In the circulatory system, veins are blood
vessels that carry blood toward the heart.
Most veins carry deoxygenated blood from the
tissues back to the heart; exceptions are
the pulmonary and umbilical veins.
Veins differ from arteries in structure and function;
for example, arteries are more muscular than
veins, veins are often closer to the skin and
contain valves to help keep blood flowing toward
the heart, while arteries carry blood away from
• The thick outermost layer of a
vein is made of connective
tissue, called tunica
adventitia or tunica externa.
• There is a middle thin layer of
bands of smooth
muscle called tunica media.
• The interior is lined
cells called tunica intima.
• Superficial veins are those whose course is close to
the surface of the body, and have no corresponding
• Deep veins are deeper in the body and have
• Communicating veins (or perforator veins) are veins
that directly connect superficial veins to deep veins.
• Pulmonary veins are a set of veins that deliver
oxygenated blood from the lungs to the heart.
• Systemic veins drain the tissues of the body and
deliver deoxygenated blood to the heart.
• The femoral vein is a blood
vessel that accompanies
the femoral artery in
the femoral sheath.
• It begins at the adductor
canal (also known as Hunter's
canal) and is a continuation of
the popliteal vein.
• It ends at the inferior margin
of the inguinal ligament,
where it becomes the external
Several large veins drain into the
• Popliteal vein
• Profunda femoris vein
• Great saphenous vein
Profunda femoris vein
• Profunda femoris
vein (or deep femoral vein)
is a large deep vein in
• It receives blood from the
inner thigh and proceeds
superiorly and medially
running alongside the
profunda femoris artery to
join with the femoral vein
approximately at the level of
the inferior-most portion of
the ischial tuberosity.
• The popliteal vein is located behind
the knee. Its course runs alongside
the popliteal artery, but carries the
blood from the knee joint and
muscles in the thigh and calf back to
• Its origin is defined by the junction of
the posterior tibial vein and anterior
• It drains the peroneal vein before
reaching the knee joint and turns into
the femoral vein when leaving
the adductor canal.
• The popliteal artery extends from
the femoral artery behind
the popliteal fossa which is the space
behind the knee.
• The fibular veins (also known as
the peroneal veins).
• The fibular veins are deep
veins that help carry blood from
the lateral compartment of the
• They drain into the posterior tibial
veins, which will in turn drain into
the popliteal vein.
• The fibular veins accompany
the fibular artery.
Anterior tibial vein
• The anterior tibial vein of
the lower limb carries
blood from the anterior
compartment of the
leg to the popliteal
vein which is formed
when it joins with
the posterior tibial vein.
• The anterior tibial vein is
accompanied by an
anterior tibial artery.
Posterior Tibial vein
• The posterior tibial
vein of the lower
limb carries blood from
compartment and plantar
surface of the foot to
the popliteal vein which it
forms when it joins with
the anterior tibial vein.
• The posterior tibial vein is
accompanied by posterior
Clinical Case:Deep Vein Thrombosis
• DVT is the formation of a blood
clot in a deep vein,
predominantly in the legs.
• DVT usually occurs in a deep leg
vein, a larger vein that runs
through the muscles of the thigh.
It can cause pain and swelling in
the leg and may lead to
complications such as pulmonary
• DVT and pulmonary embolism
together are known as venous
Signs and Symptoms
Common signs and symptoms of DVT include
pain, swelling, warmth, redness or discoloration,
and distention of surface veins, although about
half of those with the condition have no
Symptoms are more often due to other causes,
such as cellulitis, Baker's cyst, musculoskeletal
injury, or lymphedema.
Other differential diagnoses include hematoma
and connective tissue disorders.
The leg is usually painful, cyanosed (blue from
lack of oxygen) and edematous (filled with fluid),
which may result in venous gangrene.
• Anyone can develop it but it becomes more
common with age. As well as age, risk
1. Previous venous thromboembolism.
2. A family history of thrombosis
3. Medical conditions such as cancer and
4. Inactivity (for example, after an operation)
5. Being overweight or obese.
• In upper-extremity DVT, the most important
risk factor is having a central venous
catheter, and thoracic outlet syndrome also
DVT diagnosis requires the use of imaging devices
such as Ultrasonography and Venography.
Prevention and Treatment
• There are several things you can do to prevent
DVT occurring, such as stopping smoking, losing
weight if you are overweight and walking
regularly to improve the circulation in your legs
• Walking and calf exercises reduce venous stasis
because leg muscle contractions compress the
veins and pump blood up towards the heart.
• Anticoagulation, which prevents further
coagulation but does not act on existing clots, is
the standard treatment for DVT.
• Two different types of anticoagulants are
used to treat DVT:
• (a)Heparin and (b)Warfarin.
• Compression stockings help prevent calf
pain and swelling and lower the risk of ulcers
developing after having a DVT.
• As well as wearing compression stockings,
you might be advised to raise your leg
whenever you are resting. This helps to
relieve the pressure in the veins of the calf
and stops blood and fluid pooling in the calf
• Aside from anticoagulation, the anti-platelet
drug aspirin might be used in some
orthopedic surgery patients.