H) Veins Of The Lower Limb

The veins of the lower limb have both deep and superficial components.

Deep Venous Network

Veins of the Foot

Similar to the hand, there are paired dorsal and plantar veins of each digit. These unite to form dorsal/plantar metatarsal veins. These veins drain to the dorsal / plantar venous arches which run as vena comitantes with the dorsal and plantar arches.
From the dorsal arch, vena comitantes ascend with the lateral tarsal and dorsalis pedis arteries and continue with the anterior tibial artery. There are numerous connections to the origin of the great long saphenous vein, which ascends from the medial malleolus with the saphenous nerve and carries most venous blood away from the foot.
From the plantar arch, veins accompany the medial and lateral plantar vessels and continue as vena comitantes to the posterior tibial artery. Some vessels pass posterior to the lateral malleolus to ascend with the fibular artery. There are numerous connections to the short saphenous vein (via the lateral marginal vein of the foot), which begins superficial to the tendon of gastrocnemius and passes proximally with the sural nerve.
Importantly, most venous drainage from the foot is via the superficial network, in contrast to the rest of the leg.

Veins of the Lower Leg

The deep veins accompany the anterior tibial, posterior tibial and fibular arteries and unite at the base of the popliteal fossa as the popliteal vein. Most of the blood from the lower leg is returned via the deep veins, and the popliteal vein is usually single.

Veins of the Knee

The popliteal vein passes from the distal to the proximal part of the popliteal fossa, always superficial to the artery but contained within the same sheath. At about the level of the knee joint, the popliteal vein receives the short saphenous vein after it enters the popliteal fossa between the heads of gastrocnemius.

Veins of the Thigh

The popliteal vein accompanies the popliteal artery through the adductor hiatus and enters the anterior thigh, becoming the superficial femoral vein. This vein passes superiorly through the thigh, arriving at the apex of the femoral triangle medial to the artery. It then ascends through the triangle to just midline of the central inguinal ligament. Within the femoral triangle, it receives with the deep femoral vein and the termination of the long saphenous vein.
After passing through the retroinguinal space, the femoral vein becomes the external iliac vein and its course is described elsewhere.

Superficial Veins of the Leg

The short saphenous vein begins superficial to the tendon of gastrocnemius, and ascends superficial to this muscle to the inferior aspect of the popliteal fossa. Piercing the fascia covering the fossa, it empties into the popliteal vein at about the level of the knee joint.
The long saphenous vein begins at the medial malleolus, and ascends with the saphenous nerve (a branch of the femoral nerve). It passes posteriorly to the medial femoral condyle and travels in the subcutaneous tissue of the medial thigh to the femoral triangle. Within the triangle, it pierces the fascia lata through the saphenous opening, and drains into the femoral vein. This union is an important landmark for the deep lymph nodes of the inguinal region, which lie both above and below the junction. Distal superficial inguinal lymph nodes lie in the triangle, in close association with the long saphenous vein.

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