Portal Vein

Portal venous system (PVS) drains blood from the gastrointestinal tract (apart
from the lower section of rectum), spleen, pancreas, and gallbladder to the liver.

The portal vein (PV) is the main vessel of the PVS, resulting from the confluence
of the splenic and superior mesenteric veins, and drains directly into the liver,
contributing to approximately 75% of its blood flow [1]. Hepatic artery provides
the remaining hepatic blood flow. Once in the liver, PV ramifies and reaches the
sinusoids, with downstream blood being directed to the central vein at the
hepatic lobule level, then to the hepatic veins and inferior vena cava (IVC) to
reach the systemic venous system.

Porto-systemic anastomosis
also known as portocaval anastomosis is the collateral communication
between the portal and the systemic venous system. The portal venous
system transmits deoxygenated blood from most of the gastrointestinal
tract and gastrointestinal organs to the liver. 
When there is a blockage of the portal system, portocaval anastomosis
enable the blood to still reach the systemic venous circulation. Even
though this is useful, bypassing the liver may be dangerous, since it is
the main organ in charge for detoxication and breaking down of
substances found in the gastrointestinal tract, such as mediactions but
the poisons as well.
Portal vein

The portal vein is the most important vein in the portal venous system;
it starts its formation close to the level of the second lumbar
vertebrae (L2) and it is located in front (anterior) of the inferior vena
cava and at the back (posterior) of the neck of the pancreas. It is about
8cm long.

The portal vein is formed by the joining of the superior mesenteric

vein and the splenic vein. It runs upwards and lies behind the bile
duct and hepatic artery and it also lies anterior to the inferior vena cava.
It penetrates in the right border of the lesser omentum and continues
upwards in front (anterior) of the epiploic foramen to reach the porta
hepatis (transverse fissure on the liver). After it reaches the porta
hepatis, it bifurcates into a right and left branch which penetrates the
liver.
Hepatic portal vein

Vena portae hepatis

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Synonyms: none

Various veins drain into the portal vein. These veins are:

 superior mesenteric vein: drains blood mainly from small intestine

 splenic vein: receives blood from short gastric, left gastroepiploic,
inferior mesenteric, and pancreatic veins
 right and left gastric veins: drain blood from
the stomach and oesophagus
 superior pancreaticoduodenal veins: drain blood from the pancreas and
duodenum
 cystic veins: drain blood from the gallbladder and the paraumbilical vein
From the portal vein, the blood is drained into the left and right
branches of the portal vein into the left and right side of the liver. Inside
the liver it passes through tiny capillary beds called venous sinusoids of
the liver and finally into the hepatic vein which transmits the blood into
the inferior vena cava (carries deoxygenated blood to the heart).

Hepatic portal systemExplore study unit

Anastomoses

The importance of portosystemic anastomoses is to provide alternative

routes of circulation when there is a blockage in the liver or portal vein.
These routes ensure that venous blood from the gastrointestinal tract
still reaches the heart through the inferior vena cava without going
through the liver.

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The various anastomoses and the sites in which they occur are described
below:
Left gastric vein

Vena gastrica sinistra

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Synonyms: none

 The anastomosis between the left gastric veins, which are portal veins,

and the lower branches of oesophageal veins that drain into
the azygos and hemiazygos veins, which are systemic veins. The site of
this anastomosis is the lower oesophagus.
 The anastomosis between the superior rectal veins, which are portal
veins, and the inferior and middle rectal veins, which are systemic veins.
The site of this anastomosis is the upper part of the anal canal.
 The anastomosis between the paraumbilical veins, which run in the
ligamentum teres as portal veins, and small epigastric veins, which are
systemic veins. The site of this anastomosis is the umbilicus.
 The anastomosis between the intraparenchymal branches of the right
division of the portal vein and retroperitoneal veins (systemic veins)
that drain into the azygos, hemiazygos and lumbar veins (systemic
veins). The site of this anastomosis is the bare area of the liver.
 The anastomosis between omental and colonic veins (portal veins) with
the retroperitoneal veins (systemic veins) in the region of hepatic and
splenic flexure.
 Another anastomosis is between the ductus venosus (portal vein) and
the inferior vena cava (systemic vein). This is very rare and at the site of
patent ductus venosus.

Great Spahenous Vein

What is the saphenous vein?

Your saphenous veins are blood vessels in your legs that help send blood
from your legs and feet back up to your heart. You have two saphenous
veins in each of your legs. They’re called your great saphenous vein and
small saphenous vein. Your great saphenous vein is also called your long
saphenous vein, and it’s the longest vein in your body, traveling between
your foot and the top of your thigh

Where is the saphenous vein located?

Your saphenous veins are superficial veins located in your legs. Superficial
veins are closer to your skin’s surface, compared with deep veins (which
are deep inside your body). Your great saphenous vein extends from your
foot to your upper thigh. Your small saphenous vein extends from your
foot to the back of your knee.

What is the anatomy of the saphenous vein?

Your great saphenous vein and small saphenous vein both begin on the
top of your foot. They extend from the dorsal venous arch of the foot,
which is a series of small veins that bring blood from your foot toward your
saphenous vein. Your great saphenous vein begins on the medial end of
this vein, or the end that’s closer to the middle of your body.

From there, your great saphenous vein travels upward along the inner
surface of your leg. Along the way, other veins drain into your great
saphenous vein. The great saphenous vein course ends in your upper
thigh. That’s where your great saphenous vein empties into a deep vein
called your femoral vein.

Your small saphenous vein begins on the lateral end of the dorsal venous
arch of the foot. This is the end that’s closer to the outer edge of your foot.
From there, your small saphenous vein travels up the back of your calf and
ends behind your knee. It drains into your popliteal vein. This is a deep vein
that carries blood to your femoral vein.

The walls of your saphenous veins are made of three layers of tissue:

 The tunica adventitia (outer layer) gives structure and shape to your

vein.
 The tunica media (middle layer) contains smooth muscle cells.
These cells allow your vein to get wider (dilate) or narrower
(constrict) as blood flows through.
 The tunica intima (inner layer) has a lining of smooth endothelial
cells. These cells allow blood to move easily through your vein.

Dural Venous Sinuses

Dural venous sinuses are a group of sinuses or blood channels that
drains venous blood circulating from the cranial cavity. It collectively
returns deoxygenated blood from the head to the heart to maintain
systemic circulation. There are seven major dural venous sinuses located
within the cranial cavity, specifically between the periosteal and
meningeal layer of the dura mater: superior sagittal, inferior sagittal,
straight, transverse, sigmoid, cavernous, and superior petrosal sinuses.
Most of these sinuses are found adjacent to the falx cerebri and
tentorium cerebelli. The cavernous sinus is clinically the most important
dural venous sinus. Characteristic structures of venous sinuses are vital
to physicians and healthcare providers, especially in cases of possible
thrombosis and infection.

Structure and Function

The primary function of the dural venous sinuses is to drain all venous
blood within the cranial cavity and deliver it back to the cardiovascular
circulation via the internal jugular vein below the jugular foramen, which
will further drain into the superior vena cava before reaching the heart.
Aside from draining venous blood, superior sagittal sinus also
participates in the cerebrospinal fluid (CSF) circulation by serving as the
main location for CSF return after passing through arachnoid
granulations.