direct ankle perforators in Site of Perforating veins in Drainage of the lower limb
Bassi’s perforator
Site of A constant lateral direct ankle perforators in Site of Perforating veins in Drainage of the lower limb
A. Found on the outer side of the leg at the junction of the lower & middle 1/3.
B. 6 inches above lateral malleolus
Connection of A constant lateral direct ankle perforators in Site of Perforating veins in Drainage of the lower limb
Connecting between
- The SSV or one of its tributaries
- The peroneal vein
Types of Perforating veins in Drainage of the lower limb
- Direct perforator
2. Indirect perforator
Direct perforator in Types of Perforating veins in Drainage of the lower limb
connects Directly between the superficial & deep system
Indirect perforator in Types of Perforating veins in Drainage of the lower limb
- It penetrates the deep fascia to connect with vessel in a muscle, which in turn is connected to one of the deep veins.
- Stronger due to surrounding muscles
FACTORS THAT HELP THE VENOUS RETURN in Drainage of the lower limb
- The muscle pump.
- The unidirectional valves
- The negative intrathoracic pressure.
The most significant factors in the pathology of ankle ulceration in Drainage of the lower limb
In the ankle region there is little muscle and therefore few inefficient indirect perforators, and consequently the return of blood from the superficial tissues is dependent on the direct perforators which are weak
Oral questions in Drainage of the lower limb
- Site of the last valve in deep system
- People who are more prone to varicose veins
- Difference between perforator and communicator
Site of the last valve in deep system in Oral questions in Drainage of the lower limb
Sapheno-femoral valve but some people have single valve in external iliac vein (80%)
People who are more prone to varicose veins in Oral questions in Drainage of the lower limb
People who are with no valve in external iliac vein
Difference between perforator and communicator in Oral questions in Drainage of the lower limb
Perforator : is a vein that perforates deep fascia to connect between superficial and deep system of veins
Communicator: is a vein that communicates two veins in same fascial compartment
vein of gaicomini in Difference between perforator and communicator in Oral questions in Drainage of the lower limb
Popular communicator vein between SSV AND LSV or postero medial vein of thigh