Veins of the lower extremities

The venous system of the lower extremities of the person is presented by three systems: system of perforantny veins, superficial and deep systems.

Perforantny veins

The main function of perforantny veins is connection of superficial and deep veins of the lower extremities. They received the name because they perforate (penetrate) anatomic partitions (a fascia and a muscle).

Most of them are equipped with the valves located nadfastsialno via which blood gets from superficial veins to deep. About a half of kommunikantny veins of foot of valves has no therefore blood from foot flows as from deep veins in superficial, and on the contrary. Everything depends on physiological conditions of outflow and a functional load.

Superficial veins of the lower extremities

The superficial venous system originates in the lower extremities from veniplexes of fingers of foot which create venous network of a back part of foot and a skin back arch of foot. From it the lateral and medial regional veins passing respectively into small and big saphenas begin. The bottom venous network connects to a back venous arch of foot, to an instep and deep veins of fingers.

The big saphena is the longest vein in an organism which contains 5-10 pairs of valves. Its diameter is equal in a normality to 3-5 mm. The big vein ahead of a medial anklebone of foot begins and rises to an inguinal fold where connects to a femoral vein. Sometimes the big vein on a shin and a hip can be presented by several trunks.

The small saphena originates in a back part of a lateral anklebone and rises to a subnodal vein. Sometimes the small vein rises above a popliteal space and connects to a femoral, deep vein of a hip or a big saphena. Therefore before carrying out surgical intervention the doctor has to know the exact place of a confluence of a small vein in deep to make an aim section directly over an anastomosis.

The femoral and knee vein is continuous priustyevy inflow of a small vein, and it falls into a big saphena. Also a large number of hypodermic and skin veins falls into a small vein, it is preferential in the lower third of a shin.

Deep veins of the lower extremities

On deep veins flows more than 90% of blood. Deep veins of the lower extremities in a back part of foot begin with plusnevy veins from where blood flows in tibial front veins. Back and front tibial veins merge at the level of a third of a shin, forming a subnodal vein which rises above and gets to the femoral and subnodal canal which is called already femoral vein. Above an inguinal fold the femoral vein connects to an outside ileal vein and is directed to heart.

Diseases of veins of the lower extremities

Treat the most widespread diseases of veins of the lower extremities:

• Varicosity;
• Thrombophlebitis of superficial veins;
• Vein thrombosis of the lower extremities.

Varicosity is called the morbid condition of superficial vessels of system of small or big saphenas caused by valve insufficiency or an ectasia of veins. As a rule, the disease develops after twenty years, is preferential at women. It is considered that to a varicosity there is a genetic predisposition.

The varicosity can be acquired (the ascending stage) or hereditary (the descending stage). Besides, distinguish primary and secondary varicosity. In the first case function of deep venous vessels is not broken, in the second case the disease is characterized by occlusion of deep veins or insufficiency of valves.

On clinical signs allocate three stages of a varicosity:

• Compensation stage. Expanded veins gyrose varicose without any other additional symptoms are standing visible. At this stage of a disease patients, as a rule, do not see a doctor.
• Subcompensation stage. Except a varicosity patients complain of passing hypostases in anklebones and feet, pastosity, feeling of a raspiraniye in shin muscles, bystry fatigue, spasms in gastrocnemius muscles (generally at night).
• Decompensation stage. In addition to above-mentioned symptoms at patients ekzemopodobny dermatitis and a skin itch are observed. At the started form of a varicosity there can be trophic ulcers and the strong xanthopathy resulting from small dot hemorrhages and deposits of hemosiderin.

Thrombophlebitis of superficial veins is a complication of a varicose vein disease of the lower extremities. The etiology of this disease is not studied sufficiently. Phlebitis can independently develop and lead to venous thrombosis, or the disease results from an infection and joins primary thrombosis of superficial veins.

The ascending thrombophlebitis of a big saphena is especially dangerous, so there is a threat of hit of the floating part of blood clot in an outside ileal vein or a deep vein of a hip that can cause a thromboembolism in vessels of a pulmonary artery.

The deep vein thrombosis is quite dangerous disease and poses threat for the patient's life. Thrombosis of the main veins of a hip and a basin often originates in deep veins of the lower extremities.

Allocate the following reasons of development of a vein thrombosis of the lower extremities:

• Bacterial infection;
• Excessive exercise stress or injury;
• Long bed rest (for example, at neurologic, therapeutic or surgical diseases);
• Reception of contraceptive tablets;
• Puerperal period;
• IDCS;
• Oncological diseases, in particular carcinoma of the stomach, lungs and pancreas.

The deep vein thrombosis is followed by hypostasis of a shin or all leg, patients feel constant weight in legs. Skin at a disease becomes glossy, through it the drawing of saphenas accurately appears. Also distribution of pain on the internal surface of a hip, shin, foot, and also shin pain is characteristic at a foot dorsiflexion. And, clinical symptoms of a deep vein thrombosis of the lower extremities are observed only in 50% of cases, in other 50% can not cause any visible symptoms.