Anatomy of the superficial venous system of the leg

Summary

The superficial venous system of the leg starts with the epifascial veins, i.e. the various subcutaneous venous networks, the accessory saphenous veins, superficial epigastric vein, the superficial iliac circumflex vein, and the external pudendal veins. These flow into the two intrafascial veins, the great and the small saphenous veins. These, in turn, enter the deep venous system, the great saphenous vein constant in the saphenous hiatus, the small saphenous vein in just over two thirds of cases in the popliteal fossa. In addition, numerous connections exist between the superficial and the deep venous system by the perforating veins. The superficial veins communicate with each other by communicating veins. In the superficial veins numerous parietal valves are found, mostly with two, in smaller and smallest veins also with only one valve leaflet. At the entrance of the great saphenous vein into the femoral vein, there may also be an ostial valve. The wall of the superficial veins has the typical three-layered structure with a tunica intima, a tunica media and a tunica externa. The tunica intima comprises, at least in the great saphenous vein, an internal elastic membrane. In the tunica media, longitudinally arranged bundles of smooth musculature are found inside, followed by dense bundles of circularly arranged smooth musculature. In the tunica externa longitudinal muscle fiber bundles can also be found. Both the great and the small saphenous vein lie in their own fascial sheath, the floor of which is formed by the crural fascia or the fascia lata and their superficial leaf by the respective saphenous fascia. Within these „saphenous compartments” the respective veins are laterally anchored by saphenous ligaments. About 60 large-volume, clinically significant perforating veins connect the superficial with the deep venous system. At least one flap in each perforating vein prevents backflow from the deep venous system.

Keywords

Great saphenous vein - small saphenous vein - accessory saphenous veins - superficial circumflex iliac vein - superficial epigastric vein - external pudendal vein - perforating veins

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