- All right. So today's video is going to be on veins but I actually just wanted to give you a little bit of review of arteries. So this is a page that we use when learning about arteries connected to the heart and then we added onto it in our artery video when we were talking about arteries going to the upper extremity. Now a few things to review just about arteries is remember the point of arteries is to bring oxygenated blood that has been oxygenated by the lungs And it's to send it out through the aorta to a bunch of different types parts of, basically all parts of the body so they can use that oxygenated blood to power things like muscles and essentially your whole body. Now, this is very important for several reasons. So, you know, we're getting, we're using the aorta and all of these arteries that end up going down into smaller vessels called arterials. And essentially those are going into smaller places in our body. So we start with a big aorta, it goes down in arteries and in arterials. And that's important because those little smaller vessels that are arterials, they're really thin arteries because essentially things get thinner as they spread. Those are super important because they help provide that oxygen that we need. Now, there are conditions like diabetes where it is common to have impaired blood flow. And essentially, in those conditions you can have something called ischemia which is lack of oxygen that can lead to tissue death. So if you've ever heard of someone for example, with diabetes, having an amputation it could be due to several reasons. One of it can be that they just have poor sensation on the bottom of their feet oftentimes due to something called peripheral neuropathy where their nerves are damaged. And then they can have damage to their foot and not feel it and it can get infected. But the other thing that can happen is that they can have impaired blood flow to their feet. And with that, that will lead to that same thing, ischemia which is essentially deficient blood supply to a body part that can lead to that tissue death. So that's why this is so important is because we want to be able to keep all of the parts of our body functioning. And because of that, we need blood flow and oxygen. And what brings it there is all of our arteries. Now in the opposite sense, once it's used at all of that oxygen we have something, we have our veins or venules or those little tiny little branches of the veins. And those bring that deoxygenated blood back up. Now, if we have something, if we have impaired function of those veins, we can have something called chronic venous insufficiency which is basically where the veins aren't working effectively at bringing that blood back up into the heart. And with that, it can cause almost like a blood pool in the legs, which can lead to well number of different issues. So not only are arteries important for getting that deoxygenated blood out to these areas in your body but veins are very important for getting the blood back up. Now, what can happen with an artery or vein that's occluded or has like a plaque, right, you know how with heart attacks, we often talk about like a plaque being in one of their one of the person's arteries caused by, like everyone always talks about eating too many cheeseburgers or what have you. Now, that's important 'cause remember we talked about these arteries up here and we talked about right coronary artery, we talked about left coronary artery as well as the branch left anterior descending artery. Now, these are so important because remember these arteries are bringing oxygenated blood to the heart itself. So, what happens during a heart attack there are usually plaques or some sort of clot in one of these arteries that's supplying oxygen to the heart muscle itself. And what happens when a muscle doesn't get oxygen is that the tissue starts to die. So that's what a heart attack is and that's why these arteries are so important is heart attacks happen when one of these blood vessels get clogged either through plaques or a clog. And the same thing can actually happen in the brain where you have a clot or a plaque in one of the vessels that's supposed to supply blood flow and oxygen to the brain, and then that tissue dies. So this is very, very important. Now that we've had a little review regarding arteries and veins and what they can do, let's start drawing some of the veins, just like how we drew the arteries here. Now, a lot of them are going to mimic the arteries. For example, we have subclavian veins in the same area. We have axillary veins, brachial veins, radial ulnar the same arches, essentially all of this leading out to the upper extremities is going to have the same names. But remember for arteries, we have blood flow coming out of the heart, away from the heart, but for veins we're going to bring it back. So the veins are actually going to start with these digital veins, it's going to go into the palmar arteries radial and ulnar veins and et cetera, bringing its way back up into the superior vena cava, or for the lower part of the body and through the inferior vena cava. So just note that many of these things will be mirrored and that oftentimes arteries and veins will travel together and they have the same name. Now, there are things that are a little bit different so we will review that in detail now. So we're going to start with veins. All right. So we're going to do the same type of thing. I'm going to draw the heart here and then we're going to review a few different things. Now, here's our heart. Actually, yeah, here's our heart. Alrighty. Now I'm going to, again, just, this is going to be an anterior view of a person just like we did with arteries. So here's going to be right and left. And with that, I'm going to draw things that come out or are coming back into the heart. And how I'm going to draw them is I'll draw them as they come out of the heart but then more view at the end just to remind you that things really are coming back up into the heart because these are veins. All right. So let's start with a couple of vessels that are similar in terms of what we learned with arteries. So these are things that are going to feed back in through the superior vena cava. All right. So we're going to split this for the right and left and we're going to have three main vessels up there that we're going to discuss. And then the same thing on the other side. After that, we're going to talk about the vessels that make their way down into the arm. And remember, it's always, for both arms it's going to be the same on the right and the left but I'm just going to draw the right just because it makes it a little bit easier for us to follow along. So this is as is if it's going down into someone's arm. All right. So this may look similar to our other picture as you remember and we're going to label all of these in a moment, okay? Now this is as if it's going down into someone's arm. We have a little bit of a change of things. We're going to add in a couple of branches off of here that are super important that are actually are more superficial veins in our body or excuse me, in our arm. All right. So this covers our whole arm and how it feeds back into the heart. Let's start with all of that. So our big, huge, most important thing that feeds back into the heart here is going to be our superior vena cava. (pen writing on paper) And that's how all of this blood is going to get back into the heart. Now, we're going to have most of these things on the right and left. So I won't label right and left but just note that there is one on each side. You know how we have the brachiocephalic trunk for arteries, well, we're going to have brachiocephalic veins here in a comparable spot to the other, to the arteries. And remember, VV is our abbreviation for veins. Now, remember we had that subclavian vein that we talked about as a really important structure that has a lot of bridges and then end at the lateral border the first rib. Well, we're going to have the same type of thing for veins. We're going to have a subclavian vein. And we're going to make that blue. (pen writing on paper) Alrighty. Now we're going to have some similarities in terms of branches that come off. One thing that comes off right in the middle is our vertebral vein right there in red. (pen writing on paper) That's important because remember we learned that the vertebral veins travel with the vertebral arteries. And if you remember where that travels, it goes through the transverse foramen in the cervical spine. Now, have you ever heard of, like, when we're talking about animals hunting, "Oh, they got them in the jugular." So this is what they're talking about is the jugular vein. You actually have an external jugular, which is right here on both sides. (pen writing on paper) And that external jugular drains blood that comes from the face and neck. All right. So we also have an internal jugular which is a little more internal, which makes sense. (pen writing on paper) And that internal jugular drains thing this from the brain. Alrighty. So do you remember what the, what the subclavian artery turned into as it went down? Think about that for a moment. So that subclavian vein is going to turn into the axillary vein or actually vice versa. The axillary vein will feed back into the subclavian vein. (pen writing on paper) And now, as you can see we have two important veins that drain into that axillary vein. Remember, these two are more superficial so we'll make a note of that as well. The one that is lateral in the arm, 'cause remember, this is as if it's someone on arm right here it's called a cephalic vein. (pen writing on paper) Now, remember these are all deeper in the arm. This is one of the superficial veins. So I'll just make a little note, superficial. And the other superficial vein that drains into the axillary vein is called the basilic vein (pen writing on paper) which is also superficial. Now we have the same vein again here that mirrors the artery. So remember this is going to be our brachial vein that's going to feed up into axillary just like we had a brachial artery. (pen writing on paper) And again, that's deeper just like axillary is. Now just like we had in the arteries, we're also going to have a radial and then ulnar vein. So ulnars, so this is going to be medial right here. And then we're going to have our radial which is lateral right here. (pen writing on paper) Same thing as what we had in the arteries, we're going to have a superficial and deep palmar arches which are going to be right here. (pen writing on paper) And then lastly, we'll have digital veins. (pen writing on paper) All right. So let's follow this step again, just as a review. Everything is going back in towards the heart. We're going to have our digital veins, our superficial and deep palmar arch, which is going to feed into ulnar and radio veins in the brachial veins, axillary veins and don't forget, we also have basilic and cephalic that are going to feed in here. Then that axillary vein is going to turn into our subclavian vein, which gets blood from internal and external jugular, as well as vertebral vein making its way to break you as to brachial and cephalic vein and into the superior vena cava. All right. So that's all of our upper body that we need to know for this course. Now, what we're going to do is we're going to cover our lower body. So I'm going to try to do it on the same page here. If you ever have any issues seeing things, you can always just like zoom in on that stuff. So I'm going to do the same thing that we did with blood going to the head and neck and upper body and we're going to draw on those vessels first. Actually, you know what for, to make it a little bit easier I'm going to do it on another sheet. So this is going to be upper body. (pen writing on paper) Yeah. I only have so many colors, so, you know, we're going to make this work. We're going to do lower body now. (pen writing on paper) Alrighty. So, same. Just we're gonna draw a nice little heart. (pen writing on paper) All right. So everything for this is going to be feeding back in through the inferior vena cava. All right. So one other really important structure in terms of veins and blood coming back up into the heart is our liver. So I'm just going to draw our liver which is in our right upper quadrant and remember we learned those back when we first started. So here is going to be our liver. All right. So we're going to have some vessels from our liver coming back into our inferior vena cava. Now we're also going to have some veins that are a little more superficial and a little bit deeper. So I'm going to draw the more superficial ones first. We're going to have something called a hypnotic portal vein that's going to come back up in, and don't worry, I'm gonna label this all later. But it's going to come into the heart, I mean, into the, excuse me, into the liver. We're going to have a few things coming back into this that I'm going to label in a moment. Here is a little pancreas as well. Alrighty. So that covers some of our superficial veins, now we're also going to have some deeper ones. Bear with me as I continue to draw these out. (pen writing on paper) Alrighty. So with all this, let's start with the most important, arguably, arguably the most important vein that brings blood from the lower extremity back up. Oops. And I forgot a few more things up here. I'm almost done, I promise Alrighty. So like I said, arguably the most important vein is the inferior vena cava. We're gonna make it blue. And remember this inferior vena cava is going to be deeper than some of these superficial structures. (pen writing on paper) Oops. Which is also IVC is the abbreviation. All right. So let's start with the most superficial structures and then we'll go to deeper. So I'm just going to say more superficial. Alrighty. So we are going to have some things that are going to come, actually, let's start down below since we're working our way up. Actually, we'll start, let's start around the liver. I lied. We're gonna make this hopefully as easy as possible. Alrighty. So we're going to have a few different hepatic veins that are going to feed directly into the inferior vena cava. So these are bringing blood from the liver, (pen writing on paper) bringing it into the inferior vena cava. (pen writing on paper) Now, we also have something that is called the hepatic portal vein and there's actually a really good image I uploaded to Canvas called GI veins and it gives you a good little look at that. Essentially, here I'll draw it out for you. Right here. (pen writing on paper) Now we have a few different things that are going to feed into that. All right. So we have the superior mesenteric vein. And whenever we're talking about mesenteric, we're talking about anything in your GI system, your gastrointestinal system, so things coming from your stomach. So for the superior mesenteric, you're going to get things from colon, et cetera. We also have an inferior mesenteric where you'll also get things from the colon and rectum but superior gets it from a little bit more of the right side of the body and then inferior gets it a little bit more from the left side of the body and the structure's there. But we'll go ahead and label them both. So superior mesenteric is the one that comes, feeds in more superiorly, just like the name sounds. (pen writing on paper) And then we've got our inferior mesenteric. (pen writing on paper) Just so we're clear. I'm going to label our liver (pen writing on paper) 'cause as we learned with arteries, anything that's called hepatic is in liver. Alrighty. So it's going to also pass behind the pancreas here. And something else that will end up feeding into this hepatic portal vein, there's our in, oops. Oh, I messed it up. I labeled something incorrectly. We're going to redo this. This is your inferior mesenteric right here. And I mislabeled something. Let's see. What dark color can I choose to override my mistake here? We're going to choose gray. This thing that I had initially labeled as the inferior mesenteric is not the inferior mesenteric. It's confusing 'cause it kind of looks like that, but I made a mistake. That's actually the splenic vein. (pen writing on paper) And that comes from, it feeds blood from the spleen, which is over here and a couple of other things coming in here. So note my correction, this is superior mesenteric, this is inferior mesenteric and then this is splenic vein all feeding into the hepatic portal vein. All right. So those are the superficial structures that I want you to be aware of. Now we're going to move to things that are a little bit deeper or like more posterior. So, I'm actually gonna say that this is more anterior. (pen writing on paper) Thanks for rolling with me on all this. All right. So now we're going to move to more posterior structures. So inferior vena cava kind of falls as one of these structures as the most, more posterior but that was a big important one so we just included that at the beginning. Now these, again, are going to start to down here are going to mimic what happened in the legs with arteries. But before we go there, I want to talk about a few things that also mimic things that we learned about before. We're going to, just like how we had arteries, we're going to have renal veins going out to our kidneys, or actually coming back in from our kidneys, excuse me. And we're going to, just like we had with arteries we're going to have testicular or ovarian veins which are also called gonadal veins. (pen writing on paper) And one is going to come right off, or feed right into renal vein. Oops. And I forgot to label right and left since this is an anterior view. And then the other testicular or ovarian or gonadal vein is going to come from the right side and feed directly into the inferior vena cava. All right. Now, to cover more of the deeper veins that end up feeding into the inferior vena cava, again, it will mirror exactly what we just learned about in arteries. We're going to, again, I'm not going to write right and left for these just because you guys understand that we have two legs. So I'm just going to leave that out. This is the common iliac veins. And just like we talked about with arteries, things are going to feed into this. We have internal and external iliac veins. (pen writing on paper) So external is going to be going out more laterally. Internal will be more medially. (pen writing on paper) And just like we learned about with arteries, the external ones are really what's going to be connected to the ones going into the lungs. And just like we also learn with arteries the breaking point here, the point at which these changed names is the inguinal ligament. So that's what that little, those little lines are, those little diagonal lines. Now this is going to be our femoral vein. (pen writing on paper) We're going to have a superficial branch that feeds into femoral vein. That's going to be our great saphenous vein which again, is superficial. (pen writing on paper) Superficial. And then we're, also just like the arteries, We're going to have a popliteal vein right here around, so this is right where someone's knee is 'cause remember popliteal is the back of the knee. (pen writing on paper) Then we're going to have anterior and posterior tibial veins right here. (pen writing on paper) Alrighty, oops. And I'll label this little piece of femoral vein that I left here but of course it's going to be the same on both sides. All right. So let's talk about just a little overview of this. Excuse me. All right. So we have anterior and posterior tibial veins which is around the tibia in the leg. And then behind the knee, we have that feeding into the popliteal vein, which turns into the femoral vein which turns into the external iliac vein which feeds into the common iliac vein. Now don't forget, we have the great saphenous vein which is the medial superficial vein feeding into femoral as well. And we also do have internal iliac, which gathers blood from the pelvic region into that common iliac. Then these are all of our deeper structures, other than saphenous. It's going to feed back into the inferior vena cava which is going to go all the way back up to the heart. Now, a little more anterior, these structures we have three main veins coming from our gastrointestinal system or our GI system. We have superior, inferior mesenteric and then we also have splenic vein all coming and feeding into the hepatic portal vein which is going to make its way into the liver. Now the liver is really important because it filters for us. So it's going to take all of this blood from the GI system and it's going to bring it into the liver and filter it to clean it essentially. And so that's like a, that's why oftentimes if people like, for example if you were an alcoholic and drink a lot of alcohol that's going to go, you're going to drink the alcohol, it's going to go in through your GI or gastrointestinal system and it will be filtered by the liver before it comes back up to the heart. But of course, if you're consuming a lot of drugs or alcohol, that's a lot of filtering for your liver to do, which is why if someone had drinks too excessively or engages in excessive drug use, it's a lot of stress on the liver and it can lead to things called hepatitis. Remember hepatic is the word we always use when we're talking about the liver and it can lead to overuse and inflammation of the liver and even lead to very significant liver damage. So that's a side note. But the liver is going to do all of our filtering and then our hepatic veins are going to bring it into the inferior vena cava which is going to go back into the heart. A few other things that we, I want to mention is our renal veins are going to bring things into the inferior vena cava into the heart. And we also have those testicular or ovarian also known as gonadal veins that are going to come into the, the right one is going to come into the inferior vena cava directly and then the left one's going to come right into the renal vein. And that covers our veins from our lower body. So remember, these are really important 'cause we have to get that deoxygenated blood that we've used and bring it from our legs and arms and brain, et cetera. We have to bring all of that in back towards our heart. And if we can't bring it up we can't send that deoxygenated blood out to the lungs to get oxygen needed again, to feed our body. So veins are very important and that covers veins for today.