Chapter 65 – Venous Disease

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1、CHAPTER65VENOUSDISEASEJulieA.FreischlagandJenniferA.HellerThesmallsaphenousveinarisesfromthedorsalvenousanatomyarchatthelateralaspectofthefootandascendsposteriortothevenousinsufficiencylateralmalleolus,risingcephaladinthemidposteriorcalf.Thedeepvenousthrombosissmallsaphenousveincontinuestoascend,p

2、enetratesthesuperconclusionficialfasciaofthecalf,andthenterminatesintothepoplitealvein.Theexactentryofthesmallsaphenousveinintothepoplitealveinisvariable.Thesuralnerveliesparalleltothesmallsaphenousvein.Anunderstandingofvenousphysiologyprovidesthesurgeonwithvaluableinformationwithwhichtoformulatea

3、diagnosticDeepVenousSystemandtreatmentplan.TechnologicadvanceshavebroadenedtheTheplantardigitalveinsinthefootemptyintoanetworkoftherapeuticarmamentarium.Thischapterwillprovidethereadermetatarsalveinsthatcomposethedeepplantarvenousarch.Thiswithathoroughoverviewofthephysiologyandpathophysiolcontinue

4、sintothemedialandlateralplantarveins,whichthenogyofthevenoussystem,followedbyanevaluationofavailabledrainintotheposteriortibialveins.Thedorsalispedisveinsondiagnosticmodalitiesandtherapeuticinterventionsandthenbythedorsumofthefootformthepairedanteriortibialveinsatadiscussionofspecificvenousdisorde

5、rs.theankle.Thepairedposteriortibialveins,adjacenttoandflankingANATOMYtheposteriortibialartery,rununderthefasciaofthedeepposTodeterminewhetherpathophysiologyispresent,preciseteriorcompartment.Theseveinsenterthesoleusandjointheknowledgeofvenousanatomyisessential.Afterthelocationandpoplitealvein,aft

6、erjoiningwiththepairedperonealandantetypeofvenousincompetencehavebeendetermined,atherariortibialveins.Therearelargevenoussinuseswithinthesoleuspeuticplancanbeconstructed.Venousdrainageofthelegsismuscle—solealsinuses—thatemptyintotheposteriortibialandthefunctionoftwoparallelandconnectedsystems,thed

7、eepperonealveins.Bilateralgastrocnemiusveinsemptyintotheandsuperficialsystems.Thenomenclatureofthevenoussystempoplitealveindistaltothepointofentryofthesmallsaphenousofthelowerlimbwasrevisedin2002andthemostrelevan