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Adv. Vas. Son.

Test 1 Venous Anatomy and Hemodynamics

What makes up the Venous lower extremity system? Deep system carries 85% of limb blood volume, Superficial system, Perforators & communicators, Calf muscle veins (Often considered deep veins) -Gastrocnemius veins (deep)/Soleal veins (sinuses) (deep)
Deep vein facts. Have an adjacent artery w/ same name (except IVC), Deep veins are paired in calf
Is bifid femoral vein uncommon? No it's not uncommon, FV duplicity in thigh, 30% in some reports, Follow vein to see if it's a tributary vs. bifid. If it courses away= tributary
Posterior Tibial veins facts. Paired and lie along the PT artery, they are posterior to tibial
Peroneal facts. Paired and lie along the peroneal artery, Medial to the fibula
Anterior Tibial Veins facts. Paired and lie along the At artery Anterior to the interosseous membrane and Lateral to the tibia
What is the tibioperoneal trunk formed by? Formed by the confluence of the posterior tibial and peroneal veins. It then joins the distal popliteal vein @ the confluence @ the anteriortibial trunk
What do the gastrocs drain? The gastrocnemius muscles and the popliteal vein
The Soleal veins or soleal sinuses lie in the deeper soleal muscle and drain into what? Posterior tibial or peroneal veins
Is the Soleal sinus a common place for clots? Yes because blood pools there
What are the calf muscle veins? Gastrocnemius and Soleal veins
Superficial system: GSV facts Joins deep system at the CFV, and Carries approx. 15% of venous blood volume in leg, No adjacent artery
Saphenous veins are contained within fascial envelopes called the Eygptian eye GSV in the thigh in fascia, and SSV in posterior calf in fascial envelope
SSV facts Posterior aspect of the calf, Typical confluence is at the Pop vein. In 20-30% of the population, SSV will enter above the Pop vein (Giacomini vein) No adjacent artery
What is the vein of Giacomini? Connects the SSV with the GSV
Perforator veins facts. Course from superficial to deep, pass through deep fascial plane, Perforating veins have valves to prevent flow from moving from deep to superficial
Blood flow to tissue in the upper and lower extremities is governed by? Contractility of the heart, Intraluminal blood pressure, Peripheral resistance in the distal end of the arterial "tree", the capillary bed
More blood entering the arterial system means what? More blood volume for the venous system to return
Capillary bed perfusion is dependent on a what? Pressure gradient
What is a pressure gradient? Exists across all capillary beds w/ high pressure occurring in the arterial side and low pressure in the venous side. This allows blood to perfuse through tissue.
What happens if venous pressure in the venules are equal to or higher than the pressure in the arterioles? We in trouble b/c as little or no perfusion will occur in the capillary bed
Hydrostatic pressure affect on lower veins when a person is stationary affects: ↑ tranmural venous pressure distally, ↑ venous distention, ↑ venous pooling, ↓ in capillary perfusion, ↓ venous return, ↓ in cardiac output Hypotension
Flow patterns & venous resistance: Cardiac influence: Venous pressure & flow are affected by Cardiac activity, This effect is most pronounces in the thoracic vessels, Cardiac influence is usually not apparent or is reduced in the lower extremities
Pulsatility at the level of the CFV and below is evident when the PT has what? CHF will occur bilaterally
Flow patterns in the upper extremities- Central veins: Cardiac pulsatility is usually apparent and pronounces, Respiratory variation occurs, but flow during inspiration increases due to the changes in thoracic pressure
What happened to the diaphragm with inspiration? It moves downward and increases the intra-abdominal pressure. The IVC is compressed and venous outflow is temporarily reduced or stopped. Flow resumes during exhalation
What is a primary venous return mechanism? Calf veno motor pump
What does the calf veno motor pump do? Muscle contraction squeezes blood upward and valves prevent return
The efficiency of the calf veno motor pump is dependent on: Ability of the calf skeletal muscles to contract, Competency of the venous valves, and Patency of outflow veins
What is PRIMARY venous insufficiency/incompetence? Congenital absence or defect of valves
What is SECONDARY venous insufficiency/incompetence? Post-phlebitic: Valves damaged by venous thrombosis, &/or chronic outflow obstruction
What is retrograde venous flow? Antegrade popliteal venous flow during calf compression, then retrograde flow (reflux) w/cessation of compression
During muscle contraction what might happen to blood if the distal valves are incomptent? Blood may be forced downward
What might cause perforators to dilate and become incompetent? Increased deep vein intraluminal pressure
When perforating veins are incompetent what may happen? Intraluminal pressure may increase in the superficial venous system, this may contribute to varicose vein formation
What are venous insufficiency symptoms? Stasis dermatitis, Chronic ↑ in capillary pressure, Higher incidence of superficial venous thrombophelbitis in PTs w/ insufficiency, Venous ulcers
Created by: EmilyGriffin
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