Anatomy - Cvs #4 - Veins

Front 1

Profunda femoris - branches

Back 1

1. Medial circumflex femoral (ascending, transverse)
2. Lateral circumflex femoral (ascending, transverse, descending)
3. 4 perforating arteries

Front 2

Popliteal artery - branches

Back 2

1. Superior med. & lat. genicular
2. Middle genicular
3. Inferior med. & lat genicualr
4. Sural (penetrate deep fascia, -> muscle & integument)
5. Anterior tibial
6. Fibular\peroneal
7. Posterior tibial

Front 3

Anterior tibial artery - branches

Back 3

1. Muscular branches
2. Anterior med. & lat. malleolar (above extensor retinaculum)
3. Dorsalis pedis (terminal)
a. med. & lat. tarsal
b. deep plantar
c. 1st dorsal metatarsal
d. arcuate artery (-> dorsal metatarsal branches)

(runs on interosseous membrane posterior to extensor hallucis longus)

Front 4

Posterior tibial - branches

Back 4

1. Circumflex fibular (peroneal)
2. Fibular\peroneal
3. Tibial nutrient
4. Muscular
(crossed by tibial nerve)
5. post. medial malleolar branches
6. Calcaneal branches
(flexor retinaculum)
7. Medial plantar (superficial digital rr), lateral plantar (plantar metatarsal)

Front 5

Arterial anastomosis around scapula supplied by (7)

Back 5

Arterial anastomosis around scapula supplied by
1. Dorsal scapular
2. Posterior br of intercostals
3. Rr of superficial cervical
4. Suprascaular
5. Lateral thoracic
6. Med. & lat circumflex humeral
7. Subscapular
a. circumflex scapular

Front 6

Hip joint
a. Arterial anastomosis around hip joint supplied by
b. Name of the 2 anastomosis

Back 6

a. Arterial anastomosis around hip joint is supplied by
1. Superior gluteal
2. Inferior gluteal
a. Descending branches

3. Transverse branches of med. & lat circumflex femoral
4. Ascending branches of med & lat circumflex femoral
5. Ascending branch of first perforating
6. Posterior division of obturator artery -> arterty of ligamentum teres

b. Anastomosis between profunda femoris\femoral and gluetal:
Lateral: trochanteric
Medial cruciate

Front 7

Axillary vein - tributaries

Back 7

As artery +
1. Cephalic vein
2. Thoracoepigastric veins (region of superficial epigastric (IVC) -> axillary (SVC)
3. Costoaxillary veins (anastomotic veins connecting the 1-7 intercostal veins with the lateral thoracic or tharcoepigastric)

Front 8

Veins of hand

Back 8

1. Dorsal venous network of hand (-> basilic, cephalic)
2. Dorsal carpal venous network
3. Intercapital veins (the veins connecting the dorsal and palmar veins in the hand \dorsal and plantar in foot)
4. Superficial palmar venous arch (paired venae comitantes)

Front 9

Median cubital vein

Back 9

Cephalic vein <-(anteiror aspect of elbow)->basilic vein

Front 10

Median antebrachial vein
a. <-
b. divides where, to what

Back 10

a. <- dorsum of thumb (-> turns around to medial side)
b. just below the elbow divides to intermediate basilic and intermediate cephailic veins (they often replace median cubital vein)

Front 11

Azygos vein
a. <-
b. ->
c. sulcus venae azygos
d. passage through diaphragm

Back 11

a. Confluence of right lumbar ascending, right subcostal and sometimes branch from IVC (ap. level of renal vein)
b. -> SVC
c. Impression on the right lung (it arch anteriorly over the hilum of the right lung)
d. aortic hiatus or its right crus

Front 12

Azygos vein - branches

Back 12

1. Lower eight right posterior intercostal veins (5-11)
2. The right superior intercostal vein (2-4)
3. Right bronchial
4. Esophageal
(5. the two hemiazygos veins)

Front 13

Hemiazygos vein
a. <-
b. ->
c. passage through diaphragm
d. branches

Back 13

a. Confluence of the left ascending lumbar, the left subcostal and often a tributary from the left renal vein

b. azygos vein (T7-T9)

c. left crus of diaphragm\aortic hiatus

d. four lower left posterior intercostal veins (9-11)

Front 14

Gonadal vessels
a. origin of arteries
b. veins drain into

Back 14

a. abdominal aorta
b. left -> left renal, right -> IVC

Front 15

The 1st posterior intercostal space is drained by, which empty into

Back 15

Supreme intercostal vein, which empty into brachiocephalic veins

Front 16

Accessory hemiazygos vein
a. <-
b. ->
c. inconsistent connections

Back 16

a. <- 4th-7th left posterior intercostal veins
b. -> azygos vein (T7)
c. left superior intercostal, hemiazygos

Front 17

Ascending lumbar vein
a. connects
b. ends as ... by joining ....

Back 17

a. Connects
1. Common iliac
2. Iliolumbar
3. Lumbar veins

b. joins subcostal veins to form azygous venous system

Front 18

Vertebral venous plexuses

Back 18

1. Anterior external
2. Internal anterior
3. Internal posterior
4. External posterior (paired)
(5. basivertebral veins: veins in the spongy substance of the vertebral bodies, -> anterior internal vertebral venous plexus)

Front 19

Location of internal vertebral venous plexus

Back 19

In epidural space

Front 20

Batson's plexus

Back 20

The four interconnected networks surrounding the vertebral column

(connect the deep pelvic and thoracic veins draining the end of the urinary bladder, breast and prostate to the internal vertebral venous plexuses which are valveless. route for cancer metastasis, and infections (UTI -> osteomyelitis)

Front 21

Arterial supply to spinal arteries

Back 21

1. Posterior spinal (2) (<- foramen magnum from PICA or vertebral)
2. Anterior spinal artery (<- vertebral aa)
3. Radicular arteries (via intervertebral foramina, largest is Arteria radicularis Magna\artery of Adamkiewicz)

Front 22

Artery of Adamkiewicz/Great segmental medullary artery
a. what
b. <-
c. ->

Back 22

a. largest of the medullary arteries that supply the spinal cord by anastomosing with the anterior spinal artery

b. <- lower intercostal \ upper lumbar (left 65%)

c. supply most of the blood to the lower 2\3 of the anterior spinal artery)

Front 23

Describe connection between posterior intercostal artery and anterior spinal

Back 23

1. Posterior intercostal ->
2. Dorsal branch ->
3. Spinal branch ->
4. Anterior radicular
5. Anterior segmental medullary (radicular that continues on to anastomose with the anterior or posterior spinal arteries, only some are segmental medullary)

Front 24

IVC - tributaries
a. parietal
b. visceral

Back 24

a. parietal
1. common iliac veins
2. lumbar (4 pairs) veins
(pair 1-2 can also be only connected to ascending lumbar)
3. ascending lumbar veins
4. inferior phrenic veins
5. Median sacral vein

b. visceral
1. renal veins
2. right gonadal vein (<- pampiniform plexus)
3. right suprarenal vein
4. hepatic veins (u. 3)
(5. ductus venosus Arantii)

Front 25

Arterial supply to adrenal glands

Back 25

1. superior suprerenal (<- inf. phrenic <- AA)
2. middle suprarenal (<- AA)
3. inf. suprarenal (renal aa)

Front 26

Internal iliac vein - branches

Back 26

a. Parietal - as artery

b. Visceral (plexuses)
1. Venous pudendal plexus of Santorini
2. Venous vesical (and prostatic) plexus
3. Uterovaginal venous plexus (can be considered separate)
4. Rectal venous plexus
5. Sacral venous plexus

Front 27

Portal vein - <--

Back 27

All unpaired organs of the abdominal cavity

Front 28

Portal vein
a. <-
b. direct tributaries
c. ->

Back 28

a. in confluence of splenic vein and superior mesenteric vein (behind head of pancreas, L1-L2)

b.
1. cystic vein
2. right & left gastric veins
3. Prepyloric vein of Mayo\Latarget (Stedman: tributary of right gastric)
4. Paraumbilical veins
5. Superior pancreaticoduodenal

c. -> right and left branches

Front 29

Portocaval anastomoses

Back 29

1. Esophageal rr of left gastric vein <-> esophageal veins (<- azygos, hemiazygos)
a. esophageal varices = in submucosa (if rupture use Sengstaken-Blakemore tube for 24h (3 lumen tube, one for drainge of stomach and two for inflation of attached gastric and esophageal balloons, sclerotherapy (comound that acts by irritation of the venus intimal epithelium)
b. paraesophageal varices (in adventitia)

2. Venous rectal plexus (internal above pectinate line and associated with internal pudendal vein, external below)

3. Paraumbilical veins (the inner part of ligamentum teres hepatis is drained into the portal system via the left branch of the portal vein while the outer part is drained into the systemic indirectly via the great saphenous and axillary veins)(-> caput medusae - subcutaneous plexus)

4. Burow vein (an inconsistent vein connecting paraumbilical veins with inferior epigastric veins, sometimes also from vesical venous plexus)

5. Bare area of liver: hepatic veins (portal)-inferior phrenic veins

6. Retroperitoneal communication = Retzius\retroperitoneal veins = branches of left & right colic & splenic (portal) <-> branhes of lumbar (systemic)

Front 30

Cavo-caval anastomoses

Back 30

1. Lumbar veins (IVC) <-> azygos & hemiazygos veins (SVC)

2. Inferior epigastric veins (IVC) <-> Superior epigastric veins (SVC)

3. Superficial epigastric veins (IVC) <-> Thoracoepigastric veins

4. Batson\Vertebral venous plexus

Front 31

Fetal circulation - blood from placenta

Back 31

1. Umbilical vein ->
2. Ductus venosus Arantii ->
3. IVC
(valve of IVC: extend in anterior part from IVC to part of limbus fossae ovalis (a muscular ring surrounding the fossa ovalis in the right atrium))
4. Right atrium ->
5. Foramen ovale ->
6. Left atrium ->
7. Left ventricle ->
8. Ascending aorta ->
9. Arch of aorta ->
10. Mainly the 3 large arteries to head and upper limbs

Front 32

Fetal circulation - venous blood from the head

Back 32

1. SVC ->
(intervenous tubercle of right atrium: slight projection to the wall of between orifices of the venae cavae)
2. Right atrium ->
3. Right ventricle ->
4. Pulmonary trunk ->
5. Ductus arteriosus\Botallo duct ->
6. Arch of aorta (distal to the large superior arteries) ->
7. Thoracic aorta ->
8. Abdominal aorta ->
9. Common iliac arteries ->
10. Internal iliac arteries ->
11. Umbilical arteries ->
12. Placenta

Front 33

Cardinal veins
a. what
b. course

Back 33

a. the major systemic venous channels in the embryo (and adult primitive vertebrates)

b. cephalic part -> anterior cardinal, caudal part -> posterior cardinal,
ant. + post. cardinal -> common cardinal\Cuvier ducts -> sinus venosus

Front 34

Back 34

Front 35

Vitelline veins
a. what
b. derivatives

Back 35

a. Veins returning blood from the yolk sac to the embryo

b.
1. hepatic veins
2. inferior portion of vena cava
3. portal vein
4. superior mesenteric vein

(the branches conveying blood to the plexus are named the venae advehentes (imblical and\or vitelline venous systems) and become the branches of the portal vein, the vessels draining the plexus into the sinus venosus are termed the venae revhentes, and form the future hepatic veins)

Front 36

Great saphenous vein
a. <-
b. ->
c. branches
d. valves

Back 36

a. <- union of dorsal vein of great toe and dorsal venous arch (ascend in front of medial malleolus)

b. -> confluence of superficial inguinal veins\venous star of Paturet\Cockett (great saphenous vein, superficial epigastric vein, superficial circumflex iliac vein, external pudendal vein) (in saphenous hiatus through fascia lata)

c.
1. Ant. & post. accessory saphenous vein (inconsistent, run parallel to it before it enters femoral vein)
2. Ant. + post. circumflex femoral veins

Front 37

Valves in
a. great saphenous
b. external iliac\common iliac
c. femoral
d. small saphenous

Back 37

a.
1. valvula terminalis (close to the estuar (1-2mm) of the great saphenous vein into the femoral vein
2. valvula preterminalis (3-5cm distally)

b. external\common iliac
1. valvula suprasaphenica (at least 81%, proximal to saphenofemoral junction)

c. valvula infrasaphenica (distal in femoral vein)

d. valvula preterminalis, valvula terminalis

Front 38

Small saphenous vein
a. <-
b. ->
c. branches

Back 38

a. <- union of the dorsal vein of the little toe and the dorsal venous arch (-> behind lateral malleolus)

b. -> popliteal vein in popliteal space

c.
1. Superficial accessory small saphenous vein (above saphenous fascia which house the other saphenous, run parallel)
2. Cranial extension of the small saphenous vein (in the groove between biceps femoris and semimembranosus)

Front 39

Lateral venous system of inferior limb (of Albanese)
a. location
b. remnant of

Back 39

a. extended on the lateral thigh

b. remnant of the embryonic lateral marginal vein

Front 40

Common femoral cein

Back 40

Run from the confluence of the femoral vein and the deep femoral vein to the external iliac vein

Front 41

Deep femoral communicating veins (venae comitantes arteriae perforantium)

Back 41

The accompanying veins of the perforating arteries that originate from the deep femoral artery

Front 42

Soleal veins

Back 42

The veins of the soleus muscle

Front 43

Gastrocnemius veins

Back 43

3 divisions
1. medial gastrocnemius vein
2. intergemellar (gemellus: twin) vein
3. lateral gastrocnemius vein

Front 44

Deep veins of the foot

Back 44

1. Medial & lateral plantar veins
2. Deep plantar venous arch
3. Deep metatarsal veins (plantar & dorsal)
4. Deep digital veins (plantar and dorsal)
5. The pedal vein

Front 45

Sciatic vein

Back 45

The main trunk of the primordial deep venous system (the axial vein of the embryo)

Courses close to the sciatic nerve and may assume an important role as a collateral pathway for the femoral vein

Front 46

How many % of the blood in the venous system is in the deep veins?

Back 46

80%

Front 47

Perforating veins\venae perforantes

Back 47

Connects deep and superficial system - transfascial communications, have valves, valvular insufficiency --> varices

Front 48

Perforating veins
a. number
b. groups, with eponyms

Back 48

a. 95-155, where 40 is constant

b.
1. foot\pes
2. Ankle\tarsus
3. leg\crus
a. Cocketts = posterior tibial perforators (posterior accessory great saphenous vein <->posterior tibial veins)
b. Boyd = upper leg
c. Sherman = lower and mid leg
4. knee\genu
5. femur

Front 49

Staubesand's triad

Back 49

Perforating vein, small accompanying artery and cutaneous nerve