CARDIOVASCULAR 4

• superior and inferior vena cava and their

  tributaries

  caval system
• Hepatic portal system: portal vein and its tributaries
• In the thorax, the thoracic walls and visceral structures (lungs,

  esophagus, thymus) are drained by the azygos system of veins

  (the heart is drained by its own system of cardiac veins).
• The portal system drains the:

  • GI tract in the abdominopelvic cavity and its accessory organs

  (liver, gallbladder, pancreas) via its superior and inferior mesen-

  teric branches and their tributaries

  • Spleen, an organ of the lymphoid system, via the splenic vein
• The azygos system forms an important venous conduit between

  the inferior vena cava and the SVC.
• Veins that drain everything in the abdominopelvic cavity except

  the GI tract
• accessory organs (liver, gallbladder, pancreas),

  and the spleen are tributaries that primarily drain into the inferior

  vena cava (IVC).
• The perineum and external genitalia are largely

  drained by the internal pudendal vein, which corresponds to the

  artery of the same name that supplies this region.
• drains the hindgut derivatives of the GI

  tract, including the distal transverse colon, descending colon,

  sigmoid colon, and proximal rectum

  inferior mesenteric
• drains the midgut derivatives of the GI

  tract, including the distal duodenum, small intestine, ascending

  colon, and proximal transverse colon, as well as the pancreas

  Superior mesenteric
• drains the spleen, stomach, and pancreas

  Splenic
• formed by the union of the splenic and superior

  mesenteric veins, this large vein drains the stomach and

  gallbladder and receives all the venous drainage from the three

  veins just mentioned

  Portal
• blood will shunt from the portal and splenic veins

  into gastric veins of the stomach and then into esophageal

  veins that are connected to the azygos system of veins, ulti-

  mately draining into the SVC and the heart

  esophageal
• blood will drain inferiorly in the inferior mesenteric vein

  to the superior rectal vein and then into the middle and inferior

  rectal veins (anastomosis around the rectum) to access the IVC

  and the heart

  Rectal
• blood from the portal vein will drain into the

  para-umbilical veins and fill the subcutaneous veins of the

  abdominal wall (forms a tortuous tangle of veins visible on the

  abdominal surface called the caput medusae), which then may

  drain into tributaries of the SVC, IVC, and azygos system

  para-umbilical
• least important of the pathways; some blood

  will drain from retroperitoneal GI viscera into parietal veins in

  the body wall to access the caval tributaries

  retropertoneal
• parallels the deep radial artery in the lateral forearm

  radial
• parallels the ulnar artery in the medial forearm

  ulnar
• formed by the union of the radial and ulnar veins in

  the cubital fossa; this vein parallels the brachial artery in the

  medial aspect of the arm


  brachial
• in the armpit, it parallels the axillary artery in the

  axillary sheath (surrounded by the cords of the brachial nerve

  plexus)

  axillary
• parallels the subclavian artery but passes anterior

  to the anterior scalene muscle rather than posterior to it (artery

  lies posterior)

  subclavian
• The superficial set of veins of the upper limb are connected

  by communicating veins to the deep set of veins and provide an

  additional route for venous return to the heart.
• Dorsal venous network: most of the blood from the palm will

  drain into these veins (especially when the hand is squeezed)
• Cephalic: runs in the subcutaneous tissue along the lateral

  forearm and arm to ultimately drain into the axillary vein
• runs in the subcutaneous tissue along the medial fore-

  arm and distal arm to ultimately dive deep into the medial arm

  and drain into the axillary vein

  basilic
• asses from the cephalic to the basilic vein

  in the cubital fossa and is a common site for venipuncture to

  withdraw a blood sample or administer fluids intravenously

  median cubital
• the veins of the lower (and upper) limb contain valves, which assist, largely by the action of adjacent muscle contraction, to return venous blood to the heart against gravity.
• Posterior tibial: drains from the sole of the foot and medial

  ankle superiorly up the leg, paralleling the posterior tibial artery

  in the posterior compartment of the leg
• Anterior tibial: begins as the dorsalis pedis vein on the dor-

  sum of the foot and parallels the anterior tibial artery in the

  anterior compartment of the leg
• Fibular: small vein that parallels the artery of the same name in

  the lateral compartment of the leg and drains into the posterior

  tibial vein
• Popliteal: lies behind the knee and is formed by the anterior

  and posterior tibial veins
• Femoral: the popliteal becomes the femoral in the distal thigh

  and then the femoral drains deep to the inguinal ligament to

  become the external iliac vein in the pelvis
• The superficial set of veins of the lower limb are connected by

  communicating veins to the deep set of veins and provide an

  additional route for venous return to the heart.
• drains blood from the foot into the small

  and large saphenous veins at the lateral and medial aspect of

  the ankle, respectively

  Dorsal venous arch
• courses superiorly in the subcutaneous

  tissue of the calf (posterior aspect of the leg) and then dives

  deeply to drain into the popliteal vein behind the knee

  Small saphenous
• courses superiorly from the medial side of

  the ankle to run up the medial leg and thigh, draining into the

  femoral vein just inferior to the inguinal ligament

  Great saphenous
• the great saphenous vein and the cephalic vein of the

  upper limb are analogous veins, as are the small saphenous

  and the basilic vein of the upper limb (both dive deeply to join a

  deeper vein).
• veins lower limb

  1. femoral
  2. great saphenous
  3. anterior tibial
  4. popliteal
  5. small saphenous
  6. posterior tibial
• Ductus venosus (bypasses the liver)
• Foramen ovale (shunts blood from the right atrium to the left

  atrium, thus bypassing the lungs)