Lower Extremity Venous Anatomy and Evaluation

Which veins in the lower extremity contain ZERO valves?

1. Common iliac veins

2. Internal iliac veins

3. IVC

What are metatarsal veins?

Vessels that drain blood from feet before terminating at deep venous arches

What are the anterior tibial veins (ATV)

Paired vessels that originate from plantar arches and drain blood from anterior calf

What are the posterior tibial veins (PTVs)?

Paired vessels that originate at plantar arches and drain blood from posterior calf

What are the peroneal veins?

Paired vessels that drain blood from lateral calf

What is the popliteal vein?

Vessel that originates from anterior tibial veins and tibioperoneal trunk that courses posterior to popliteal artery

What is the femoral vein?

Continuation of popliteal vein that courses posterior to femoral artery

What is the deep or profunda femoral vein?

Vessel that joins femoral vein and drains blood from thigh muscles

What is the common femoral vein (CFV)?

Vessel that originates from femoral vein and deep or profunda femoral vein

What is considered to be the longest vein in the body?

GSV

What is the greater saphenous vein (GSV)?

Superficial vessel that originates at dorsal venous arch and terminates at saphenofemoral junction in groin

What is the anterior accessory saphenous vein (AASV)?

Superficial vessel that joins GSV at groin

What is the small saphenous vein (SSV)?

Superficial vessel that originates at dorsal venous arch and joins popliteal vein in distal thigh

Identify this image.

1. IVC

2. Common iliac vein

3. Internal iliac vein

4. External iliac vein

5. Common femoral vein

6. GSV

7. Deep femoral vein

8. Femoral vein

9. Popliteal vein

10. SSV

11. Peroneal veins

12. Posterior tibial veins

13. Anterior tibial veins

Identify this image.

Saphenofemoral junction (SFJ)

1. CFV

2. GSV

3. Superficial epigastric vein

Identify this image.

Calf veins

1. SSV

2. Gastrocnemius veins

3. Popliteal vein

Identify this image.

Calf veins

1. Popliteal veins

2. Peroneal veins

Identify this image.

Eye sign used to distinguish saphenous veins from tributaries

Identify this image.

1. Deep femoral artery

2. CFV

3. SFA

4. GSV

5. Anterior accessory vein

What are perforator veins?

Vessels that connect superficial and deep venous systems

Identify this image.

1. Dodd perforators that connect GSV to FV

2. Hunterian perforators that connect GSV to FV

3. Boyd or paratibial perforators that connect GSV to posterior tibial veins

4. Cockett’s or posterior tibial perforators that form around ankle

What are communicating veins?

Vessels that connect great and small saphenous veins

What is the posterior arch vein?

Vessel that connects GSV to posterior tibial or Cockett’s perforators

What is the vein of Giacomini?

Vessel that originates at saphenopopliteal junction and becomes posterior circumflex vein

What are sural veins?

Vessels that serve as blood reservoirs and terminate at popliteal vein

What is the soleal plexus or sinus?

Vessels that serve as blood reservoirs that terminate at posterior tibial or peroneal veins

How is a lower extremity venous exam performed?

1. Evaluate all vessels in reverse Trendelenburg or semi-erect position

2. Patient should externally rotate leg with knee slightly bent

What is the normal sonographic appearance of an lower extremity venous exam?

1. Deep veins of thigh demonstrate spontaneous and phasic flow

2. Calf veins DO NOT demonstrate spontaneous flow

3. NO CARDIAC PULSATILITY