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Why Are Spider Veins of the Legs a Serious and a Dangerous Medical
1 Anti-aging Therapeutics Volume 9–2007 Prevention or Reversal of Deep Venous Insufficiency and Treatment: Why Are Spider Veins of the Legs a Serious and A Dangerous Medical Condition? Imtiaz Ahmad M.D., F.A.C.S a, b, Waheed Ahmad M.D., F.A.C.S c, d a Cardiothoracic and Vascular Associates (Comprehensive Vein Treatment Center), Hamilton, NJ, USA b Robert Wood Johnson University Hospital, Hamilton, NJ, USA. c Comprehensive Vein Treatment Center of Kentuckiana, New Albany, IN 47150, USA. d Clinical professor of surgery, University of Louisville, Louisville, KY, USA. ABSTRACT Spider veins (also known as spider hemangiomas) unlike varicose veins (dilated pre-existing veins) are acquired lesions caused by venous hypertension leading to proliferation of blood vessels in the skin and subcutaneous tissues due to the release of endothelial growth factors causing vascular neogenesis. More than 60% of the patients with spider veins of the legs have significant symptoms including pain, itching, burning, swelling, phlebitis, cellulites, bleeding, and ulceration. Untreated spider veins may lead to serious medical complications including superficial and deep venous thrombosis, aggravation of the already established venous insufficiency, hemorrhage, postphlebitic syndrome, chronic leg ulceration, and pulmonary embolism. Untreated spider vein clusters are also responsible for persistent low-grade inflammation; many recent peer- reviewed medical studies have shown a definite association of chronic inflammation with obesity, cardiovascular disease, arthritis, Alzheimer’s disease, and cancer. Clusters of spider veins have one or more incompetent perforator veins connected to the deeper veins causing reflux overflow of blood that is responsible for their dilatation and eventual incompetence. -
Cardiovascular System 9
Chapter Cardiovascular System 9 Learning Outcomes On completion of this chapter, you will be able to: 1. State the description and primary functions of the organs/structures of the car- diovascular system. 2. Explain the circulation of blood through the chambers of the heart. 3. Identify and locate the commonly used sites for taking a pulse. 4. Explain blood pressure. 5. Recognize terminology included in the ICD-10-CM. 6. Analyze, build, spell, and pronounce medical words. 7. Comprehend the drugs highlighted in this chapter. 8. Describe diagnostic and laboratory tests related to the cardiovascular system. 9. Identify and define selected abbreviations. 10. Apply your acquired knowledge of medical terms by successfully completing the Practical Application exercise. 255 Anatomy and Physiology The cardiovascular (CV) system, also called the circulatory system, circulates blood to all parts of the body by the action of the heart. This process provides the body’s cells with oxygen and nutritive ele- ments and removes waste materials and carbon dioxide. The heart, a muscular pump, is the central organ of the system. It beats approximately 100,000 times each day, pumping roughly 8,000 liters of blood, enough to fill about 8,500 quart-sized milk cartons. Arteries, veins, and capillaries comprise the network of vessels that transport blood (fluid consisting of blood cells and plasma) throughout the body. Blood flows through the heart, to the lungs, back to the heart, and on to the various body parts. Table 9.1 provides an at-a-glance look at the cardiovascular system. Figure 9.1 shows a schematic overview of the cardiovascular system. -
The Anatomy of Th-E Blood Vascular System of the Fox ,Squirrel
THE ANATOMY OF TH-E BLOOD VASCULAR SYSTEM OF THE FOX ,SQUIRREL. §CIURUS NlGER. .RUFIVENTEB (OEOEEROY) Thai: for the 009m of M. S. MICHIGAN STATE COLLEGE Thomas William Jenkins 1950 THulS' ifliillifllfllilllljllljIi\Ill\ljilllHliLlilHlLHl This is to certifg that the thesis entitled The Anatomy of the Blood Vascular System of the Fox Squirrel. Sciurus niger rufiventer (Geoffroy) presented by Thomas William Jenkins has been accepted towards fulfillment of the requirements for A degree in MEL Major professor Date May 23’ 19500 0-169 q/m Np” THE ANATOMY OF THE BLOOD VASCULAR SYSTEM OF THE FOX SQUIRREL, SCIURUS NIGER RUFIVENTER (GEOFFROY) By THOMAS WILLIAM JENKINS w L-Ooffi A THESIS Submitted to the School of Graduate Studies of Michigan State College of Agriculture and Applied Science in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE Department of Zoology 1950 \ THESlSfi ACKNOWLEDGMENTS Grateful acknowledgment is made to the following persons of the Zoology Department: Dr. R. A. Fennell, under whose guidence this study was completed; Mr. P. A. Caraway, for his invaluable assistance in photography; Dr. D. W. Hayne and Mr. Poff, for their assistance in trapping; Dr. K. A. Stiles and Dr. R. H. Manville, for their helpful suggestions on various occasions; Mrs. Bernadette Henderson (Miss Mac), for her pleasant words of encouragement and advice; Dr. H. R. Hunt, head of the Zoology Department, for approval of the research problem; and Mr. N. J. Mizeres, for critically reading the manuscript. Special thanks is given to my wife for her assistance with the drawings and constant encouragement throughout the many months of work. -
Microlymphatic Surgery for the Treatment of Iatrogenic Lymphedema
Microlymphatic Surgery for the Treatment of Iatrogenic Lymphedema Corinne Becker, MDa, Julie V. Vasile, MDb,*, Joshua L. Levine, MDb, Bernardo N. Batista, MDa, Rebecca M. Studinger, MDb, Constance M. Chen, MDb, Marc Riquet, MDc KEYWORDS Lymphedema Treatment Autologous lymph node transplantation (ALNT) Microsurgical vascularized lymph node transfer Iatrogenic Secondary Brachial plexus neuropathy Infection KEY POINTS Autologous lymph node transplant or microsurgical vascularized lymph node transfer (ALNT) is a surgical treatment option for lymphedema, which brings vascularized, VEGF-C producing tissue into the previously operated field to promote lymphangiogenesis and bridge the distal obstructed lymphatic system with the proximal lymphatic system. Additionally, lymph nodes with important immunologic function are brought into the fibrotic and damaged tissue. ALNT can cure lymphedema, reduce the risk of infection and cellulitis, and improve brachial plexus neuropathies. ALNT can also be combined with breast reconstruction flaps to be an elegant treatment for a breast cancer patient. OVERVIEW: NATURE OF THE PROBLEM Clinically, patients develop firm subcutaneous tissue, progressing to overgrowth and fibrosis. Lymphedema is a result of disruption to the Lymphedema is a common chronic and progres- lymphatic transport system, leading to accumula- sive condition that can occur after cancer treat- tion of protein-rich lymph fluid in the interstitial ment. The reported incidence of lymphedema space. The accumulation of edematous fluid mani- varies because of varying methods of assess- fests as soft and pitting edema seen in early ment,1–3 the long follow-up required for diagnosing lymphedema. Progression to nonpitting and irre- lymphedema, and the lack of patient education versible enlargement of the extremity is thought regarding lymphedema.4 In one 20-year follow-up to be the result of 2 mechanisms: of patients with breast cancer treated with mastec- 1. -
Vessels and Circulation
CARDIOVASCULAR SYSTEM OUTLINE 23.1 Anatomy of Blood Vessels 684 23.1a Blood Vessel Tunics 684 23.1b Arteries 685 23.1c Capillaries 688 23 23.1d Veins 689 23.2 Blood Pressure 691 23.3 Systemic Circulation 692 Vessels and 23.3a General Arterial Flow Out of the Heart 693 23.3b General Venous Return to the Heart 693 23.3c Blood Flow Through the Head and Neck 693 23.3d Blood Flow Through the Thoracic and Abdominal Walls 697 23.3e Blood Flow Through the Thoracic Organs 700 Circulation 23.3f Blood Flow Through the Gastrointestinal Tract 701 23.3g Blood Flow Through the Posterior Abdominal Organs, Pelvis, and Perineum 705 23.3h Blood Flow Through the Upper Limb 705 23.3i Blood Flow Through the Lower Limb 709 23.4 Pulmonary Circulation 712 23.5 Review of Heart, Systemic, and Pulmonary Circulation 714 23.6 Aging and the Cardiovascular System 715 23.7 Blood Vessel Development 716 23.7a Artery Development 716 23.7b Vein Development 717 23.7c Comparison of Fetal and Postnatal Circulation 718 MODULE 9: CARDIOVASCULAR SYSTEM mck78097_ch23_683-723.indd 683 2/14/11 4:31 PM 684 Chapter Twenty-Three Vessels and Circulation lood vessels are analogous to highways—they are an efficient larger as they merge and come closer to the heart. The site where B mode of transport for oxygen, carbon dioxide, nutrients, hor- two or more arteries (or two or more veins) converge to supply the mones, and waste products to and from body tissues. The heart is same body region is called an anastomosis (ă-nas ′tō -mō′ sis; pl., the mechanical pump that propels the blood through the vessels. -
Lower Limb Venous Drainage
Vascular Anatomy of Lower Limb Dr. Gitanjali Khorwal Arteries of Lower Limb Medial and Lateral malleolar arteries Lower Limb Venous Drainage Superficial veins : Great Saphenous Vein and Short Saphenous Vein Deep veins: Tibial, Peroneal, Popliteal, Femoral veins Perforators: Blood flow deep veins in the sole superficial veins in the dorsum But In leg and thigh from superficial to deep veins. Factors helping venous return • Negative intra-thoracic pressure. • Transmitted pulsations from adjacent arteries. • Valves maintain uni-directional flow. • Valves in perforating veins prevent reflux into low pressure superficial veins. • Calf Pump—Peripheral Heart. • Vis-a –tergo produced by contraction of heart. • Suction action of diaphragm during inspiration. Dorsal venous arch of Foot • It lies in the subcutaneous tissue over the heads of metatarsals with convexity directed distally. • It is formed by union of 4 dorsal metatarsal veins. Each dorsal metatarsal vein recieves blood in the clefts from • dorsal digital veins. • and proximal and distal perforating veins conveying blood from plantar surface of sole. Great saphenous Vein Begins from the medial side of dorsal venous arch. Supplemented by medial marginal vein Ascends 2.5 cm anterior to medial malleolus. Passes posterior to medial border of patella. Ascends along medial thigh. Penetrates deep fascia of femoral triangle: Pierces the Cribriform fascia. Saphenous opening. Drains into femoral vein. superficial epigastric v. superficial circumflex iliac v. superficial ext. pudendal v. posteromedial vein anterolateral vein GREAT SAPHENOUS VEIN anterior leg vein posterior arch vein dorsal venous arch medial marginal vein Thoraco-epigastric vein Deep external pudendal v. Tributaries of Great Saphenous vein Tributaries of Great Saphenous vein saphenous opening superficial epigastric superficial circumflex iliac superficial external pudendal posteromedial vein anterolateral vein adductor c. -
Comprehensive Review of the Superficial Veins of the Forearm from a Historical, Anatomical and Clinical Point of View
IJAE Vol. 124, n. 2: 142-152, 2019 ITALIAN JOURNAL OF ANATOMY AND EMBRYOLOGY Circulatory system Comprehensive review of the superficial veins of the forearm from a historical, anatomical and clinical point of view Lucas Alves Sarmento Pires1,2,*, Albino Fonseca Junior1,2, Jorge Henrique Martins Manaia1,2, Tulio Fabiano Oliveira Leite3, Marcio Antonio Babinski1,2, Carlos Alberto Araujo Chagas2 1 Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil 2 Morphology Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil 3 Interventional Radiology Unit, Radiology Institute, University of São Paulo Medical School, São Paulo, Brazil Abstract The superficial veins of the forearm are prone to possess different patterns of anastomosis. This is highly significant, as venipunctures in the upper limb are among the most performed procedures in the world and they often rely on the veins of the cubital fossa. In addition, the relationship of these veins to the cutaneous nerves are also prone to vary and are often uncer- tain. These veins are also manipulated in the creation of arteriovenous fistula for dialisis, which remains as the best choice of treatment for renal failure patients. Such fistulas are often per- formed on the wrist or the cubital fossa, with the cephalic vein or basilic vein. It is known that anatomical variations of the vessels and nerves on the cubital fossa may induce the profession- als to error, and one of the most common complications of venipuncture are accidental nerve puncture, which can lead to paresthesia and pain. We aim to perform a comprehensive review of the venous arrangements of the cubital fossa and their clinical aspects, as well as of veni- puncture from a historical perspective and of the complications of venipuncture and arterio- venous fistula from an anatomical point of view, with the purpose of compiling available data and help healthcare professionals to reduce puncture errors or arteriovenous fistula complica- tions and improve patient care. -
The Cardiovascular System
11 The Cardiovascular System WHAT The cardiovascular system delivers oxygen and HOW nutrients to the body tissues The heart pumps and carries away wastes blood throughout the body such as carbon dioxide in blood vessels. Blood flow via blood. requires both the pumping action of the heart and changes in blood pressure. WHY If the cardiovascular system cannot perform its functions, wastes build up in tissues. INSTRUCTORS Body organs fail to function properly, New Building Vocabulary and then, once oxygen becomes Coaching Activities for this depleted, they will die. chapter are assignable in hen most people hear the term cardio- only with the interstitial fluid in their immediate Wvascular system, they immediately think vicinity. Thus, some means of changing and of the heart. We have all felt our own “refreshing” these fluids is necessary to renew the heart “pound” from time to time when we are ner- nutrients and prevent pollution caused by vous. The crucial importance of the heart has been the buildup of wastes. Like a bustling factory, the recognized for ages. However, the cardiovascular body must have a transportation system to carry system is much more than just the heart, and its various “cargoes” back and forth. Instead of from a scientific and medical standpoint, it is roads, railway tracks, and subways, the body’s important to understand why this system is so vital delivery routes are its hollow blood vessels. to life. Most simply stated, the major function of the Night and day, minute after minute, our tril- cardiovascular system is transportation. Using lions of cells take up nutrients and excrete wastes. -
Blood Vessels and Circulation
19 Blood Vessels and Circulation Lecture Presentation by Lori Garrett © 2018 Pearson Education, Inc. Section 1: Functional Anatomy of Blood Vessels Learning Outcomes 19.1 Distinguish between the pulmonary and systemic circuits, and identify afferent and efferent blood vessels. 19.2 Distinguish among the types of blood vessels on the basis of their structure and function. 19.3 Describe the structures of capillaries and their functions in the exchange of dissolved materials between blood and interstitial fluid. 19.4 Describe the venous system, and indicate the distribution of blood within the cardiovascular system. © 2018 Pearson Education, Inc. Module 19.1: The heart pumps blood, in sequence, through the arteries, capillaries, and veins of the pulmonary and systemic circuits Blood vessels . Blood vessels conduct blood between the heart and peripheral tissues . Arteries (carry blood away from the heart) • Also called efferent vessels . Veins (carry blood to the heart) • Also called afferent vessels . Capillaries (exchange substances between blood and tissues) • Interconnect smallest arteries and smallest veins © 2018 Pearson Education, Inc. Module 19.1: Blood vessels and circuits Two circuits 1. Pulmonary circuit • To and from gas exchange surfaces in the lungs 2. Systemic circuit • To and from rest of body © 2018 Pearson Education, Inc. Module 19.1: Blood vessels and circuits Circulation pathway through circuits 1. Right atrium (entry chamber) • Collects blood from systemic circuit • To right ventricle to pulmonary circuit 2. Pulmonary circuit • Pulmonary arteries to pulmonary capillaries to pulmonary veins © 2018 Pearson Education, Inc. Module 19.1: Blood vessels and circuits Circulation pathway through circuits (continued) 3. Left atrium • Receives blood from pulmonary circuit • To left ventricle to systemic circuit 4. -
A Case of the Bilateral Superior Venae Cavae with Some Other Anomalous Veins
Okaiimas Fol. anat. jap., 48: 413-426, 1972 A Case of the Bilateral Superior Venae Cavae With Some Other Anomalous Veins By Yasumichi Fujimoto, Hitoshi Okuda and Mihoko Yamamoto Department of Anatomy, Osaka Dental University, Osaka (Director : Prof. Y. Ohta) With 8 Figures in 2 Plates and 2 Tables -Received for Publication, July 24, 1971- A case of the so-called bilateral superior venae cavae after the persistence of the left superior vena cava has appeared relatively frequent. The present authors would like to make a report on such a persistence of the left superior vena cava, which was found in a routine dissection cadaver of their school. This case is accompanied by other anomalies on the venous system ; a complete pair of the azygos veins, the double subclavian veins of the right side and the ring-formation in the left external iliac vein. Findings Cadaver : Mediiim nourished male (Japanese), about 157 cm in stature. No other anomaly in the heart as well as in the great arteries is recognized. The extracted heart is about 350 gm in weight and about 380 ml in volume. A. Bilateral superior venae cavae 1) Right superior vena cava (figs. 1, 2, 4) It measures about 23 mm in width at origin, about 25 mm at the pericardiac end, and about 31 mm at the opening to the right atrium ; about 55 mm in length up to the pericardium and about 80 mm to the opening. The vein is formed in the usual way by the union of the right This report was announced at the forty-sixth meeting of Kinki-district of the Japanese Association of Anatomists, February, 1971,Kyoto. -
The Venous System
The Venous System Discussion paper prepared for The Workplace Safety and Insurance Appeals Tribunal October 2004 Prepared by: Robert Maggisano MD, FRCS(C), FACS, GKHS Assistant Professor, University of Toronto Chief of Vascular Surgery and Director of Non-invasive Vascular Laboratory, Sunnybrook and Women’s Health Sciences Centre A.W. Harrison MD, FRCS(C) Professor of Surgery, University of Toronto Former Chief of Surgery and VP Medical Affairs, Sunnybrook and Women’s Health Sciences Centre Dr. Robert Maggisano obtained his Medical degree from the University of Toronto in 1974. He did post-graduate training in surgery at the University of Toronto from 1975 to 1980, including in cardiovascular surgery at Toronto General Hospital as well as in vascular surgery at Wellesley Hospital and at Toronto General Hospital. He subsequently did a fellowship in vascular surgery with Dr. E. Wylie at the University of California in San Francisco, in 1980, and with Dr. S. Crawford at the Baylor College of Medicine in Houston, Texas, in 1981. He was granted his Canadian Fellowship in general surgery (FRCS (C)) in 1979, and he was Board certified in general surgery by the American College of Surgery in 1981. He obtained his Certificate of Competence in vascular surgery from the Royal College of Physicians and Surgeons of Canada in 1983, and he was admitted to the American College of Surgery (FACS) in 1985. He joined the University of Toronto faculty in 1981 and holds the rank of Associate Professor at the Division of Vascular Surgery of the Department of Surgery. His clinical and research interests are in vascular surgery. -
VENOUS HEMODYNAMICS WHAT HAPPENS WHEN FLOW IS WRONG…… Liz Lawrence, RDMS,RDCS, RVT KNOW YOUR ANATOMY the START of VENOUS ANATOMY the Capillary Bed
OBJECTIVES OF THIS LECTURE: UNDERSTAND VENOUS ANATOMY AND HEMODYNAMICS BE ABLE TO IDENTIFY NORMAL AND ABNORMAL VENOUS ANATOMY AND HEMODYNAMICS BY DUPLEX ULTRASOUND RECOGNIZE THE CLINICAL SIGNS AND SYMPTOMS OF VENOUS HYPERTENSION BECOME FAMILIAR WITH SUPERFICIAL VENOUS ANATOMY AND HEMODYNAMIC ABNORMALITIES KNOWLEDGE OF THE SCANNING PROTOCOL, PATIENT POSITIONS, AND MANEUVERS TO DEMONSTRATE VENOUS INSUFFICIENCY Liz Lawrence, RDMS,RDCS, RVT VENOUS HEMODYNAMICS WHAT HAPPENS WHEN FLOW IS WRONG…… Liz Lawrence, RDMS,RDCS, RVT KNOW YOUR ANATOMY THE START OF VENOUS ANATOMY The Capillary Bed Arterioles Venules Size is 20-30µm Micrometer On millionth of a meter SUPERFICIAL VENOUS ANATOMY Superficial veins flow to the major superficial veins - Saphenous Veins: Greater Lessor / Small Perforators: Hunterian Dodd Boyd Cockett LOWER EXTREMITY DEEP VENOUS ANATOMY Superficial veins flow into the Deep Veins Common Femoral Profunda/Deep Femoral Femoral Vein Popliteal Vein Gastrocnemius Veins Posterior Tibial Veins Anterior Tibial Veins Peroneal Veins LOWER VEINS FLOW TO THE HEART Carried to the heart by the Inferior Vena Cava VENOUS FLOW IS EFFECTED BY ABDOMINAL AND THORACIC PRESSURE This is important to remember when looking at venous flow patterns VENOUS VALVES Valves are responsible for keeping flow going in the right direction – TOWARD THE HEART When the valves fail it results in Venous Hypertension NORMAL VALVES WHEN VEIN VALVES ARE ABNORMAL VALVE SEEN BY ULTRASOUND INCOMPETENT VALVE BY COLOR DOPPLER The flow color of this popliteal vein is red at a valve– the same color as the artery (which is in the direction of the foot) this is indicative of an incompetent vein valve 2D VENOUS ULTRASOUND IMAGING NORMAL VEINS VEINS WITH COMPRESS WITH THROMBUS PRESSURE DON’T! VARIATIONS OF VEIN THROMBUS CHRONIC VENOUS DISEASE Veins that have residual matter left after an acute thrombus resolves.