Transcript The Veins 静脉

The Veins
SHANDONG UNIVERSITY
Liu Zhiyu
The Veins
General feature
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Thin walls, larger lumens, venous
valves, venous plexus, venous rete
Two sets
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Superficial vein
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Deep veins
Special structures:
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Sinuses of dura mater
Diploic veins
The Veins
Venous valve
Sinuses of dura mater
Diploic veins
The Veins
Composition
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The pulmonary veins
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R. & L. superior & inferior pulmonary
veins → left atrium
The systemic veins
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Superior vena cava system
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Inferior vena cava system (hepatic portal
system)
Cardiac vein system
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Superior vena cava system
Veins of head and neck
Facial vein
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Begins at medial angle of eye
(angular vein)
Runs downward and backward
through the face, posterior to the
facial artery
Below angle of mandible, joins
anterior branch of retromandibular
vein to form common facial vein,
which drains into internal jugular
vein
Veins of head and neck
Facial vein
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Connections with cavernous sinus
through the ophthalmic vein, and
also through pteygoid veous
plexus via the deep facial vein
Veins of head and neck
Retromandibular v.
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Formed by union of superficial
temporal and maxillary veins
Divides into an anterior branch that
unites with facial vein and a posterior
branch that joins posterior auricular
vein to become external jugular vein
Veins of head and neck
★ External jugular vein
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Formed behind angle of mandible
by union of posterior auricular,
posterior branch of
retromandibular and occipital vein
Crossing sternocleidomastoid to
enter subclavian vein
Anterior jugular vein
 Drains submandibular and anterior
neck regions
 Descends near midline, runs
posterior to sternal end of
sternocleidomastoid to drain into
external jugular vein or subclavian
vein
Veins of head and neck
★ Internal jugular vein
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Begin at jugular foramen, descending to
join the subclavian vein to form
brachiocephalic vein
Lies lateral first to internal and then to
common carotid a. within carotid sheath
Chief extracranial tributaries
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Common facial vein
Lingual v.
Pharyngeal v.
Superior thyroid v.
Middle thyroid v.
Veins of head and neck
Subclavian vein
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Continuation of axillary vein at the
lateral border of first rib
Joins internal jugular vein to form the
brachiocephalic vein.
★Venous angle the junction of the
subclavian vein and internal jugular
vein
Superficial veins of the upper limb
Cephalic vein
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Arises from the lateral side of the dorsal
venous rete on the back of hand
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Winds around the lateral border of the
forearm; it then ascends into the cubital
fossa and up the front of the arm on the
lateral side of the biceps.
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It continues up in the deltopectoral groove
and then to the infraclavicular fossa,
where it pierces clavipectoral fascia to
drain into axillary vein.
Superficial veins of the upper limb
Basilic vein
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Arises from the medial side of the dorsal
venous rete of hand
Winds around the medial border of the
forearm; it then ascends into the cubital
fossa and up the front of the arm on the
medial side of the biceps to middle of the
arm where it pierces the deep fascia and
joins the brachial vein or axillary vein
Superficial veins of the upper limb
Median cubital vein
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Links cephalic vein and basilic vein in the
cubital fossa
It is a frequent site for venipuncture to
remove a sample of blood or add fluid to
the blood
Variations in the venous pattern of the upper limb
Superficial veins are variable and are of significance clinically
Veins of thorax
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Brachiocephalic veins
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Formed by union of internal jugular
and subclavian veins posterior to
the sternoclavicular joint
Veins of thorax
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Superior vena cava
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Formed by union of right and left
brachiocephalic veins behind the right
sternocostal synchorndrosis of first rib
Runs vertically down on right of ascending
aorta
Joined by azygos vein at level of sternal
angle
Enters right atrium at lever of lower border
of third right sternocostal joint
Collects blood from veins of upper half of
body
Veins of thorax
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Azygos vein
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Begins as continuation of right
ascending lumbar vein
Ascending along the right side of
vertebral column
Joins superior vena cava by aching
above right lung root at level of T4 to T5
Receives right posterior intercostals and
subcostal veins plus some of bronchial,
esophageal and pericardial veins, and
hemiazygos vein
Tributaries
Hemiazygos v.
Accessory hemiazygos v.
Veins of thorax
Veins of vertebral column
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External vertebral venous plexus
Internal vertebral venous plexus
Inferior vena cava system
Veins of lower limb
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Great saphenous v.
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Begins the medial end of dorsal venous arch of food
Passes anterior to the medial malleolus and ascends
on the medial side of the leg, then passes behind the
knee and curves forward around the medial side of
the thigh
Inclines anteriorly through the thigh to enter the
femoral vein through the saphenous hiatus which
lies about 3~4 cm below and lateral to the pubic
tubercle
Tributaries:
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Superficial medial femoral v.
Superficial lateral femoral v.
External pudendal v.
Superficial epigastric v.
Superficial iliac circumflex v.
Superficial epigastric v.
Superficial circumflex iliac v.
External pudendal v.
Superficial medial femoral v.
Superficial lateral femoral v.
Great saphenous v.
Veins of lower limb
Small saphenous v.
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Arises from the lateral part of the dorsal
venous arch of foot
Ascends behind lateral malleolus and
then runs up the midline of the back of
the leg
Pierces the deep fascia and enters the
popliteal v.
Drains the lateral side of the foot and
ankle and the back of the leg.
Veins of pelvis
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Internal iliac vein
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Parietal tributaries: accompany
with arteries
Visceral tributaries
External iliac vein–
accompany the artery
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Common iliac vein– formed
by union of internal and external
iliac veins in front of sacroiliac joint,
end upon L4~L5 by uniting each
other to form inferior vena cava
Veins of pelvis
Internal iliac vein
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Parietal tributaries: accompany with arteries
Visceral tributaries
① Rectal venous plexus →superior rectal vein→inferior mesenteric v.
→inferior rectal vein→internal iliac v.
→anal vein→internal pudendal v.
② Vesical venous plexus →vesical v.
③ Uterine venous plexus →uterine v.
Inferior vena cava
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Formed by union of two
common iliac veins anterior
and just to the right of L4~L5
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Ascends on the right side of
aorta, pierces vena cava
foramen of diaphragm at the
level of T8, and drains into the
right atrium
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Conveys blood from the whole
body below the diaphragm to
the right atrium
Inferior vena cava
Chief tributaries
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Parietal
 Paired inferior phrenic v.
 paired lumbar v. (four)
Visceral
 Right and left renal veins
 Right suprarenal vein (left drain into left
renal vein)
 Right testicular or ovarian v. (left drain
into left renal vein)
 Hepatic veins: right, left and
intermediate
Hepatic portal vein
General features
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Formed behind the neck of pancreas
by the union of superior mesenteric
vein and splenic vein
Ascends upwards and to the right,
posterior to the first part of
duodenum and then enters the
lesser omentum to the porta hepatis,
where it divides into right and left
branches
There are no functioning valves in
hepatic portal system
Drains blood from gastrointestinal
tract from the lower end of
oesophagus to the upper end of anal
canal, pancreas, gall bladder, bile
ducts and spleen
Variation and anomalies
of hepatic portal vein
Hepatic portal vein
Tributaries of hepatic portal v.
1. Superior mesenteric v.
2. Inferior mesenteric v.
3. Splenic v.
4. Left gastric v.
5. Right gastric v.
6. Cystic v.
7. Paraumbilical v.
Portosystemic anastomoses
1. At the lower end of the oesophagus
Hepatic portal vein → left gastric vein →
esophageal venous plexus → esophageal vein
→ azygos vein → superior vena cava
2. At rectal venous plexus
Hepatic portal vein → splenic vein → inferior
mesenteric vein → superior rectal vein → rectal
venous plexus → inferior rectal and anal veins →
internal iliac vein → inferior vena cava
3. At periumbilical venous rete
Hepatic portal vein→paraumbilical
vein→periumbilical venous rete→
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thoracoepigastric and superior epigastric vein →
superior vena cava
superficial epigastric and inferior epigastric veins
→ inferior vena cava
Portal-systemic anastomoses
4. Portal-retroperitoneal anastomosis
Between the retroperitoneal branches of
the colic veins and the lumbar veins,
pancreaticoduodenal veins with the renal
veins and the subcapsular veins of the liver
with the phrenic veins, twigs of colic veins
(portal) anastomosing with systemic
retroperitoneal veins