The veins of the lower limb provide a vital role in the circulatory system, draining deoxygenated blood from the lower limb and returning it to the heart. These can be divided into two distinct groups - deep veins and superficial veins. Deep veins are located underneath the deep fascia of the lower limb, accompanying the major arteries. Superficial veins are found in the subcutaneous tissue and eventually drain into the deep veins. In this article, we shall explore the anatomy and clinical correlations of the major veins of the lower limb to gain a better understanding of their functions.
The main venous structure of the foot is the dorsal venous arch, which mostly drains into the superficial veins. Some veins from the arch penetrate deep into the leg, forming the anterior tibial vein. On the plantar aspect of the foot, medial and lateral plantar veins arise. These veins combine to form the posterior tibial and fibular veins. The posterior tibial vein accompanies the posterior tibial artery, entering the leg posteriorly to the medial malleolus.
On the posterior surface of the knee, the anterior tibial, posterior tibial and fibular veins unite to form the popliteal vein. The popliteal vein enters the thigh via the adductor canal.
Once the popliteal vein has entered the thigh, it is known as the femoral vein. It is situated anteriorly, accompanying the femoral artery. The deep vein of the thigh (profunda femoris vein) is the other main venous structure in the thigh. Via perforating veins, it drains blood from the thigh muscles into the distal section of the femoral vein. The femoral vein leaves the thigh by running underneath the inguinal ligament, at which point it is known as the external iliac vein.
The gluteal region is drained by inferior and superior gluteal veins. These empty into the internal iliac vein.
Deep vein thrombosis (DVT) is the formation of a blood clot within the deep veins of the lower limbs, causing blockage of the vessel. Locally, this can cause pain, swelling and tenderness of the affected limb. The main complication of a DVT is pulmonary embolism, where the thrombus can become dislodged and travel into pulmonary circulation. If occlusion of the pulmonary circulation occurs, it can prevent blood from returning to the heart, resulting in mechanical shock.
Patients considered high risk of developing a DVT undergo prophylactic treatment to prevent thrombosis.
The superficial veins of the lower limb run in the subcutaneous tissue. There are two major superficial veins - the great saphenous vein, and the small saphenous vein.
The great saphenous vein is formed by the dorsal venous arch of the foot, and the dorsal vein of the great toe. It ascends up the medial side of the leg, passing anteriorly to the medial malleolus at the ankle, and posteriorly to the medial condyle at the knee. As the vein moves up the leg, it receives tributaries from other small superficial veins. The great saphenous vein terminates by draining into the femoral vein immediately inferior to the inguinal ligament.
Surgically, the great saphenous vein can be harvested and used as a vessel in coronary artery bypasses.
The small saphenous vein is formed by the dorsal venous arch of the foot, and the dorsal vein of the little toe. It moves up the posterior side of the leg, passing posteriorly to the lateral malleolus, along the lateral border of the calcaneal tendon. It moves between the two heads of the gastrocnemius muscle and empties into the popliteal vein in the popliteal fossa.
The superficial veins of the lower limb provide an important function in the circulatory system, draining deoxygenated blood from the lower limb and returning it to the heart. Their anatomy and clinical relevance must be taken into account to gain a better understanding of their role within the body.
Deep veins are located underneath the deep fascia of the lower limb, accompanying the major arteries. Generally, these veins share the same name of their associated artery, and often, the artery and vein are located within the same vascular sheath, with arterial pulsations aiding the venous return. Superficial veins are found in the subcutaneous tissue and eventually drain into the deep veins.
The foot and leg are drained by the main venous structure of the foot - the dorsal venous arch - which mostly drains into the superficial veins. Some veins from the arch penetrate deep into the leg, forming the anterior tibial vein. On the plantar aspect of the foot, medial and lateral plantar veins arise, combining to form the posterior tibial and fibular veins. The posterior tibial vein accompanies the posterior tibial artery, entering the leg posteriorly to the medial malleolus. On the posterior surface of the knee, the anterior tibial, posterior tibial and fibular veins unite to form the popliteal vein. The popliteal vein enters the thigh via the adductor canal.
Once the popliteal vein has entered the thigh, it is known as the femoral vein. It is situated anteriorly, accompanying the femoral artery. The deep vein of the thigh (profunda femoris vein) is the other main venous structure in the thigh, draining blood from the thigh muscles via perforating veins. It then empties into the distal section of the femoral vein, which leaves the thigh by running underneath the inguinal ligament, at which point it is known as the external iliac vein.
The gluteal region is drained by inferior and superior gluteal veins, which empty into the internal iliac vein.
Deep vein thrombosis (DVT) is the formation of a blood clot within the deep veins of the lower limbs, causing blockage of the vessel. Locally, this can cause pain, swelling and tenderness of the affected limb. The main complication of a DVT is pulmonary embolism, where the thrombus can become dislodged and travel into pulmonary circulation. If occlusion of the pulmonary circulation occurs, it can prevent blood from returning to the heart, resulting in mechanical shock.
Patients that are considered high risk of developing a DVT undergo prophylactic treatment to prevent thrombosis.
The superficial veins of the lower limb run in the subcutaneous tissue. There are two major superficial veins - the great saphenous vein, and the small saphenous vein.
The great saphenous vein is formed by the dorsal venous arch of the foot, and the dorsal vein of the great toe. It ascends up the medial side of the leg, passing anteriorly to the medial malleolus at the ankle, and posteriorly to the medial condyle at the knee. As the vein moves up the leg, it receives tributaries from other small superficial veins. The great saphenous vein terminates by draining into the femoral vein immediately inferior to the inguinal ligament.
Surgically, the great saphenous vein can be harvested and used as a vessel in coronary artery bypass grafts due to its greater length and diameter. This procedure is technically challenging and requires precision to ensure correct connection to the recipient arteries and veins.
The small saphenous vein is formed by the dorsal venous arch of the foot, and the dorsal vein of the little toe. It moves up the posterior side of the leg, passing posteriorly to the lateral malleolus, along the lateral border of the calcaneal tendon. It moves between the two heads of the gastrocnemius muscle and empties into the popliteal vein in the popliteal fossa.
The veins of the lower limb provide an important function in the circ
The lower limbs are the part of the body between the hip and the foot and can be divided into the foot and leg, thigh and gluteal regions. The main venous structure of the foot is the dorsal venous arch, which mostly drains into the superficial veins. Some veins from the arch penetrate deep into the leg, forming the anterior tibial vein. On the plantar aspect of the foot, medial and lateral plantar veins arise before joining and forming the posterior tibial and fibular veins. The posterior tibial vein accompanies the posterior tibial artery, entering the leg posteriorly to the medial malleolus. On the posterior surface of the knee, the anterior tibial, posterior tibial and fibular veins unite to form the popliteal vein which then travels through the adductor canal to enter the thigh.
Once the popliteal vein has left the knee, it is known as the femoral vein and runs anteriorly in the thigh accompanying the femoral artery. The deep vein of the thigh, or profunda femoris vein, is the other main venous structure in the thigh which empties into the distal section of the femoral vein via perforating veins. The femoral vein leaves the thigh by running underneath the inguinal ligament, transforming into the external iliac vein.
The gluteal region is drained by inferior and superior gluteal veins, which in turn empty into the internal iliac vein. The superficial veins of the lower limb run in the subcutaneous tissue and comprise of two major veins: the great saphenous vein and the small saphenous vein.
The great saphenous vein is formed by the dorsal venous arch of the foot, and the dorsal vein of the great toe. It ascends up the medial side of the leg, passing anteriorly to the medial malleolus at the ankle and posteriorly to the medial condyle at the knee, before terminating by draining into the femoral vein immediately inferior to the inguinal ligament. The small saphenous vein is formed by the dorsal venous arch of the foot, and the dorsal vein of the little toe. It moves up the posterior side of the leg, passing posteriorly to the lateral malleolus, along the lateral border of the calcaneal tendon and empties into the popliteal vein in the popliteal fossa.
Deep vein thrombosis (DVT) is the formation of the blood clot within the deep veins of the lower limbs, causing blockage of the vessel. Locally, this causes pain, swelling and tenderness of the affected limb. The main complication of a DVT is pulmonary embolism, where the thrombus can become dislodged and travel into pulmonary circulation, preventing blood from returning to the heart and resulting in mechanical shock. High risk patients undergo prophylactic treatment to prevent thrombosis.
In the lower limbs, venous blood flows from the skin to superficial veins, which drain into the deep veins. If the valves in the veins become incompetent, blood can flow back into the superficial veins, causing them to become dilated and tortuous. This condition is known as varicose veins and can cause various soft tissue changes due to the increased pressure in the venous system. This can cause blood to extrude into skin, as well as brown pigmentation and ulceration of the surrounding tissue.
Varicose veins can be treated by vein ligation and stripping, foam sclerotherapy or thermal ablation. Vein ligation and stripping involves making an incision in the groin or popliteal fossa, identifying the responsible vein and stripping it away. Foam sclerotherapy involves injecting a sclerosing agent into the varicosed veins and thermal ablation involves heating the vein from inside, causing irreversible damage that closes it off.
