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Anatomia

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Anatomia del sistema venoso degli arti inferiori

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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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Anatomia

  1. 1. Anatomia e caratterizzazione Eco- Color-Doppler delle vene degli arti inferiori Stefano Ermini - Firenze www.veneinforma.com
  2. 2. Utilità dell’Anatomia  Compilazione del referto, trasferimento di informazioni ( usare nomi conosciuti evitando riferimenti non usuali ad autori )  Individuare le strutture che vogliamo studiare  Sapere dove cercare per individuare i circoli di compenso One cannot reasonably examine any part of the body without knowledge of anatomy Hollinshead WH L’ecodoppler venoso non è solo una indagine morfologica, ma soprattutto una indagine funzionale che presuppone la conoscenza della fisiopatologia. Non si può studiare la fisiopatologia senza conoscere l’anatomia.
  3. 3. Tibiali PosterioriPeroniere Poplitea V.Soleo V.GemellariSafena Esterna Safena Interna Femorale Comune Femorale Superficiale Femorale Profonda Ligamento Inguinale Iliaca Esterna
  4. 4. Soleo - Tibiali Post Gemellari - Tibiali Post Soleo - Tibiali Post Gemellari - Tibiali Post Rami Intermuscolari V.Giacomini V.Giacomini Accessoria V.Epigastrica V.Pudenda
  5. 5. Perforanti Safeniche e Dell’Arcata Post Perforante Boyd - Paratibiali Perforanti Soleo Perforanti Gemellari Perforanti Hunter/Dodd Perforante Sottocross
  6. 6. Le posizioni dell’esame Cross SF Prof e Superf. Coscia Poplite e Giacomini Profondo Gamba Paziente Allettato Courtesy Pieri A.
  7. 7. Fascia Superficiale Fascia Superficiale Fascia Profonda Vene ProfondeVene Profonde SafeneSafene CollateraliCollaterali R 1N 1 R 2N 2 R 3, R 4N 3, N 4 I Piani Anatomici Cute N= Network N1= assi venosi profondi, sotto la fascia muscolare N2= assi safenici e v.di Giacomini, nello sdoppiamento della fascia superficiale N3=Collaterali sovrafasciali, immediatamente sottocutanee
  8. 8. Occhio Safenico di Marc Bailly Sartorio Grande adduttore Sottocute Fascia Safenica
  9. 9. Piani di Scansione Longitudinale Trasversale Foto S.Castellani Foto S.Castellani
  10. 10. Vista di faccia Sezione Trasversale Sezione Longitudinale
  11. 11. Posizione della Valvola Giunzionale Sezione Trasversale Sezione Longitudinale Commissure La scansione longitudinale sulla cross SF può mascherare i reflussi commissurali
  12. 12. Safena Origine ramo Safena Origine Collaterale Safena Origine Perforante Sia le perforanti che le collaterali si inseriscono sulla parete laterale della safena, in corrispondenza delle commissure valvolari, dove si raggiungono velocità maggiori che in corrispondenza dei seni valvolari. Anche per questo motivo la scansione trasversale è da preferire, perché consente una immediata definizione del ramo connesso alla safena.
  13. 13. 45° 135°L’angolazione della sonda in scansione trasversale consente di mantenere un angolo di incidenza degli ultrasuoni che ottimizza il rilevamento del flusso.
  14. 14. La Cross Safeno Femorale
  15. 15. Arco safenico FC Epigastrica Safena Interna Immaggine da cadavere - da G.GenoveseImmagine intraoperatoria Immagine intraoperatoria
  16. 16. Femorale Comune Safena InternaEpigastrica Pudenda Immagine intraoperatoria della cross SF
  17. 17. H della Safena Anteriore Safen a Interna Safena Anteriore Epigastric a Femorale C.
  18. 18. Arteria Fem.Su p Arteria Fem.Prof VFC Arco Safenico Nervo Elementi della Cross Safeno Femorale Dall’Est Verso l’Int: • Il Nervo Femorale Comune • Le due Arterie Femorali • La Vena Femorale Comune • L’Arco Safenico I linfonodi generalmente si trovano superficialmente alla a. Femorale Superficiale e/o accompagnano la Safena Anteriore
  19. 19. Posizionamento dell’arteria femorale in relazione alla cross SF Destra Sinistra Arteria Fem.Sup Arteria Fem.Pro f VFC Safen a Interna Safena Anteriore Arco safenic o Fig.1 =è la situazione più tipica. La divisione dell’arteria femorale avviene cranialmente all’ arco safenico Fig.2= la divisione dell’arteria femorale avviene distalmente all’arco safenico Fig. 3= l’arco safenico origina dalla faccia esterna della vena FC e si trova in mezzo fra le due arterie Fig.1 Fig.2 Fig.3
  20. 20. MedialeLaterale Safena Interna Safena Acc. Anteriore Segno dell’Allineamento di Marc Bailly Identifica la posizione della safena interna e anteriore rispetto ad una retta ideale che interseca i vasi femorali (Mediale = Safena Interna , Laterale = Safena Anteriore)
  21. 21. FC SA Linfonodo Linfonodi sulla Cross Safeno Femorale
  22. 22. Sbocco Separato Della Safena Anteriore e della Safena Interna
  23. 23. Ruolo delle collaterali della Cross SF nei circoli vicarianti VFC Iliaca Cross SF VFC Iliaca Cross SF
  24. 24. Safena Interna V V A Vasi Femorali Safena Interna Vasi Femorali Sartorio Adduttore Lungo Sartorio Adduttore Lungo Terzo superiore di coscia La divisione della Vena Femorale Comune in Superficiale e Profonda
  25. 25. Safena int Adduttori Safena int Sartorio Terzo Medio di coscia
  26. 26. Inserzione della vena di Giacomini sulla safena Interna Sartorio Adduttore Lungo Grande Adduttore
  27. 27. Fascia Muscolare 4 cm. Le Perforanti Hunteriane Safena Interna Perforante
  28. 28. Ruolo delle Perforanti di Hunter in Flebologia 1) Rientro del flusso safenico in una situazione fisiologica 2) Punto di fuga ( come la cross safeno femorale) da cui originano vene varicose (Fig.A) 3) Punto di fuga vicariante in una sindrome post- flebitica(Fig.B) Fig.A Fig.B
  29. 29. Mediale Laterale Femore Arteria Poplitea Vena Poplitea Safena Interna Safena Esterna M.Gemello Mediale M.Gemello Laterale M.Bicipite Femorale M.Sartorio M.Plantare M.Semitendinoso N.Tibiale N.Peroneo Comune M.Semimembranoso Il Cavo Popliteo
  30. 30. Gemello Mediale Condilo Femorale Condilo Femorale Safena Esterna Gemello Laterale VPVJ AP Nervo Sciatico Popliteo Esterno
  31. 31. Vena Poplitea Safena Esterna N.Tibiale (SPI) SPE Safena Esterna
  32. 32. Sbocco comune delle gemellari e della safena esterna nella v.poplitea
  33. 33. PopliteaPiccola safena Vena di Giacomini Foto S.Castellani
  34. 34. Varianti Anatomiche della Vena di Giacomini V.Di Giacomini V.Giacomini Accessoria
  35. 35. Ruolo della Vena di Giacomini Nei Circoli Vicarianti
  36. 36. Courtesy Pieri A.
  37. 37. Safena Esterna Tibia
  38. 38. Safena Esterna Gemello Laterale Gemello Mediale Soleo Vasi
  39. 39. Soleo Safena Esterna Soleo Gastrocnemio Laterale Perone Tibia Immagini Arto Destro Gastrocnemio Laterale Gastrocnemio Mediale Gastrocnemio Mediale Direzione della scansione
  40. 40. Soleo Gastrocnemio Laterale Gastrocnemio Mediale Tibia Gastrocnemio Mediale Soleo Direzionedellascansione
  41. 41. Posizione delle vene gemellari all’interno dei ventri muscolari Ciò spiega il dolore alla deambulazione che accompagna la trombosi di una vena gemellare, simile a quello di uno strappo muscolare.
  42. 42. Identificazione dei Vasi Peroneali
  43. 43. Le perforanti di Gamba 1)Perforante di Boyd 2)Paratibiali 3)3° Inferiore 1)Perforanti Gemellari 1) Le vene perforanti di gamba rappresentano un sistema di ridistribuzione dell’ ipertensione venosa superficiale e profonda. 2) La loro dilatazione rappresenta sempre un compenso funzionale secondario ad altre patologie. 3) Il numero delle perforanti eco-rilevabili nel soggetto sano è ridottissimo.
  44. 44. Boyd Paratibiali Arcata Posteriore ( Cocket) Gemellari ( faccia postero-mediale)
  45. 45. Perforanti di gamba, varianti infinite Fascia profonda Fascia profonda AsseSafenico AsseProfondo Fascia profonda AsseSafenico L’angolo di Inserzione AsseProfondo AsseSafenico AsseProfondo
  46. 46. Le Perforanti Multitronculari Tipo 1 Tipo 1A : Rami multipli superficiali su uno stesso asse Tipo 1B : Rami multipli superficiali su assi diversi Asse profondo Perforante
  47. 47. Le Perforanti Multitronculari Tipo 2 Tipo 1A : Rami multipli profondi
  48. 48. Le Perforanti Multitronculari Tipo 3 Rami multipli superficiali e profondi in assi diversi
  49. 49. Perforante Boyd Safena Interna Tibia
  50. 50. Perforante Multitronculare Tipo 1B Ramo Sup. Ramo Sup. Ramo Prof.
  51. 51. Condilo Femorale Mediale Safena Interna Sartorio Gemello Interno Cisti Di Baker Le Cisti Di Baker
  52. 52. Grazie per la vostra attenzione
  53. 53. Sbocco Separato Della Safena Anteriore e della Safena Interna

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