Page 35 - Libro 2

1 — Vascular Anatomy
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a continuation of the lateral segment of the dorsal venous arch of the foot. The SSV courses poste- riorly up the calf, penetrating the deep fascia in the upper half of the calf. In approximately 70% of individuals, the SSV terminates into the popli- teal vein at the saphenopopliteal junction. In the remainder of cases, the SSV continues above the knee as the vein of Giacomini.
The deep venous system begins with the deep plantar arch, which continues as the medial and lat- eral plantar veins. These veins then unite to form the posterior tibial veins (Fig. 1-25). The pared pos- terior tibial veins accompany the posterior tibial artery. The paired peroneal veins ascend the calf in the same plane as the peroneal artery. Approxi- mately two-thirds of the way up the calf, the pe- roneal veins join the posterior tibial veins to form the tibio-peroneal trunk veins. The anterior tibial
veins are the continuation of the vena comitantes of the dorsalis pedis artery. The anterior tibial veins pass between the tibia and fibula through the upper part of the interosseous membrane. The veins then unite with the tibio-peroneal trunk veins to form the popliteal vein. The popliteal vein is medial to the popliteal artery distally and moves lateral to the artery as it passes through the adductor canal. The femoral vein is the continuation of the popliteal vein and accompanies the superficial femoral artery to the groin (Fig. 1-26). The profunda femoral (deep femoral) vein courses the thigh along the profunda femoris artery. The profunda femoris and femoral veins unite to form the common femoral vein. The common femoral vein lies medial to the common femoral artery. The external iliac vein is the continu- ation of the common femoral vein above the ingui- nal ligament.
SUMMARY
In summary, the blood vessels of the body have the same basic microscopic ar- rangement. Varying combinations of muscle, collagen, elastic fibers, and connec- tive tissue provide essential differences between the arteries and veins to allow for their specific functions. Arteries and veins of differing sizes are oriented to provide for the efficient delivery of nutrients to the organs and tissue beds as well as to return blood back to the heart to complete the cycle. The network of arteries and veins is complex but, if examined by region (arm, leg, abdomen, etc.), can be easier to understand. Proper knowledge of vascular anatomy will aid the vascular technologist or sonographer to achieve a technically adequate vascular ultrasound examination.
Critical Thinking Questions
1. When examining the carotid system, the physician asks you to be sure to document the origin of the superficial thyroid artery. Normally, in which direction should you focus your examination in order to visualize this vessel?
2. In your department, part of the documentation includes tapping over
the superficial temporal artery and observing the ECA Doppler signal for oscillations in the waveform produced by the tapping. This is done to confirm the vessel being insonated is the ECA. Why are there no oscillations within the ICA?
3. If a patient presents with an abdominal aortic aneurysm that is present from just below the renal arteries to the bifurcation of the common iliac arteries, what branches of the aorta may be involved in the aneurysmal dilation?
4. You are asked to examine a patient with a penetrating injury to the medial aspect of the mid-thigh. What vessels may have sustained an injury and thus should be thoroughly examined?