VIENNES OF THE LARGE CIRCLE OF CIRCULATION

VIENNA OF THE HEART

VIENNES OF THE SMALL CIRCLE OF CIRCULATION

PRIVATE Vienna Anatomy

PULMONARY VENINS(venae pulmonales) - remove oxygenated blood from the lobes, segments of the lungs and pulmonary pleura. As a rule, two right and two left pulmonary veins fall into the left atrium.

CROWN SINE(sinus coronarius) - a blood vessel located in the posterior part of the coronary sulcus. It opens into the right atrium and is a collector for the large, middle and small veins of the heart, the oblique vein of the left atrium, the posterior vein of the left ventricle. The veins flowing into the coronary sinus form an independent pathway for venous outflow from the heart.

GREAT VIENNA OF THE HEART (vena cordis magna) - inflow of the coronary sinus, located in the anterior interventricular, and then in the coronary sulcus. Collects blood from the anterior walls of the ventricles, the interventricular septum.

THE MIDDLE VIENNA OF THE HEART (vena cordis media) - lies in the posterior interventricular groove, the inflow of the coronary sinus. Collects blood from the posterior walls of the ventricles of the heart.

SMALL VIENNA OF THE HEART(vena cordis parva) - lies on the posterior surface of the right ventricle, and then in the coronary groove. The inflow of the coronary sinus collects blood from the posterior wall of the right ventricle and atrium.

BACK VIENNA OF THE LEFT VENTRICLE (vena posterior ventriculi sinistri) - inflow of the coronary sinus. Collects blood from the back wall of the left ventricle, on which it is located.

OBLIQUE VIENNA OF THE LEFT ATRIAL(vena obliqua atrii sinistri) - the inflow of the coronary sinus, which removes blood from the posterior wall of the left atrium.

THE SMALLEST VEINS OF THE HEART (venae cordis minimae) - small veins that flow directly into the cavity of the right atrium. An independent pathway of venous outflow from the heart.

FRONT VEINS OF THE HEART(venae cordis anteriores) - collect blood from the walls of the arterial cone and the anterior wall of the right ventricle. They flow into the right atrium, are an independent pathway for the outflow of venous blood from the heart.

NEPARNAYA VIENNA(vena azygos) - is a continuation of the right ascending lumbar vein, located in the posterior mediastinum to the right of the spine. Having circled from above the right main bronchus flows into the superior vena cava. Its large tributaries are the semi-unpaired and accessory semi-unpaired veins, as well as the subcostal, upper diaphragmatic, pericardial, mediastinal, esophageal, bronchial, XI-IV right posterior intercostal veins.

SEMI-UNPAIRED VIENNA(vena hemiazygos) - is formed from the left ascending lumbar vein, passes into the posterior mediastinum, is located to the left of the spine and at the level of VIII-IX of the thoracic vertebra flows into the azygos vein.

ADDITIONAL SEMI-PAIR VIENNA (vena hemiazygos accessoria) - an inflow of a semi-azygos vein, formed from VI-III left posterior intercostal veins.

SHOULDER VEINS (venae brachiocephalicae) - large venous vessels formed when the subclavian and internal jugular veins merge. The right brachiocephalic vein is half as long as the left and runs almost vertically. The tributaries of the brachiocephalic veins are the lower thyroid, unpaired thyroid, pericardio-diaphragmatic, deep cervical, vertebral, intravenous thoracic, lower intercostal veins and veins of the mediastinal organs. When the brachiocephalic veins merge, the superior vena cava is formed.

INNER JARA VIENNA(vena jugularis interna) - begins in the area of \u200b\u200bthe jugular opening, being a continuation of the sigmoid sinus. Vienna is formed by intra- and extracranial tributaries. Collects blood from the cranial cavity (brain and its dura maze), from the labyrinth of the inner ear, the face area, the venous plexus of the pharynx, tongue, larynx, thyroid and parathyroid glands, sublingual and submandibular glands, neck muscles.

Intracranial tributaries of the internal jarring veins - intracranial tributaries of the internal jugular vein are sinuses of the dura mater of the brain, diploic veins of the bones of the cranial vault, emissary veins of the skull, venous plexuses of the base of the skull, veins of the dura mater of the brain, veins of the brain, veins of the orbit and veins of the labyrinth.

Sinuses of the cerebral duct (sinus durae matris) - non-collapsing channels between the sheets of the durae of the brain, collecting blood from the veins of the brain. They do not have a middle (muscular) membrane and valves. They have anatomical connections with diploic veins and veins of the cranial vault.

UPPER SAGITTAL SINE (sinus sagittalis superior) - lies at the base of the sickle of the brain from the cock's crest to the sinus drain. The wall of the sinus has side pockets - lacunae.

LOWER SAGITTAL SINUS(sinus sagittalis inferior) - located in the free edge of the sickle of the brain and opens into a straight sinus.

DIRECT SINUS(sinus rectus) - formed when the great vein of the brain and the lower sagittal sinus merge. It runs along the zone of attachment of the brain serop to the cerebellar hint.

CROSS SINUS(sinus transversus) - passes in the frontal plane in the groove of the occipital bone of the same name.

SIGMOID SINUS (sinus sigmoideus) - continuation of the transverse sinus anteriorly. Passes in the grooves of the same name on the occipital, parietal and temporal bones and in the area of \u200b\u200bthe jugular foramen passes into the internal jugular vein.

BAD SINUS (sinus occipitalis) - passes at the base of the cerebellar sickle.

CAVEAL SINUS(sinus cavernosus) - spongy venous structure on the sides of the Turkish saddle. The wedge-parietal, superior and inferior stony sinuses, and eye veins flow into the sinus. The internal carotid artery and the abducens nerve pass through the sinus, and the oculomotor, trochlear nerves, the first and second branches of the trigeminal nerve are located in the lateral wall.

INTERCESTRAL SINUSES(sinus intercavernosi) - connect the cavernous sinuses in front and behind the pituitary gland.

WEDGE-SHAPED-DARK SINUS(sinus sphenoparietalis) - a tributary of the cavernous sinus, passes along the small wings of the sphenoid bone.

UPPER STONE SINUS (sinus petrosus superior) - connects the cavernous and sigmoid sinuses, runs along the upper edge of the temporal bone pyramid.

LOWER STONE SINUS (sinus petrosus inferior) - connects the cavernous sinus and the upper bulb of the internal jugular vein, runs along the posterior edge of the pyramid of the temporal bone.

SINUS STOCK (confluens sinuum, Herophilus pulp) - the connection of the transverse, superior sagittal, occipital and direct sinuses of the dura mater. Located inside the cranial cavity near the internal occipital protuberance.

DIPLOIC VIENNA (venae diploicae) - veins located in the spongy substance of the bones of the cranial vault. Connect the sinuses of the dura mater with the superficial veins of the head.

EMISSARY VIENNA (venae emissariae) - graduate veins, connect the sinuses of the dura mater and superficial veins of the head. Most constantly located in the parietal, mastoid openings, in the condylar canal. The parietal emissary vein connects the superficial temporal vein and the superior sagittal sinus, the mastoid - the sigmoid sinus and the occipital vein, the condylar - the sigmoid sinus and the external vertebral plexus. The emissary veins do not contain valves.

BASILARY Plexus(plexus basilaris) - located on the clivus of the occipital bone and connects the cavernous and stony sinuses with the venous plexuses of the spinal canal.

VENOUS Plexus OF THE SUBLINGUAL CANAL(plexus venosus canalis hypoglossi) - connects the venous plexus around the large opening and the internal jugular vein.

OVAL VENOUS Plexus(plexus venosus foraminis ovalis) - connects the cavernous sinus and the pterygoid venous plexus.

The venous plexus of the sleepy canal(plexus venosus caroticus internus) - connects the cavernous sinus with the pterygoid plexus.

BRAIN VEINS (venae cerebri) - located in the subarachnoid space and do not have valves. They are divided into superficial and deep. The former include the superior and inferior cerebral, superficial middle cerebral, superior and inferior veins of the cerebellar hemisphere. They flow into the venous sinuses. The deep veins include the basal, anterior cerebral, internal cerebral, superior and inferior villous, veins of the transparent septum, thalamo-striatal veins. These veins eventually merge into a large cerebral vein (Galena) that flows into the rectus sinus.

VIENNA EYES (venae orbitae) - represented by the superior and inferior ocular veins and their tributaries, flow into the cavernous sinus and veins of the head. The superior ocular vein is formed by the nasolabial vein, ethmoid veins, lacrimal veins, veins of the eyelids, veins of the eyeball. The lower ocular vein is formed by the fusion of the veins of the lacrimal sac, medial, lower rectus and lower oblique muscles of the eye. The lower ophthalmic vein with one trunk anastomoses with the upper ophthalmic vein (cavernous sinus), and the other with the deep vein of the face. In addition, it has anastomoses with the pterygoid venous plexus and the infraorbital vein.

EXTRACANCIAL INFLUENCES OF THE INNER YARNY VENA -pharyngeal, lingual, facial, temporomandibular, upper and middle thyroid veins.

FACE VIENNA (vena facialis) - is formed at the fusion of the supra-block, supraorbital and angular veins. From the medial angle of the eye it goes down and laterally in the projection of the nasolabial fold. Anastomoses with the superior ocular vein. Tributaries: veins of the upper eyelid, external nasal veins, veins of the lower eyelid, superior and inferior labial veins, deep vein of the face, veins of the parotid gland, palatine vein, submental vein.

OUTDOOR JARLA VIENNA (vena jugularis externa) - is formed when the occipital and posterior ear veins merge. Lies between the subcutaneous muscle and the superficial layer of the own fascia of the neck. Inflow of the subclavian vein.

FRONT JARVENA (vena jugularis anterior) - follows from the level of the hyoid bone, crosses the sternocleidomastoid muscle and flows into the external jugular vein in the lower part of the neck.

JAR VENOUS ARCH (arcus venosus jugularis) - anastomosis between the right and left anterior jugular veins, located in the suprasternal interaponeurotic cellular tissue space. May be damaged when performing a lower tracheotomy.

UPPER LIMB VEINS(venae membri superioris) – are divided into superficial (dorsal metacarpal, lateral and medial saphenous veins of the hand, median ulnar vein, intermediate vein of the forearm) and deep (superficial and deep palmar venous arches, radial, ulnar and brachial veins), widely anastomosed with each other.

LATERAL SUBCUTANEOUS Vein of the hand (vena cephalica) - starts from the dorsal venous network of the hand from the base of the first finger, on the shoulder it passes in the lateral groove and further into the sulcus deltoideopectoralis and flows into the axillary vein.

Medial subcutaneous vein of the hand(vena basilica) - is formed on the elbow of the forearm, passes in the medial groove of the shoulder and in its middle pierces the fascia of the shoulder and flows into the brachial vein.

MIDDLE ELBOW VIENNA (vena mediana cubiti) - in the anterior region of the elbow connects the lateral and medial saphenous veins of the arm, forming an anastomosis in the shape of the letter "N", and when falling into the middle of the anastomosis of the intermediate vein of the forearm, the latter takes the shape of the letter "M". Since the median cubital vein does not have valves, has anastomoses with deep veins, and lies subcutaneously, it is often used for intravenous injections.

Axillary vein(vena axillaris) - accompanies the artery of the same name from the outer edge of the first rib to the lower edge of the large round muscle. The vein is formed by the parasal venous plexus, the lateral saphenous vein of the arm, the brachial veins, the lateral thoracic vein, and the thoracic hypogastric veins. Collects blood from the upper limb, shoulder girdle and chest of the respective side.

CONNECTIVE VIENNA (vena subclavia) - continuation of the axillary vein until it merges with the internal jugular vein. Accepts the thoracomial and external jugular veins. Collects blood from the upper limb, shoulder girdle, partly the chest wall of the corresponding side and partly from the head and neck region.

VENOUS ANGLE(angulus venosus) - Pirogov's venous angle, formed when the internal jugular and subclavian veins merge. The confluence of the lymphatic ducts.

Superior vena cava, v. cava superior , is a short valveless thick vessel, which is formed as a result of the fusion of the right and left brachiocephalic veins behind the junction of the cartilage of the I right rib with the sternum.

V.cava superior follows vertically downward and at the level of the junction III of the right cartilage with the sternum flows into the right pr-e. In front of the vein is the thymus gland (thymus) and the mediastinal part of the right lung covered with pleura. On the right, the mediastinal pleura is adjacent to the vein, on the left is the ascending part of the aorta. Behind v.cava superior in contact with the anterior surface of the root of the right lung. The azygos vein flows into the superior vena cava on the right, and small mediastinal and pericardial veins on the left. V.cava superior collects blood from three groups of veins: veins of the head and neck, veins of both upper extremities and veins of the walls of the chest and partly abdominal cavities, i.e. from those areas that are supplied with blood by the branches of the arch and the thoracic part of the aorta. The inflow of the superior vena cava is the azygos vein.

1. Unpaired vein, v. azygos , is a continuation into the thoracic cavity of the right ascending lumbar vein ( v. lumbalis ascendens dextra ), which lies behind the psoas major muscle and on its way anastomoses with the right lumbar veins flowing into the inferior vena cava. Having passed between the muscle bundles of the right leg of the lumbar part of the diaphragm into the posterior mediastinum, v. lumbalis ascendens dextra gets the name of the azygos vein ( v. azygos ). Behind and to the left of it are the spinal column, the thoracic part of the aorta and the thoracic duct, as well as the right posterior intercostal ai. In front of the vein lies the esophagus. At the level of IV-V thoracic vertebrae v.azygos goes around the root of the right lung from behind, goes forward and downward and flows into the superior vena cava. There are two valves at the mouth of the azygos vein. The veins of the posterior wall of the chest cavity flow into the azygos vein on its way to the superior vena cava:

1) right superior intercostal vein , v. intercostalis superior dextra ;

2) posterior intercostal veins , v. v. intercostales posteriores IV-XI , which are located in the intercostal spaces next to the a-s of the same name, in the groove under the corresponding rib, and collect blood from the tissues of the walls of the chest cavity and partly of the anterior abdominal wall (lower posterior intercostal veins). In each of the posterior intercostal veins flow:

Back branch , r.dorsalis , which forms in the skin and muscles of the back;

Intervertebral vein , v. intervertebralis , formed from the veins of the external and internal vertebral venous plexuses; a spinal branch flows into each intervertebral vein , r.spinalis , which, along with other veins (vertebral, lumbar and sacral), is involved in the outflow of venous blood from the spinal cord.

Internal vertebral venous plexuses (anterior and posterior), plexus venosi vertebrales interni (anterior et posterior) , are located inside the spinal canal (between the hard shell of the spinal cord and the periosteum) and are represented by veins that repeatedly anastomose among themselves. The plexuses extend from the foramen magnum above to the apex of the sacrum below. The spinal veins flow into the internal vertebral plexuses , v.v.spinales , spongy vertebral veins . From these plexuses, the blood flows through the intervertebral veins passing through the intervertebral foramen (next to the spinal nerves) into the azygos, semi-unpaired and accessory semi-unpaired veins and external venous vertebral plexuses (anterior and posterior).

External vertebral venous plexuses(front and back) ( plexus vertebrales venosi externi (anterior et posterior ), which are located on the anterior surface of the vertebrae, and also braid their arcs and processes. The outflow of blood from the external vertebral plexuses occurs in the posterior intercostal, lumbar and sacral veins (vv.intercostales posteriores, lumbales et sacrales) , as well as directly into the unpaired, semi-unpaired and accessory semi-unpaired veins. At the level of the upper spinal column, the plexus veins flow into the vertebral and occipital veins ( vv.vertebrales, vv.occipitales ).

3) veins of the chest organs: esophageal veins , vv. esophageales ; bronchial veins , vv. bronchiales ; pericardial veins , vv. pericardiacae , and mediastinal veins , vv. mediastinales .

4) semi-unpaired vein, v.hemiazygos , (sometimes called the left, or small azygos vein), thinner than the azygos vein, because only 4-5 lower left posterior intercostal veins flow into it. Semi-unpaired vein is a continuation of the left ascending lumbar vein (v.lumbalis ascendens sinistra ) , passes between the muscle bundles of the left leg of the diaphragm into the posterior mediastinum, adjacent to the left surface of the thoracic vertebrae. To the right of the semi-unpaired vein is the thoracic part of the aorta, behind - the left posterior intercostal ai. At the level VII-X of the thoracic vertebrae, the semi-unpaired vein turns abruptly to the right, crosses the anterior vertebral column (located behind the aorta, esophagus and thoracic duct) and flows into the azygos vein ( v.azygos ). In a semi-unpaired vein:

An accessory semi-unpaired vein going from top to bottom , v.hemiazygos accessoria taking 6-7 left upper intercostal veins ( v.v.intercostales posteriores I-VII ),

Esophageal veins, v.v.esophageales ,

Mediastinal veins, v.v. mediastinales .

The most significant ducts of the azygos and semi-unpaired veins are the posterior intercostal veins, v.v. intercostales posteriores, each of which is connected with its anterior end to the anterior intercostal vein ( v.intercostalis anterior ) - by the inflow of the internal thoracic vein ( v.thoracica interna ), which creates the possibility of the outflow of venous blood from the walls of the chest cavity back into the azygos and semi-unpaired veins and forward into the internal chest veins.

Brachiocephalic veins (right and left), v.v.brachiocephalicae (dextra et sinistra) , valveless, are the roots of the superior vena cava, collect blood from the organs of the head and neck and upper extremities. Each brachiocephalic vein is formed from two veins - the subclavian and internal jugular. Each of these veins flow:

1. Small veins from internal organs: thymus veins, v.v.thymicae ; pericardial veins, v.v.pericardiacae ; pericardio-diaphragmatic veins, v.v.pericardiacophrenicae ; bronchial veins, v.v.bronchiales ; esophageal veins, v.v.esophageales ; mediastinal veins, v.v.mediastinales (from the lymph nodes and connective tissue of the mediastinum).

2.1-3 lower thyroid veins , v.v.thyroideae inferiores , through which blood flows from the unpaired thyroid plexus ( plexus thyroideus impar ),

3. Inferior laryngeal vein , v. laryngea inferior , bringing blood from the larynx, which anastomoses with the upper and middle thyroid veins.

4. Vertebral vein , v. vertebralis ... The first of them accompanies the vertebral artery, passes with it through the transverse openings of the cervical vertebrae to the brachiocephalic vein ( v. brachiocephalica ), taking on its way the veins of the internal vertebral plexuses.

5. Deep cervical vein, v. cervicalis profunda , starts from the external vertebral plexuses, and also collects blood from the muscles located in the occipital region. This vein runs behind the transverse processes of the cervical vertebrae and flows into the brachiocephalic vein near the mouth of the vertebral vein or directly into the vertebral vein.

6. Internal chest veins , v.v.thoracicae internae . They accompany the internal thoracic artery, two on each side. Their roots are the upper epigastric and musculophrenic veins. , v.v.epigastricae superiores et v.v.musculophrenicae ... The first of them are anastomosed in the thickness of the anterior abdominal wall with the lower epigastric veins flowing into the external iliac vein. The anterior intercostal veins that lie in the anterior intercostal spaces flow into the internal thoracic veins , v.v.intercostales anteriores , which anastomose with the posterior intercostal veins ( v.v.intercostales posteriores ), flowing into the azygos and semi-unpaired veins.

7. Highest intercostal vein , v. intercostalis suprema , collecting blood from 3-4 upper intercostal spaces.

text_fields

text_fields

arrow_upward

Superior vena cava (v. cava superior),a constituent part of the systemic circulation, drains blood from the upper half of the body - the head, neck, upper limbs, chest wall.

The superior vena cava is formed from the fusion of two brachiocephalic veins (behind the junction of the first right rib with the sternum) and lies in the upper part of the mediastinum. At the level of the II rib, it penetrates into the cavity of the pericardium (pericardial sac) and flows into the right atrium.

The diameter of the superior vena cava reaches 20–22 mm, its length is 7–8 cm. Near the heart, a large azygos vein, as well as mediastinal and pericardial veins, flow into it.

Unpaired vein

text_fields

text_fields

arrow_upward

Unpaired vein (v. azygos)starts in the abdomen, where it is called right ascending lumbar vein.It originates from numerous tributaries - the parietal veins of the abdominal cavity and forms anastomoses with the veins of the paravertebral plexus, the common iliac and sacral veins.

Rising along the right side of the vertebral bodies, it passes through the diaphragm and follows behind the esophagus called the azygos vein. The diaphragmatic and right intercostal veins, veins from the mediastinal organs (pericardium, esophagus, bronchi) and the semi-unpaired vein flow into it. There are two valves at the place where the azygos vein flows into the superior vena cava.

Semi-unpaired vein

text_fields

text_fields

arrow_upward

Semi-unpaired vein (v, hemiazygos)thinner than unpaired, begins in the abdominal cavity called the left ascending lumbar vein. In the thoracic cavity, it lies in the posterior mediastinum to the left of the aorta, takes the left intercostal, esophageal and mediastinal veins, as well as an additional semi-unpaired vein, which forms when the upper intercostal veins merge. The semi-unpaired vein basically repeats the course of the azygos vein, into which it flows at the level of the VIII thoracic vertebra, crossing the spine.

Intercostal veins

text_fields

text_fields

arrow_upward

Intercostal veins (vv. intercostales)accompany the arteries of the same name, together with which, as well as with the nerves, they form neurovascular bundles of the intercostal space.

The anterior intercostal veins flow, respectively, into the right and left internal thoracic vein, accompanying the artery of the same name, and the posterior ones - into the unpaired, semi-unpaired, left brachiocephalic and accessory semi-unpaired veins. There are valves at the mouths of the intercostal veins.

A dorsal branch flows into each posterior intercostal vein, collecting blood from the muscles and skin of the back, as well as from the spinal cord, its membranes and the venous plexus of the spine.

Brachiocephalic vein

text_fields

text_fields

arrow_upward

Brachiocephalic vein (v. brachiocephalisa)arises behind the sternoclavicular joint in the venous angle from the junction of two veins: the internal jugular and subclavian. The left vein is almost twice as long as the right and runs in front of the branches of the aortic arch. Behind the place of attachment of the I rib to the sternum, the right and left veins are connected and form the superior vena cava. The brachiocephalic vein collects blood from the veins accompanying the branches of the subclavian artery, and in addition, from the veins of the thyroid and thymus glands, larynx, trachea, esophagus, from the venous plexuses of the spine, deep veins of the neck and head, veins of the upper intercostal muscles and the mammary gland.

The most significant tributaries of the brachiocephalic veins are the thyroid, mediastinal, vertebral, internal thoracic and deep cervical veins. Through the terminal branches of the vein, anastomoses are established between the systems of the superior and inferior vena cava. So the internal thoracic veins begin in the anterior abdominal wall as the superior epigastric veins. They anastomose with the inferior epigastric veins belonging to the inferior vena cava system.

Internal jugular vein

text_fields

text_fields

arrow_upward

Internal jugular vein (and. jugularis interna)begins in the jugular opening of the skull as a direct continuation of the sigmoid sinus of the dura mater and descends along the neck in the same neurovascular bundle with the carotid artery and the vagus nerve.

The internal jugular vein (together with the external jugular) collects blood from the head and neck, i.e. from areas that are supplied by the common carotid artery, and, in particular, from the sinuses of the dura mater, into which blood flows from the veins of the brain. In addition, in the cranial cavity, veins from the orbit, inner ear, cancellous bones of the roof of the skull and meninges flow into the internal jugular vein. Of the extracranial branches, the largest are facial vein (v. facialis),accompanying the facial artery and submandibular vein.The latter collects blood from the temporal region, ear, mandibular joint, parotid salivary gland, jaw and masticatory muscles. In the neck, tributaries from the pharynx, tongue and thyroid gland flow into the internal jugular vein.

Throughout its length, the vein and its tributaries have valves.

External jugular vein

text_fields

text_fields

arrow_upward

External jugular vein (v. jugularis externa)is formed at the level of the angle of the lower jaw as a result of the fusion of the mandibular and posterior auricular veins and descends along the outer surface of the sternocleidomastoid muscle, covered by the fascia and the subcutaneous muscle of the neck. The vein flows into the subclavian or internal jugular vein or, rarely, into the venous angle. This vein drains blood away from the skin and muscles of the neck and occipital region. The occipital, anterior jugular and suprascapular veins flow into it.

Superior vena cava (v. cava superior) collects blood from the veins of the head, neck, both upper limbs, veins of the thoracic and partially abdominal cavities and flows into the right atrium. The azygos vein flows into the superior vena cava on the right, and the mediastinal and pericardial veins on the left. It has no valves.

Unpaired Vienna (v. azygos) is a continuation into the thoracic cavity of the right ascending lumbar vein (v. lumbalis ascendens dextra), has two valves at the mouth. The unpaired vein, esophageal veins, mediastinal and pericardial veins, posterior intercostal veins IV-XI and the right superior intercostal veins flow into the azygos vein.

Semi-unpaired vein (v. hemiazygos) is a continuation of the left ascending lumbar vein (v. lumbalis ascendens sinistra). The mediastinal and esophageal veins flow into the semi-unpaired vein, an accessory semi-unpaired vein (v. hemiazygos accessoria), which takes I-VII upper intercostal veins, posterior intercostal veins.

Posterior intercostal veins (vv. intercostales posteriores) collect blood from the tissues of the walls of the chest cavity and part of the abdominal wall. An intervertebral vein flows into each posterior intercostal vein (v. intervertebralis), into which, in turn, the spinal branches flow (rr. spinales) and vein of the back (v. dorsalis).

Into the internal anterior and posterior vertebral venous plexuses (plexus venosi vertebrales interni) the veins of the spongy substance of the vertebrae and the spinal veins fall. Blood from these plexuses flows into the accessory semi-unpaired and azygos veins, as well as into the external anterior and posterior vertebral venous plexuses (plexus venosi vertebrales externi), from which blood flows into the lumbar, sacral and intercostal veins and into the additional semi-unpaired and azygos veins.

Right and left brachiocephalic veins (vv. brachiocephalicae dextra et sinistra) are the roots of the superior vena cava. They have no valves. Collect blood from the upper limbs, organs of the head and neck, upper intercostal spaces. The brachiocephalic veins form when the internal jugular and subclavian veins merge.

Deep cervical vein (v. cervicalis profunda) originates from the external vertebral plexuses and collects blood from the muscles and the auxiliary apparatus of the muscles of the occipital region.

Vertebral vein (v vertebralis) accompanies the artery of the same name, taking blood from the internal vertebral plexuses.

Internal thoracic vein (v. thoracica interna) accompanies the artery of the same name on each side. The anterior intercostal veins flow into it. (vv. intercostales anteriores), and the roots of the internal thoracic vein are the musculophrenic vein (v. musculophrenica) and superior epigastric vein (v. epigastrica superior).

13. Veins of the head and neck

Internal jugular vein (v. jugularis interna) is a continuation of the sigmoid sinus of the dura mater of the brain, has an upper bulb in the initial section (bulbus superior); the inferior bulb is located above the confluence with the subclavian vein (bulbus inferior). There is one valve above and below the lower bulb. Intracranial tributaries of the internal jugular vein are the ocular veins (vv. ophthalmicae superior et inferior), veins of the labyrinth (vv. labyrinthi) and diploic veins.

Through the diploic veins (vv. diploicae) - posterior temporal diploic vein (v. diploica temporalis posterior), anterior temporal diploic vein (v. diploica temporalis anterior), frontal diploic vein (v. diploica) and occipital diploic vein (v. diploica occipitalis) - blood flows from the bones of the skull; have no valves. With the help of emissary veins (vv. emissariae) - mastoid emissary vein (v. emissaria mastoidea), condylar emissary vein (v. emissaria condylaris) and parietal emissary vein (v emissaria parietalis) - diploic veins communicate with the veins of the outer cover of the head.

Extracranial tributaries of the internal jugular vein:

1) lingual vein (v. lingualis), which is formed by the deep vein of the tongue, the hyoid vein, the dorsal veins of the tongue;

2) facial vein (v. facialis);

3) superior thyroid vein (v. thyroidea superior); has valves;

4) pharyngeal veins (vv. pharyngeales);

5) submandibular vein (v. retromandibularis).External jugular vein (v. jugularis externa) has paired

valves at the level of the mouth and middle of the neck. The transverse veins of the neck flow into this vein. (vv. transversae colli), anterior jugular vein (v. jugularis anterior), suprascapular vein (v. suprascapularis).

Subclavian vein (v. subclavia) unpaired, is a continuation of the axillary vein.

The vena cava (in Latin - vena cava inferior) is the main part of the entire system of venous communication in the body. The hollow veins consist of several trunks - upper and lower, which serve to collect blood throughout the human body. Blood flows through the vein to the heart. Deviations in the work of the veins can provoke various diseases.

What is an inferior vena cava (IVC)?

It is the largest vein in the human body in diameter.

There are no valves in its structure.

Briefly about the length of the inferior vena cava:

1. The inferior vena cava begins in the area between 4-5 vertebrae in the lumbar region. It is formed between the right and left iliac veins;
2. Further, the inferior vena cava runs along the lumbar muscles, or rather their front part;
3. Then it follows near the duodenum (on the back);
4. Further, the inferior vena cava lies in the groove of the hepatic gland;
5. Passes through the diaphragm (it has an opening for a vein);
6. It ends in the pericardium, so all the components flow into the right atrium, and on the left come into contact with the aorta.

When a person breathes, the inferior vena cava tends to change its diameter. On inspiration, the process of compression occurs and the vein decreases in size, on exhalation it increases. The size change can be from 20 to 34 mm, and this is the norm.

The purpose of the inferior vena cava is to collect blood, which has already passed through the body and gave up its beneficial properties. The spent blood goes directly to the heart muscle.

Structure

The anatomy of the inferior vena cava is well studied, and thanks to this, there is accurate information about its structure. It consists of 2 large tributaries - parietal and visceral.

The parietal duct is located in the pelvic region and in the peritoneum.

The parietal duct system contains the following veins:

• Lumbar. They are found in the walls of the entire peritoneal cavity. The number of vessels almost never exceeds 4. There are valves in the vein;
• Diaphragmatic inferior veins. Here they are divided into 2 parts - the left and right lobes of the bloodstream. They flow into the vena cava in the area where it comes from the sulcus in the hepatic gland.

The main task of visceral tributaries is the outflow of blood from various organs. The veins are divided depending on the organ from which they extend.

Visceral inflow diagram:

• Renal. Everything flows into a vein at approximately the level of the 1st and 2nd vertebra. The left vessel is slightly longer in length;
• Hepatic. They connect to the inferior vena cava where the liver is located. Due to the passage of the vessel along the liver, the tributaries are very small. There are no valves in the building;
• Adrenal. It is short in structure, there are no valves. It originates at the entrance to the adrenal gland. Considering that the organ is paired, there are several vessels from the adrenal glands, one from each. The vein system collects blood from the left and right adrenal glands;
• Testicular / ovarian or genital vein. The vessel is present regardless of gender division, but originates in different places. In men, it begins on the back of the testicular wall. In appearance, the vein resembles a plexus of vines of small branches that connect to the spermatic cord. For women, the characteristic beginning is in the area of \u200b\u200bthe ovarian gate.

Due to the huge amount of inflow and structure of the vein, which has a length for most of the body, the diagnosis of pathologies can be difficult. Due to the fact that the inferior vena cava forms when many vessels merge, damage to any area can lead to serious problems.

Inferior vena cava syndrome

Pregnant women are at risk for this syndrome. This pathology cannot be classified as a disease, but it is a definite deviation. The body does not properly adapt to the development of the uterus, as well as to the forced change in blood flow.

Most often, the syndrome is observed in women who carry either a fairly large fetus, or several children at the same time. During pregnancy, pressure can be exerted on the inferior vena cava, from which squeezing occurs. This is due to the low pressure inside the vein.

Medical sources report that individual signs of pathology in the venous blood flow in the IVC department can be found in more than 50% of pregnant women, but noticeable symptoms appear in only 10%. A vivid clinical picture occurs only in 1 in 100 women.

Causes of the syndrome

The causes of the syndrome:

• The blood composition has changed;
• As a consequence of the anatomy of the body, caused by a hereditary factor;
• High blood platelet count;
• Vein disease that is infectious in nature;
• The appearance of a tumor in the abdominal region.

Pathology manifests itself in different ways, depending on the structure of the individual. The most common problem is blockage of the vessel due to the formation of a blood clot.

Thrombosis, during which the blood vessels in the legs are blocked, are usually deep. Almost half of the patients have an ascending path of thrombosis. Malignant tumors located in the area behind the peritoneum or on the organs of the abdominal cavity provoke the formation of blockage of the IVP in about 40% of all situations.

Additional information on SVC for correct diagnosis:

• Cancer of the bronchus or lungs;
• Aortic aneurysm;
• Expansion of the lymph nodes of the mediastinum due to metastases from cancerous tumors in other organs;
• Organ damage with infectious agents, as a result of inflammation. These include tuberculosis and an inflammatory response in the pericardium;
• Thrombus formation due to prolonged installation of a catheter, electrode.

Inferior vena cava syndrome in pregnant women

In pregnant women, inferior vena cava syndrome is common. This is due to an increase in the uterus and changes in the venous circulation. Most often, this syndrome occurs when a woman is carrying two or more children.

The dangerous moment is the situation with the occurrence of a slight collapse, which occurs during a cesarean section. If the inferior vena cava is compressed by the uterus, a violation of blood exchange in the uterus and kidneys is often observed. This threatens the child, because it can provoke serious consequences, such as placental abruption.

The course of the disease, the nature of complications and the outcome from clogging of the vein is one of the most dangerous and complex conditions, since blood circulation in the largest vein of the body is impaired. The syndrome is complicated by the fact that a number of restrictions are imposed on the use of examinations due to pregnancy.

An additional complication lies in the fact that the problem is quite rare and the special literature contains limited information on the disease.

What is the upper vena cava (VPV)?

The upper floor vein is a short vein that runs from the head and collects venous blood (more about blood) from the upper body. It enters the right atrium.

The SVC carries blood from the neck, head, arms, and also transports blood from the bronchi and lungs through special bronchial veins. From part it transports the blood of the walls of the peritoneum. This is achieved by entering the azygos vein into it.

SVC is formed due to the fusion of the left and right brachiocephalic veins. Its location is at the top of the mediastinum.

Superior vena cava syndrome

This syndrome is more relevant for men between the ages of 40 and 65. At the center of the syndrome is contraction from the outside or thrombus formation that occurs due to various pulmonary diseases.

Among them are:

• Lungs' cancer;
• Spread of metastases and enlargement of lymph nodes;
• Aortic aneurysm;
• Thrombosis;
• Tuberculosis;
• Infectious pericardial inflammation.

Superior vena cava syndrome is expressed depending on the rate of disturbance of the blood flow process, as well as the level of development of bypass pathways of blood supply.

The main symptoms of superior vena cava syndrome:

• Bluish skin color;
• Swelling of the face and neck area, occasionally hands;
• Swelling of the venous trunks in the neck.

Patients complain of hoarseness in voice, heavy breathing even in the absence of exertion, an unreasonable cough and pain in the chest. The vena cava syndrome is treated depending on the reasons that provoked it, as well as the degree of the disease.

Pathogenesis

The pathogenesis of the disorder - the return of blood to the heart occurs with certain changes, mainly with reduced pressure or in less quantity. Due to a decrease in the transport function of NVP, stagnation occurs in the lower limbs and pelvis. Venous transport lines become congested, and not enough blood is supplied to the heart.

Due to a lack of blood, the heart is not able to provide the lungs with blood, and, accordingly, the amount of oxygen in the body is significantly reduced. Hypoxia occurs, and the flow into the arterial bed is significantly reduced.

The body is looking for workarounds for the outflow of blood destined for the inferior vena cava. Thanks to this, the symptoms may have a mild appearance. The severity of the lesion due to blood clots or external pressure is reduced.

If thrombosis involves the renal department, then the risk of an acute form of renal failure increases significantly, as a result of plethora in the veins. Filtration of urine and its amount is significantly reduced, periodically reaching anuria (lack of urine flow). Due to the lack of release of waste components, a high concentration of nitrogen processing products occurs, this can be creatinine, urea, or all together.

Pathology in the bloodstream passes with serious complications, the development of the syndrome is especially dangerous, which affects the renal and hepatic tributaries.

In the latter case, the probability of mortality is high, even with modern treatment methods. If the occlusion occurred earlier than the place where these veins fall, the syndrome does not pose a serious threat to life.

Symptoms

The level of clogging of the vein directly affects the degree of symptom onset. Symptoms of the syndrome in pregnant women become most noticeable in the 3rd trimester, when the fetus reaches a large size. The clinical picture is aggravated when the woman lies on her back.

Symptoms of blockage of the inferior vena cava depend on the degree of decrease in the lumen, sometimes it is even enlarged, and only one segment is affected. The rate of blockage and the location of the problem also affect the level of clinical symptoms.

Given the level of blockage, the syndrome is distal when the problem is found below the site where the renal vein flows, otherwise the problem involves the renal and hepatic sites.

The main symptoms are:

Mostly a syndrome in which compression is noted does not cause significant harm to human health. Symptoms depend on the level of compression; in severe forms, the condition can damage the fetus, up to detachment of the placenta. Varicose veins on the legs or the formation of blood clots are periodically noted.

Compression of the inferior vena cava provokes insufficient cardiac output. As a result, some stagnant phenomenon appears in the body, and organs and other tissues lack nutrients and oxygen. The situation can lead to hypoxia.

If renal failure has reached an acute form and thrombosis in the inferior vena cava is added, then patients often complain of pain in the lumbar region of varying intensity.

In patients, the state of health deteriorates sharply, intoxication progresses very quickly. Ultimately, there is a possibility of falling into a uremic coma.

If the function of the inferior vena cava at the junction with the tributaries of the liver is impaired, patients complain of pain in the abdomen or epigastric part, periodically the pain syndrome passes into the right arch of the ribs. This condition is characterized by the appearance of jaundice, the progression of ascites is of a sharp type. The body suffers greatly from the growing intoxication.

Nausea, vomiting, and fever are common. In the acute form of the syndrome, symptoms worsen extremely quickly. Risk of acute liver or kidney failure (often together). This condition leads to a high risk of death.

When the lumen of the inferior vena cava is blocked, it always affects the legs and provokes complications of the bilateral type.

The problem is characterized by the appearance of symptoms:

• Pain in the lower extremities, buttocks, groin, abdomen;
• Additionally, the appearance of edema is noted, which is evenly distributed over the entire leg, lower abdomen, groin and pubis;
• Veins become visible on the skin. The expansion of the reasons is obvious - due to the blockage of the normal current of the inferior vena cava, the vessels partially take over the function of blood movement.

About 70% of all clinical cases of thrombus formation in the inferior vena cava are associated with trophic changes in the soft tissues of the lower extremities. In parallel with severe edema, wounds appear that do not heal, and often there are many foci of appearance. Conservative treatments are powerless against disease.

Most men with pathology of the inferior vena cava are faced with congestion in the pelvic organs, as well as in the scrotum. For the stronger sex, this threatens impotence and infertility.

Pregnant women often face pressure on the inferior vena cava due to the developing uterus. In this case, the symptoms are minimal or absent altogether.

Mostly signs of problems of the inferior vena cava occur in the 3rd trimester:

• Swelling of the legs;
• Severe and growing weakness;
• Dizziness;
• Faintness.

When lying on your back, all the symptoms described above appear to worsen, since the uterus simply blocks the blood flow.

Severe cases of problems of the inferior vena cava are accompanied by loss of consciousness, a similar symptom is episodic. In addition, pronounced hypotension occurs, which affects the development of the fetus.

Diagnostics

Phlebography is used to detect occlusion or external pressure on the inferior vena cava (this applies to the superior and inferior system). Phlebography is one of the most informative ways to detect and diagnose IVC. The study is necessarily supplemented with urine and blood tests.

The number of platelets in the blood is determined, which are responsible for clotting and the formation of blood clots. In the urine, the presence of kidney pathology is determined.

Additional examinations can be ultrasound, MRI, X-ray, CT.

Treatment

The methods of therapy should be selected individually for each patient, since the course strongly depends on the characteristics of the organism and the location of the occlusion. The use of medication is possible only in extreme cases, when treatment is urgent. If the symptoms are mild, doctors recommend resorting to normalizing the rhythm of life and normalizing nutrition.

Basic rules for treatment

Treatment of thrombosis is mainly aimed at preventing the formation of thromboembolism, preventing further growth of the thrombus, eliminating a high degree of edema, and unclogging the lumen in the vessel.

To achieve these goals, several key techniques are used:

• Use of medicines. Predominantly conservative treatment involves the use of drugs for thinning the blood (anticoagulants), as well as means for eliminating the blood clot by resorption. Additionally, non-steroidal anti-inflammatory drugs can be prescribed, they are used in case of pain. During an exacerbation, it is recommended to use an elastic bandage;
• Surgical intervention. If the likelihood of thromboembolism is high, then surgery is performed. There are several types of surgery: plication and endovascular procedure.

Plication

This is a reduction in the vena cava using surgery. In the process, line seams are installed on the walls of the vena cava

During the operation, a lumen is formed using U-shaped brackets. Thus, the lumen is divided into several parts. The diameter of each channel is within 5 mm. This size is enough for the blood flow to be normalized, and the blood clot could not pass further. It is advisable to carry out the intervention if a tumor is found in the abdominal cavity or the space behind the peritoneum.

Endovascular surgery

Through the use of the operation, it is possible to expand the vessels. This is achieved by installing a kava filter, which is an umbrella-shaped wire device. The procedure is simple and does not cause negative effects. The high efficiency of the operation on the vena cava is noted.

Kava filters are individually sized.

They are of the following types:

• Permanent. They will not be removed and are firmly installed in the walls with antennae at the ends;
• Removable. They are installed temporarily, and when the need for them disappears, the filters are removed.

Video: Inferior vena cava and its tributaries

Conclusion

The inferior vena cava is one of the main vessels of the body. The insidiousness of problems with it lies in the fact that the syndrome can be asymptomatic and greatly harm health, up to provoking death.