Two types of perforating vein can be distinguished below the popliteal fossa: Perforating veins not related to intramuscular veins: they directly connect superficial veins with deep intermuscular veins (anterior or posterior tibial veins, peroneal veins, and tibioperoneal trunk) (Figure 97); Perforating veins connected to intrainuscular veins: they connect superficial veins with gastrocnemius or soleus veins (Figure 98)and often have multiple branches. connecting superficial, intermuscular. and intramuscular networks. There are also transgastrocnemius perforating veins of the soleus muscle, which connect a…
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At this level, the perforating veins usually ensure communication with the profunda femoris network. Exploration of the short saphenous vein, even using a simple pocket Doppler frequently detects reflux above the saphenopopliteal junction, extending onto the posterior surface of the thigh. The ultrasonographer will then be faced with two types of situation: just before it starts to curve, the saphenopopliteal junction gives rise to an overlying trunk (Figure 94). This vessel, initially suprafascial, gradually leaves the superficial plane to join…
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Perforating veins corresponding to the short saphenous territory are situated in a zone between the posterolateral surface of the thigh and the bimalleolar line, which passes underneath the medial and lateral malleoli and separates the territory of perforating veins of the foot from that of the perforating veins of the ankle. Some anatomical landmarks will help define their topography: the popliteal crease (in the center of the popliteal fossa); the cutaneous projection of the soleus muscle arch (4 fingerbreadths below…
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It might seem surprising to study the perforating veins before describing the veins of the long saphenous territory, but this approach is based on comparison of anatomical and functional data. It is therefore, logical to present the perforating veins just after studying the saphenofemoral junction, which actually corresponds to the most proximally situated principal perforating vein. As their name suggests, perforating veins, which ensure communication between superficial veins and the deep network, perforate the muscular aponeurosis. Just like the saphenous…
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Transverse sections are necessary in the thigh because of the superimposition of superficial veins. This problem no longer applies in the leg, as the subcutaneous tissues are thinner. On the other hand, the various networks form complex anastomoses and hemodynamic circuits in a single plane. The surface anatomy of these veins can therefore be easily studied with the patient standing. Perforating veins of the knee and leg are presumed to be involved in the pathogenesis of varicose veins to such…
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The femoral region is characterized by the presence of one or several perforating veins within the adductor canal. These veins, usually called Dodd’s perforators, connect the long saphenous trunkr or one of its tributaries with the femoral vein. Figure 61A Perforating veins of the adductor canal (Dodd’s perforators). Vastus medialis muscle Aponeurosis Sartorius muscle Long saphenous vein Femoral artery Saphenous nerve Femoral vein Gracilis muscle Adductor magnus muscle Figure 61B Perforating veins of the adductor canal (Dodd’s perforators). Vastus medialis…
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A transverse section of the inguinal region (Figure 60-A) reveals, from lateral to medial: the sartorius muscle (M. sartorius), the femoral artery just before giving rise to the arteria profunda femoris, the femoral vein, the termination of the long saphenous vein inside its aponeurotic sheath, and f nally, the adductor longus muscle (M. adductor longus ). The ultrasonographic appearance is typical at this level (Figure 60-B). On transverse sections, with the transducer placed along the inguinal fold, a “Mickey Mouse”…
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Rather than describing a perforating vein whose situation is not always as precise and as constant as that described by the author after whom it is named,. it is preferable to define groups of perforating veins (Figures 57 and 58). In general, only one structure of these groups of veins will become pathologically enlarged. Figure 57 Main groups of perforating veins. proximal terminal perforating veins perineal perforating veins distal terminal perforating veins Dodd’s perforating veins or perforating veins of the…
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Under physiological conditions, 90% of venous blood returns to the heart via deep veins and 10% via superficial veins. This venous return is ensured by several pumps, the most important being diaphragmatic inspiration for the femorocaval system and the valvulomuscular pump in the calf. A continuously modified equilibrium is established at rest between the forces which generate venous return and those which oppose venous return (Figure 50). The most constant factor opposing venous return is hydrostatic pressure related to gravity….
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