Inferior vena cava (v.

cava inferior)

Inferior vena cava (v. cava inferior) is the widest blood vessel in the human body. It gathers blood from
the most part of organs of the abdominal and pelvic cavities, walls of these cavities and from lower extremites.

Back surface of the inferior vena cava lies on the lumbal part of the vertebral column and covers right lumbal,
renal, middle suprarenal and lower phrenic arteries. The right surface of the inferior vena cava adjoins to musculus
psoas major muscle. The left surface of this vein lies close to the descending part of the aorta. In the abdominal
cavity to the right from the inferior vena cava the right ureter and hilum of right kidney lie. Near the right edge of
this vein sympathetic trunk lies. In front of the inferior vena cava is located parietal peritoneum. The level of the
fourth lumbal vertebrae the inferior vena cava is crossed by a radix mesenterii. In the abdominal cavity in front of
the inferior vena cava there are at the duodenum, pancreas, portal vein and bile duct. The front suface of this vein
covered by a peritoneum forms posterior wall of an epiploic foramen. Over this foramen the inferior vena cava lies
in the back part of the right longitudinal sulcus of the liver, where this vein is tightly bound to the liver by hepatic
veins.

The inferior vena cava comes to the thoracic cavity through the central tendon of the diaphragm, then it
penetrates to the pericardial cavity and is opened from below into the right atrium. The inferior vena cava
has parietal and visceral influents (tributaries).

The parietal influents of the inferior vena cava in the abdominal cavity are pair inferior and lumbal veins.

The inferior phrenic veins (vv. phrenicae inferiors) as thin trunks lie near the arteries of the same name.
On a level of a foramen of the inferior vena cava they disembogue into the vena cava inferior. The inferior phrenic
veins in the diaghpragm anastomose with pericardiophrenic and musculophrenic veins, which are influents of
internal thoracic veins.

Lumbar veins (vv. lumbales) in the number of 4 — 5 lie near to lumbar arteries. Each lumbar vein is
formed by the conjunction of anterior and posterior influents (behind psoas major muscle). The anterior influent
gathers blood from the lateral wall of the abdomen, the posterior influent — from the skin and muscles of the
lumbar region, internal and external vertebral plexuses. From the right the lumbar veins anastomose with the right
ascending lumbar vein, from the left — with the left ascending lumbar vein. The lumbar veins also anastomose
with sacral veins, influents of the external iliac vein.

The visceral influents of the inferior vena cava are pair of testicular (ovarian) veins, renal veins and
suprarenal veins.

Testicular (ovarian) veln (v. testicuiaris, s. ovarica) is pair. The testicular vein begins from the posterior
margin of testis, forming the socailed pampiniform plexus. It lies in the spermatic cord. A testicular vein is formed
after the outcome of veins of this plexus from inguinal canal. The right testicular vein disembogues into the inferior
vena cava, at the acute angle the left one — into the left renal vein.

The ovarian vein begins from the hilum of the ovarium, goes upward and disembogues into the inferior vena cava
from the right side and into the left renal vein from the left side. Small veins from the walls of the ureter
disembogue into the testicular (ovarian) vein in the abdominal cavity.

The renal vein (v. renalis)is pair, it goes from the hilum of the kidney in front of the renal artery. The left
renal artery is longer than the right one, and it lies across the aorta in front of it. The renal veins disembogue into
the inferior vena cava at the level of intervertebral disk between the first and second lumbal vertebrae.

The suprarenal vein (v. suprarenalis) has anatomo — topographic differences from the left and from the
right. The right suprarenal vein disembogues into the inferior vena cava, the left one — into the renal vein. Small
suprarenal veins disembogue into inferior phrenic, lumbar and hepatic veins and into the influents of the portal
vein (pancreatic, splenic and gastric veins).
 Hepatic veins (vv. hepaticae) are formed in the parenchyma of the liver in number 3 — 4 and disembogue
into the inferior vena cava on the vena cava of the liver. One of the hepatic veins (usually right one) before
inflowing into the inferior vena cava is conjoint with the venous ligament which is an overgrown venous duct
functioning in the fetus.

The veins of the pelvis

The common iliac veins (vv. iliacae communes), left and right, interflow on a level of an
invertebral disk of the fourth and fifth lumbaI vertebrae and form the inferior vena cava.

The left common iliac vein goes at first in the medial direction and then behind the artery of the same name The
right common ileac vein is shorter than the left one; it goes behind the artery of the same name. Into the left
common iliac vein median sacral vein (v. sacralis mediana) disembogues. It goes along the pelvic surface of the
sacrum, appearing from the anterior sacral venous plexus. The anterior sacral plexus is formed from anastomosing
with each other veins and with lateral sacral veins, venous plexus of the bladder and with external vertebral
venous plexus.

On a level of the sacroiliac joint each common iliac vein is formed by interflow of external and internal iliac veins.

The internal iliac vein (v. iliaca interna) lies on the lateral surface of the small pelvis behind the artery of
the same name, it has parietal and visceral influents (tributaries).

The parietal influents by their topography and regions of spreading correspond to the arteries of the
same name.

The visceral influents are formed from the large plexus of organs of the small pelvis.

The parietal influents (5 tributaries) are:

iliolumbal, lateral sacral, obturator, superior and inferior gluteal veins.

The iliolumbar vein (v. iliolumbale) goes upward behind the musculus psoas major and gathers blood
from this muscle, musculus quadratus lumborum and from the iliac bone. This vein anastomoses with the branches
of the ascending lumbar veins, with the deep, circumflex iliac vein and with the lateral sacral vein.

The lateral sacral vein (v. sacralis lateralis) is usually paired; it goes upward along the lateral part of pelvic
surface of the sacrum. It gathers blood from the sacrum, from muscles of this region, from spinal veins, outgoing
from the anterior sacral foramina, anastomose with veins of the vertebral plexus and median sacral vein.

The superior and inferior gluteal veins (vv. gluteae superiors et inferiores) in their topography correspond
to the branches of the arteries of the same name. The inferior gluteal vein anastomoses with the influents of the
first perforating vein, which is an influent of the deep vein of the thigh.

The obturator vein (v. obturatoria) goes from the femoral region through the obturator canal (near the
artery and nerve of the same name). In the pelvic cavity the obturator vein goes along its lateral wall and gathers
blood from a medial group of the femoral muscles, skin of this region and external genitals and from the hip joint.
It anastomoses with the influents of the external iliac vein.

The visceral influents (tributaries) of the internal iliac vein are:

the internal pudendal vein, the vein of the vesical plexus, prostatic plexus (in males), uterine and vaginal venous
plexuses (in females).

The internal pudendal vein (v. pudenda interna) is formed as a result of interflowing of deep and dorsal
veins of the penis (v. dorsalis profunda penis, vv. profundae penis). It receives veins from the bulb of the penis
(vein of bulb of penis, v. bulbi penis) (in females — from the bulb of the vestibule, vein of the bulbe of vestibule, v.
bulbi vestibuli), posterior scrotal veins (vv. scrotales posteriores) and inferior rectal veins. The internal pudendal
vein lies along the artery of the same name. Sometimes it disembogues into the inferior gluteal vein.

The prostatic venous plexus (plexus venosus vesicalis) rounds the prostatic gland and seminal vesicles. In
males this plexus anastomoses with the dorsal vein and deep veins of the penis, entering into the pelvic cavity
through the urogenital diaphragm.

In females there is a venous plexus around the urethra, anastomosing with vaginal and uterine plexus.
From these plexus venous blood goes into the internal iliac vein through the uterine veins.

The vesical venous plexus (plexus venosus vesicalis) surrounds the urinary bladder, blood flows from it
into vesical veins.

The rectal venous plexus (plexus venosus rectalis) lies in the depth of tela submucosa of the rectum and
on its posterior and lateral surfaces. From this plexus venous blood flows through unpaired superior rectal vein
(into inferior mesenteric vein) and through paired middle and inferior rectal veins (into internal iliac).

The external iliac vein (v. iliaca extent), is paired. It is a continuation of the femoral vein in the pelvic
cavity. The external iliac vein gathers blood from the lower limbs and partially from the walls of the pelvis, it goes
upward along the external iliac artery and touches musculus psoas minor from the medial side. On a level of the
sacroiliac joint the external iliac vein interflows with the internal iliac vein forming the common iliac vein.

The influents of the external iliac vein are: the inferior epigastric vein and the deep circumflex iliac vein.

The inferior epigastric vein (v. epigastrica inferior), paired, lies near the artery of the same name on the
internal surface of the rectus abdominis muscle and anastomoses with the superior epigastric vein (an influent of
the internal thoracic vein), with the superficial epigastric vein (an influent of the femoral vein) and paraumbilical
veins (the influents of the portal vein. One of the small influents of the inferior epigastric vein disembogues behind
the pubic bone into the obturator vein.

The deep circumflex iliac vein is paired, it goes close to the artery of the same name along the iliac crest.
It anastomoses with the branches of the iliolumbar vein (an influent of the internal iliac vein) and gathers blood
from muscles of the abdomen and adjacent muscles of the pelvis.

The veins of the lower limb

There are superficial and deep veins anastomosing at the lower limb with each other. On the
back of the foot the dorsal venous arch of the foot (arcus venosus dorsalis pedis) is located, which is
formed by dorsal digital veins (vv. digitalis dorsales pedis). From this arch lateral and medial marginal
veins begin. The continuation of the medial marginal vein (v. marginalis medialis) is a long (great)
saphenous vein. The lateral marginal vein (v marginalis lateralis) continues into a small (short) saphenous
vein.

On the sole of the foot the plantar digital veins (vv. digitalis plantares) interflow with each other
and form plantar metatarsal veins (vv. meta tarsales plantares), disemboguing into the plantar venous
arch. Blood flows from this arch through the medial and lateral marginal veins into the posterior tibial
veins.

The long saphenous vein (v. saphena magna) begins before the lateral malleolus and goes
along the medial surface of the crus. The long saphenous vein of the leg circumflexes posteriorly the
medial epicondylus of the femur, then goes upward, lies on the surface of the distall end of the sartorius
muscle. Reaching the saphenous opening, it goes through the cribriform fascia, then overpasses the
falciform margin of the oval fossa and disembogues into the femoral vein. Numerous subcutaneous veins
of the leg and thigh anastomose with deep veins of the leg.
 The influents (tributaries) of the long saphenous vein:

the external pudendal veins (vv. pudendae externae), superficial circumflex iliac vein (v. circumflexa
ilium supetficialis), superficial epigastric vein (v. epigastrica supetficialis), superficial dorsal veins of the
penis (clitoris) (vv. dorsales superficiales penis(clitoritis) and anterior scrotal (labial) veins (vv. scrotales

The small saphenous vein of the leg (v. saphena parva) is a continuation of the lateral marginal
vein on the foot. It is formed behind the lateral malleolus and goes at first to the lateral edge of Achilles
tendon. This vein gathers blood from the dorsal venous network of the foot (rete venosum dorsalc pedis),
subcutaneous plantar veins, lateral calcaneal region of the foot, the posteriolateral region of the crus and
anastomoses with the long saphenous vein and deep veins of the leg. In the upper third part of the crus the
small saphenous vein goes between the heads of the gastrochnemic muscle and disembogues into the
popliteal vein in the popliteal fossa.

The deep veins of the lower limb (v. profundae membri inferioris) begin from the veins of the
plantar venous arch as paired posterior tibial veins (vv. tibiales posteriores), anastomosing with the
paired anterior tibial veins (vv. fibulares). The posterior tibial veins receive fibular veins unite with
anterior tibial veins and form the popliteal vein in the popliteal fossa.

The popliteal vein (v. poplitea) is located between the tibial nerve and popliteal artery, lying
closely to the posteriolateral surface of this artery. The small saphenous vein of the leg and veins
corresponding to the branches of the popliteal artery disembogue into the popliteal vein. The popliteal
vein enters the adductor canal and continues there as a femoral vein.

The femoral vein (v. femoralis) in the adductor canal lies behind and partially laterally to the
femoral artery. From this position the vein runs under the inguinal ligament into the lacuna vasorum. The
veins flowing into v. femoralis are all finery. On a level of the oval fossa the large saphenous vein,
external genital veins, superficial circumflex iliac vein and superficial epigastric veins disembogue into
the femoral vein. The external pudendal veins (vv. pudendae externae), paired, lie adjacent to the arteries
of the same name. They gather blood from the lower part of the anterior abdominal wall, scrotum, labium
majus, skin of the penis and clitoris. The superficial circumflex iliac vein lies on the lateral surface of the
upper part of the thigh accompanying the arteries of the same name. The superficial epigastric veins,
paired, gather blood from the skin of the inferior regions of the anterior abdominal wall.

The veins of the lower limb.

Sources and Locations of

Main infiuents Regions of blood
Veins location of opeulng
Basic tributaries gathering
forming Wtere it falls
Superficial From the veins of I.Subcutaneus The skin and sub- The femoral vein
veins, the hallux and veins of the anter- cutaneous fat of below the inguinal
Long me- omedial surface of the anteromedial ltganient
saphenous dial edge of the the leg regions of foot,
vein foot, afore the 2.External crus and femur, ex-
me- pudendal ternal genitals and
dial malleolus vel ns anterior wall of
3.Superficial epi- abdomen
gastric vein
4.superficial cir-
cumflexil iac vein
Small From lateral veins 5.Subcutaneus The skin and sub- The popliteal vein
saphenous of veins of the poste- cutaneous fat of in popliteal fossa
vein foot adjacent to riolateral surface the posteriolateral
the of regions of foot and
lateral malleolus crus clus
Deep veins. From deep veins 6. Muscular It interflows with
The muscles, liga-
Anterior tibial of branch- the posterior tibial
ments, bones of
vein fpaired) the back of foot es veins and forms
the back of the foot
the popliteal vein
and the anterior re-
in the lower part of
gion of crus
popliteal fossa
Posterior tibial From lateral and 7. Fibular branches It interflows wiih
The muscles, liga-
vein (paired) medial planlar the anterior tibial
ments and bones
veins veins ancl fornls
of the sole and
the popliteal vein
posterior region of
in the lower part of
crus
popliteal fossa
Popliteal vein As a result of 8.The veins of the It continues into
inter- genus the Femoral vein
The skin, liga-
flowing of the 9. small saphenous
ments, muscles
ante- vein
bones of ihe foot
rior and posterior
and the crus, knee
tibial veins in the
Jonil
lower part of the
popliteal fossa
Femoral vein The continuation 10.Deep vein of The skin, ligaments, It continues into
of the popliteal thigh muscles, the external iliac vein
vein 11 The long bones of foot crus, on a level of
ft om the lowet saphe- thigh, the skin and the inguinal ligament
opening of the ad- nous vein subcutaneous fat
ductor canal. of the external
genitals
and the anterior
wall of abdomen
 The system of the portal vein

The portal vein (v. portae) gathers blood from all unpaired organs of the abdominal cavity.

The portal vein is formed behind the head of the pancreatic gland from

inferior mesenteric vein

superior mesenteric vein

the splenic vein

The right renal vein goes obliquely from the bottom to the top. The portal vein goes
obliquely upwards and to the right between the descending part of the duodenum and to the head
of the pancreas. Behind the portal vein the inferior vena cava lies in the hepato — duodenal
ligament. The portal vein lies posteriorly between the bile duct and proper hepatic artery. In the
liver the portal vein is divided into left and right branches — left and right lobes of the liver
respectively. The right branch (r. dexter) is shoter and wider, then the left one. The left branch (r.
sinister) of the portal vein goes at first in the transversal sulcus of the liver (portal hepatis) and is
divided into smaller branches in quadrate and caudate lobes, then it goes into parenchyma of the
liver.

The left and right branches of the portal vein are divided into segmental branches, then they are
divided into smaller ones. Inter lobular veins inside the hepatic lobules are divided into wide
capillary vessels, so called sinusoids, which disembogue into the central vein lying in the center
of the hepatic lobule. From each lobule sublobular veins come out which interflow and form
larger veins and at last form 3 — 4 hepatic veins, which disembogue into the inferior vena cava.
As a result the blood coming into the inferior vena cava from portal vein goes through two
capillary nets, one in the region of influents of the portal vein and the second in the hepatic
lobules.

Superior mesenteric vein (v. mesenterica superior) is the largest branch of the portal vein,
which lies to the right from an artery of the same name in the fold of the radix mesenteri.

This vein gathers blood from the walls of mesenteric part of the small intestine, its
mesentery, mesenteric lymph nodes, caecum and appendix, ascending colons, from the part of
stomach, greater omentum, duodenum and pancreas. Into the superior mesenteric vein 16 — 20
jejunal and ileal (vv. Jejunales et ileales) veins, ileocolic vein (v. ileocolica), right and middle
colic veins (v. colica dextra et v. colica media), following the arteries of the same name
disembogue.

Often into the superior mesenteric vein the right gastroepiploic vein (v. gastroepiploica dextra),
lying along the greater curvature of the stomach is opened. Into the right gastroepiploic vein,
gastric veins from walls and fundus of the stomach and veins of greater omentum (epiploic
veins, vv. epiploicae) disembogue. Sometimes the right gastroepiploic vein disembogued into the
superior mesenteric vein together with one of the veins of the colic vein as a common trunk, the
so — called a gastrocolic vein. Into the gastrocolic vein or into the end part of the right
gastroepiploic the vein a superior anterior pancreatoduodenal vein is opened. The superior
posterior pancreatoduodenal vein (v. pancreaticoduodenalis superior posterior) disembogued
strait into the portal vein in the middle of the hepatoduodenal ligament. The inferior
pancreatoduodenal vein (v. pancreatoduodenalis inferior) goes between the head of the
pancreatic gland and duodenum and disembogues into the ending part of one of the jejunal veins
into the ileal vein. All pancreatoduodenal veins anastomose with each other.

The splenicvein

The splenic vein is formed as a result of interflow of the left gastroomental (v.
gastroomentalis sinistra) vein and veins of the pancreas (pancreatic veins, vv.
pancreaticae).

The splenic vein lies flat behind the body of pancreas a little lower than the splenic artery. The
end par of the splenic vein goes across the abdominal part of the aorta on a level between the
coeliac trunc and superior mesenteric artery. The left gastroomental vein lies near the artery of
the same name on the greater curvature of the stomach.

This vein gathers veins from the fundus of the stomach and from the left part of the greater
omentum. The veins of the pancreatic gland as short trunks disembogue into the splenic vein
along its length.

The inferior mesenteric vein (v. mesenterica inferior) goes upward till the level of the
duodenojejunal flexure, forming the left border of the inferior duodenal recess of the mesentery.
Then the inferior mesenteric vein makes a flexure to the right, lies behind the pancreas and pairs
with the superior mesenteric vein. Often the inferior mesenteric vein disembogues into the end
part of the splenic vein.
 The influents (tributaries) of the inferior mesenteric vein are the superior rectal
vein (v. rectalis superior), the left colic vein (v. colica sinistra), the sigmoid vein (v.
sygmoidea).

The right and left gastric veins, prepyloric, cystic and paraumbilical veins disembogue straright
into the portal vein before the porta hepatis. The gastric veins lie along the smaller curvature of
the stomach, sometimes they disembogue into the end part of the splenic vein, anatomosing with
esophageal veins, which are influents of azygos and hemiazygos veins. The prepyloric vein (v.
prepylorica) lies along the right gastric artery from the left to the right anastomosis with the left
and right gastric veins (vv. gastricae sinistra et dextra). The cystic vein (v. cystica) gathers blood
from the walls of the gallbladder. The paraumbilical veins (vv. paraumbilicales) in the number of
4 — 5 begin as thin trunks in the paraumbilical region and lie along the round ligament of the
liver. Sometimes the paraumbilical veins are opened into the remains of umbilical veins of the
fetus in the middle of the round ligament of the liver. The left paraumbilical vein often is linked
by a transversal anastomose with one of the right paraumbilical veins.

The paraumbilical veins in the region of the anterior abdominal wall anastomosis with
superior, inferior and superficial epigastric veins.

The system of portal vein of the liver.

Main
Sources and Locations of
inf1uents Regions of blood
Veins location of opening
Basic gathering
forming Wtere it falls
tributaries
1. Left
Splenic vein Fromintraorganic Spleen, region of Interflows behind
gastroepi-
fundus Bnrl
splenic veins in the ploic vein. the head of pancreas
poste-
hilum of the spleen 2. Short gastric rior wall of stom- with superior
veins ach, body and tail or mesenteric vein,
3. Pancreatic
of pancreas, left forming the portal
veins
half of the greater vein
onlentum
1. Illiocolic Small intestine
Superior From numerous Interflows with the
vein and
2. Right and
mesenteric vein veins of duode- its mesentery, splenic vein
midde
num, jejununl and colic veins cecum, ascending behind the head of
3. Right colon and the
Ileum in the middle the pancreas,
gastroepi- right
of mesenterium
ploic veins half of transverse forming the portal
and
 4.
from veins of the colon, appendix vein
Pancreatoduo-
head of pancreas. denal veins vermiformis, head
5. Pancreatic
and part of the
veins
body of the
pancre-
as, the right half
of
the body of stom-
ach and greater
omentum
1. Left colic
Inferior mesenteric From superior rec- Upper part of rec- Disembogues into
vein
2.Superior tum, sigmoid
vein tal and sigmoid splenic vein be-
rectal colon,
veins in the mesen- vein descending colon hind the hend of
3.Sigmoid and the left half
tery of the sigmoid pancreas (some-
veins of
colon transverse colon times disem-
bogues into thc
superior mesentcr-
ic vein)
Unpaired organs
Portal vein From the splenic, 1. Cystic vein Enters into the
of
2. the abdominal
(of the liver) superior and inferi- porta hepatis,
Paraumbilical cav-
ity (stomach,
or mesenteric veins veins where it disinte-
small
3. Right and
behind the head of and large intes- grates into capil-
left
pancreas. gastric veins tines, pancreas, lary vessels, form-
4. Prepyloric
spleen) ing the system of
vein
the portal vein,
from it hepatic
veins disembogu-
ing into inferior
vena cava are
formed

The intersystem venous anastomoses.

The veins the

Influents of which are The location of the
anastomosing Anastomosing veins anastomo
Superior vena cava, Superior epigastric Inferior epigastric vein In the depth of anterior
inferior vena cava vein (an influent of external thoracic wall
(an influent of internal iliac vein) and
thoracic vein) and tho- superficial
 racicoepigastric vein
(an vein (an influent of the
influent of the axillary femoral vein from the
vein from the system system of inferior vena
of cava)
superior vena cava)
Superior vena cava, Azygos vein, Right lumbar veins, left On the posterior wall of
inferior vena cava hemiazy- lumbar veins (the abdomen
gos vein (right and left system
ascending lumbar of inferior vena cava)
veins
from the system of su-
perior vena cava)
Superior vena cava, Spinal veins (influents
The spinal veins (influ-
inferior vena cava of posterior
ents of lumbar veins Inside the vertebral ca-
intercostals
from nal and around the ver-
veins from the system
the system of inferior tebral column
of
vena cava)
superior vena cava)
Superior vena cava, Superior epigastric Paraumbilical veins In the depth of anterior
portal vein vein (system of portal vein) abdominal wall
(an influent of the
inter-
nal thoracic vein from
the system of superior
vena cava)
Superior vena cava, Esophageal veins Left gastric vein (the In the cardial part of the
portal vein (influ- system of portal vein) stomach
ents of azygos vein
from
the system of superior
vena cava)
Inferior vena cava, portal Inferior epigastric Paraumbilical veins In the depth of anterior
vein vein (from the system of abdominal wall
(an influent of por-
external tal vein)
iliac vein from the
sys-
tem of inferior vena
cava)
Inferior vena cava, portal Middle rectal vein (an Superior rectal vein (an In the wall of rectum
vein tnfluent of internal influent of left
thac mesenter-
vein), inferior rectal ic vein from the system
vein of portal vein)
(an influent of internal
pudendal vein from
the
system of inferior
vena
cava)