2Veins normally accompany arteries and often have similar names. Veins are always larger than the arteries and are sometimes more visible than arteries because they are closer to the skin surface.Most veins eventually empty the un-oxygenated blood into the vena cavas.
4The Veins Composition The pulmonary veins The systemic veins R. & L. superior & inferior pulmonary veins → left atriumThe systemic veinsSuperior vena cava systemInferior vena cava system (hepatic portal system )Cardiac vein system→right atrium
5The head, neck, upper limb and the thoracic cavity return blood to to the right atrium of the heart via the superior vena cava.The lower limb, abdominal and plevis cavity return blood to the right atrium of the heart via the inferior vena cava.
6Before blood is returned to the heart from the stomach, pancreas, small intestine, and spleen, it goes through the liver for filtration.
7This portion of this part of systemic system is known as the hepatic portal system. The gastric vein (stomach), splenic vein (spleen), pancreatic vein (pancreas), and mesenteric veins (small intestines) empty into the portal vein that carries the blood to the liver.
8In the liver, the portal vein branches into smaller venules and finally into capillary beds. In the capillary beds of the liver, nutrients are exchanged for storage and the blood is purified.The capillaries then join into venules that empty into the hepatic vein, which carries blood to the inferior vena cava.
9A. Introduction The Recurrent Factors of the Blood in Veins The venous valves.The dilation of the ventricles of the heart.The negative pressure of the thoraciccavity.The movements of the viscera.The impulses of the artery.the continuous blood flow from capillaries.
10B. The Pulmonary Veins Pulmonary Veins 1. Right superior pulmonary v. 2. Right inferior pulmonary v3. Left superior pulmonary v.4. Left inferior pulmonary v.the above all left ventricle
11C. The Systematic Veins 1. The superior vena caval system 2. The inferior vena
12C. The Systematic Veins The superior vena caval system Head & neck internaljugular v.Superiorvena cavaBrachio-cephalic v.VenousangleUpperlimbSubclavianv.ThoraxAzygos vein
13Veins of head and neck Facial vein Begins at medial angle of eye (angular vein)Runs downward and backward through the face, posterior to the facial arteryBelow angle of mandible, joins anterior branch of retromandibular vein to form common facial vein, which drains into internal jugular vein
14Veins of head and neck Facial vein Connections with cavernous sinus through the ophthalmic vein , and also through pteygoid venous plexus via the deep facial vein
15Veins of head and neck “Danger triangle of the face” lies between root of nose and two angles of mouthIn this area the facial vein has no valvesConnections with cavernous sinus and pteygoid venous plexus
16Veins of head and neck Retromandibular v. Formed by union of superficial temporal and maxillary veinsDivides into an anterior branch that unites with facial vein and a posterior branch that joins posterior auricular vein to become external jugular vein
17Veins of head and neck ★ External jugular vein Anterior jugular vein Formed behind angle of mandible by union of posterior auricular, posterior branch of retromandibular and occipital veinCrossing sternocleidomastoid to enter subclavian veinAnterior jugular veinDrains submandibular and anterior neck regionsDescends near midline, runs posterior to sternal end of sternocleidomastoid to drain into external jugular vein or subclavian vein
18Veins of head and neck ★ Internal jugular vein Begin at jugular foramen, descending to join the subclavian vein to form brachiocephalic veinLies lateral first to internal and then to common carotid a. within carotid sheathChief extracranial tributariesCommon facial veinLingual v.Pharyngeal v.Superior thyroid v.Middle thyroid v.
19Veins of head and neck ★Venous angle Subclavian vein Continuation of axillary vein at the lateral border of first ribJoins internal jugular vein to form the brachiocephalic vein.★Venous anglethe junction of the subclavian vein and internal jugular vein
20Veins of the Head and Neck Inferior thyroid veinBrachiocephalic vein
21Veins of the Upper Limb B. Superficial veins 1. Cephalic v. 2. Basilic v.3. Median cubital v.
22Veins of the Upper Limb 4. Median anterbrachial v. 5. Dorsal venous rete of hand[intravenousdrip ]injection]
23Superficial veins of the upper limb Cephalic veinArises from the lateral side of the dorsal venous rete on the back of handWinds 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.It continues up in the deltopectoral groove and then to the infraclavicular fossa, where it pierces clavipectoral fascia to drain into axillary vein.
24Superficial veins of the upper limb Basilic veinArises from the medial side of the dorsal venous rete of handWinds 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
25Superficial veins of the upper limb Median cubital veinLinks cephalic vein and basilic vein in the cubital fossaIt is a frequent site for venipuncture to remove a sample of blood or add fluid to the blood
26Variations in the venous pattern of the upper limb Superficial veins are variable and are of significance clinically
27Veins of the Upper Limb A. Deep Veins (follow the arteries given the same name:)1. Subclavian v.2. Axillary v.3. Brachial v.4. Radial v.5. Ulnar v.
28Parietal Tributaries Anterior Wall of Thorax Veins of the ThoraxParietal Tributaries Anterior Wall of Thorax1. Thoracoepigastric v.axillary v.2. Anterior intercostal vv. internal thoracic v. brachiocephalic v.
29Veins of the Thorax Posterior Wall of Thorax 1. Post. intercostal vv. left side: accessory hemiazygos v. hemiazygos v.right side: azygos v. sup. vena cava
30Veins of the Thorax B. Visceral Tributaries 2. Bronchial v. 1. Esophageal v.2. Bronchial v.
31Veins of thoraxBrachiocephalic veins Formed by union of internal jugular and subclavian veins posterior to the sternoclavicular joint
32Veins of thorax Superior vena cava Formed by union of right and left brachiocephalic veins behind the right sternocostal synchorndrosis of first ribRuns vertically down on right of ascending aortaJoined by azygos vein at level of sternal angleEnters right atrium at lever of lower border of third right sternocostal jointCollects blood from veins of upper half of body
33Veins of thorax Azygos vein Hemiazygos v. Accessory hemiazygos v. Begins as continuation of right ascending lumbar veinAscending along the right side of vertebral columnJoins superior vena cava by aching above right lung root at level of T4 to T5Receives right posterior intercostals and subcostal veins plus some of bronchial, esophageal and pericardial veins, and hemiazygos veinTributariesHemiazygos v.Accessory hemiazygos v.
34Veins of thorax Veins of vertebral column External vertebral venous plexusInternal vertebral venous plexus
35The inferior vena caval system Wall and paired visceraAbdomenInferiorvena cavaUnpaired visceraLiverHepatic v.PelvisInternaliliac v.Common iliac v.LowerlimbExternaliliac v.
36Veins of the Abdomen The Hepatic Portal Venous System Unpaired Visceral Tributaries The Hepatic Portal Venous SystemDigestiveapparatusSpleenInferiorvenacavaHepatic poral v.(LiverHepatic v)
37Veins of the Lower Limb B. Superficial Veins 1. Great saphenous v. → femoral v.1) superficial medial femoral v.2) superficial lateral femoral v.3) superficial iliac circumflex v.4) superficial epigastric v.5) external pudendal v.
38Veins of the Lower Limb 2. Small saphenous v. popliteal v. 3. Dorsal venous arch of foot
39Veins of lower limb Great saphenous v. Begins the medial end of dorsal venous arch of footPasses 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 thighInclines 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 tubercleTributaries:Superficial medial femoral v.Superficial lateral femoral v.External pudendal v.Superficial epigastric v.Superficial iliac circumflex v.
40Superficial epigastric v. Superficial circumflex iliac v.External pudendal v.Superficial lateral femoral v.Superficial medial femoral v.Great saphenous v.
42Veins of lower limb Small saphenous v. Arises from the lateral part of the dorsal venous arch of footAscends behind lateral malleolus and then runs up the midline of the back of the legPierces the deep fascia and enters the popliteal v.Drains the lateral side of the foot and ankle and the back of the leg.
43Veins of the Lower Limb Deep Veins External iliac v. 2. Femoral v. 3. Popliteal v.4. Anterior tibial v.5. Posterior tibial v.
44Veins of pelvis Internal iliac vein Parietal tributaries: accompany with arteriesVisceral tributariesExternal iliac vein– accompany the arteryCommon 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
45Veins of the Pelvis 1. Superior gluteal v. 2. Inferior gluteal v. A. Parietal Tributaries1. Superior gluteal v.2. Inferior gluteal v.3. Obturator v.4. Lateral sacral v.
47Veins of the Pelvis B. 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.4. Veins of perineum internal pudendal v.
48Inferior vena cavaFormed by union of two common iliac veins anterior and just to the right of L4~L5Ascends on the right side of aorta, pierces vena cava foramen of diaphragm at the level of T8, and drains into the right atriumConveys blood from the whole body below the diaphragm to the right atrium
49Inferior vena cava Chief tributaries Parietal Paired inferior phrenic v.paired lumbar v. (four)VisceralRight and left renal veinsRight 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
50Hepatic portal vein General features Formed behind the neck of pancreas by the union of superior mesenteric vein and splenic veinAscends 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 branchesThere are no functioning valves in hepatic portal systemDrains blood from gastrointestinal tract from the lower end of oesophagus to the upper end of anal canal, pancreas, gall bladder, bile ducts and spleen
51Hepatic 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.
52Portosystemic anastomoses hepatocirrhosis 1. At the lower end of the oesophagusHepatic portal vein → left gastric vein → esophageal venous plexus → esophageal vein → azygos vein → superior vena cava2. At rectal venous plexusHepatic portal vein → splenic vein → inferior mesenteric vein → superior rectal vein → rectal venous plexus → inferior rectal and anal veins → internal iliac vein → inferior vena cava3. At periumbilical venous reteHepatic portal vein→paraumbilical vein→periumbilical venous rete→thoracoepigastric and superior epigastric vein → superior vena cavasuperficial epigastric and inferior epigastric veins → inferior vena cava
53Portal-systemic anastomoses 4. Portal-retroperitoneal anastomosisBetween 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