Veins of Lower Limb

Introduction

WATCH VIDEO OF VENOUS DRAINAGE OF LOWER LIMB [Click Here]

The veins of the lower extremity are subdivided into two sets- superficial and deep. The two set of veins are connected by perforating veins. Both sets of veins are provided with valves, which are more numerous in the deep than in the superficial set.

Describe the superficial veins of lower limb.

Superficial veins: the two important superficial veins are:

• Great saphenous vein
• Small saphenous vein

Great saphenous vein

• Is the longest vein of the body.
• It begins on the medial aspect of dorsum of foot by union of medial marginal vein & medial end of dorsal venous arch.   
•  It then ascends in front of medial malleolus, crosses the medial surface of lower third of tibia and ascend along the medial border of tibia to reach the posteromedial aspect of knee (about one hand-breadth posterior to patella).
• It further ascends along the medial side of thigh to reach the saphenous opening.
•  It passes through the saphenous opening, pierces cribriform fascia and femoral sheath to drain into femoral vein.
• Tributaries:
  • In leg:
    • Posterior arch vein
    • Anterior leg veins
  • In thigh
    • Anterolateral and posteromedial veins of thigh and
    • Three vein  join it before is pierces cribriform fascia:
      • superficial epigastric vein
      • superficial circumflex iliac vein
      • superficial external pudendal vein
• Is accompanied by saphenous nerve in the leg and foot.
• Is connected to deep veins via perforating veins.

Small saphenous vein

• It begins at the lateral side of the dorsal venous arch.
• It then ascends behind the lateral malleolus and then along the posterior aspect of leg.
• It pierces popliteal fascia to open into the popliteal vein.
• It drains lateral side of the foot and leg.
•  It is accompanied by sural nerve.

Describe the deep  veins of lower limb.

Deep veins accompany the major arteries viz. anterior tibial, posterior tibial, popliteal and femoral veins.

 What are perforating veins?

• Perforating veins are communicating veins between superficial & deep veins.
• They possess valves that prevent flow of blood from deep to superficial veins.
• They are present mainly in the region of ankle & medal side of lower part of leg.

Enumerate the factors that help in venous return.

• Contraction of muscles (especially calf muscle).
• Presence of valves prevents back-flow.
• Pulsations of arteries.
• Negative intrathoracic pressure.

Why soleus is known as peripheral heart?

In upright position, venous return from lower limb is largely dependent of contraction of calf muscles. Soleus contains rich plexus of valve less veins (venous sinuses) and the contraction of the muscle within the tight sleeve of fascia pushes the blood upwards from its large venous sinuses into the deep veins. During relaxed state of soles, the venous sinuses are filled from the superficial veins via perforating veins.

Applied Aspect