Lymphatic and venous drainage of lower limb Veins

Lymphatic and venous drainage of lower limb

Veins of lower limb v Superficial veins § Great saphenous vein § Small saphenous vein v Deep veins § Venae comitantes v Perforating veins § Communicating veins

Great saphenous vein ü Longest vein ü Continuation of medial end of dorsal venous arch ü Front of medial malleolus ü A fingers breadth behind the medial border of tibia ü One hands breadth posterior to patella ü Saphenous opening to drain into femoral vein

Medial femoral cutaneous nerve Saphenous nerve q Structures accompanying • In thigh Medial femoral cutaneous nerve • At knee Saphenous branch of descending genicular artery • In leg and foot Saphenous nerve

Tributaries • • Posterior arch vein Anterior leg vein Anterolateral vein Postero- medial vein Superficial epigastric Superficial circumflex iliac Superficial external pudendal • Deep external pudendal Superficial epigastric V Superficial circumflex iliac vein Superficial external pudendal V Femoral V Posteromedial vein Great Saphenous V Saphenous nerve Antero lateral vein Anterior leg vein Medial malleolus Posterior arch vein Dorsal venous arch

Perforating veins • Mid- Hunter: Hunters Canal, connects Femoral with GSV • Knee: Connects post tibial With GSV • Medial ankle – 3, Connects post tibial With GSV • Lateral ankle -1, Communicates the SSV with peroneal vein

Small saphenous vein ü Continuation of lateral end of dorsal venous arch ü Lateral to tendo calcaneous ü Sural nerve on lateral side ü Dips into popliteal fossa ü Drains into popliteal vein Popliteal vein Small saphenous vein

Applied aspects Varicosities: § Thrombosis of deep veins § Increased intra abdominal pressure § Incompetency of valves • Incompetency of sapheno-femoral valve • Incompetency of valves in perforating veins Aortic –coronary bypass operations: as a graft

Applied anatomy

Horizontal group Vertical Group Lymphatic drainage of LL Superficial inguinal lymph nodes v Upper (Horizontal) Ø Lateral group Ø Medial group v Lower (Vertical)

Deep inguinal lymph nodes • 1 -3 • Medial side of femoral vein • Afferents ü deep lymph vessels accompanying the femoral vessels ü Glans penis or glans clitoridis ü Few from superficial inguinal nodes

Applied anatomy • Lymphedema- Filaria • Enlargement of lymph nodes • Syphilitic lesions