Physiologie des Venensystems der Extremitäten – Teil 1: Grundbausteine

Das Venensystem der Extremitäten ist ständigen hydrostatischen Druckveränderungen ausgesetzt. Es muss neben der Volumenspeicherung auch Funktionen im Stoffaustausch übernehmen. Die Kenntnis über diese physiologischen Mechanismen hilft im klinischen Alltag bei der Diagnostik von Venenerkrankungen und bei der Auswahl der Therapieform. Die Venenfunktion kann durch 4 Grundbausteine definiert werden: Venenanatomie, Herz-Kreislauf-System/Zwerchfellpumpe, Wadenmuskelpumpe und Fußpumpe.

Abstract

The venous system is constantly subject to changes in hydrostatic pressure in the extremities as the body changes position. In addition to storing blood volumes, the venous system also plays an important role in the exchange of substances. In the first part of the training series, the function of the veins is defined by four basic elements: vein anatomy, cardiovascular system/diaphragmatic descent, the foot pump, and the calf muscle pump. Venous valves are duplications of the intima, and valve cycles consist of an opening, equilibrium, and closing phase. The vascular width of a vein is regulated by neural-humoral controls so that a sympathetically induced adrenergic stimulation mediates venous constriction. The calf muscle pump is divided into proximal and distal parts whose haemodynamic effects differ. In the foot there is a medial and a lateral plantar vein, with the lateral plantar vein playing a crucial role (foot pump) in mobilizing blood volume due to its size and venous capacity. The function of the diaphragmatic descent on the venous return in the supine position without movement of the lower extremity depends on the degree of filling of the inferior vena cava. In combination with the calf muscle pump and foot pump, this results in a complex functional unit. In everyday clinical practice, knowledge of the physiological mechanisms of venous return helps in the diagnosis of venous diseases, and in the selection of the correct therapeutic approach.

Schlüsselwörter

Venenphysiologie - Venenklappen - Zwerchfellpumpe - Fußpumpe - Wadenmuskelpumpe - Kreislaufregulation

Keywords

vein physiology - venous valves - diaphragmatic descent - foot pump - calf muscle pump - circulatory regulation

Publikationsverlauf

Artikel online veröffentlicht:
02. Juni 2023

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