Vessel that carries blood to the heart. Except for the pulmonary veins, veins bear deoxygenated blood from capillaries, which converge into threadlike venules and then veins, finally emptying into the venae cavae (see cardiovascular system; vena cava). Blood moves through veins by contraction of the surrounding muscles. Backflow is prevented by valves in most veins' inner layer (tunica intima), which lacks the elastic membrane lining of arteries. The thin middle layer (tunica media) is mostly collagen fibres, and the thick outer layer (tunica adventitia) is mostly connective tissue. Seealso circulation; varicose vein.
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Twisted vein distended with blood. Varix also covers arteries and lymphatic vessels (see lymphatic system). Varicose veins occur mostly in the legs, when malfunctioning valves let blood pool in veins near the skin. Causes include hereditary valve and vein wall weakness and internal or external pressure on veins. Varices are common in pregnancy, suggesting that hormone abnormalities play a role. Symptoms include a heavy feeling, with leg cramps and swelling after standing a long time. Complications include skin ulcers and thrombosis. Treatment involves strong support hose, injection therapy, or surgery. Varices in the esophagus, which often occur in liver disease, can ulcerate and bleed. Seealso hemorrhoid.
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In the circulatory system, a vein is a blood vessel that carries blood back toward the heart (as opposed to artery, a blood vessel carrying blood away from the heart). The majority of veins in the body carry low-oxygen blood from the tissues back to the heart; the exceptions being the pulmonary and umbilical veins which both carry oxygenated blood.
The return of blood to the heart is assisted by the action of the skeletal-muscle pump which helps maintain the extremely low blood pressure of the venous system. Fainting can be caused by failure of the skeletal-muscular pump. Long periods of standing can result in blood pooling in the legs, with blood pressure too low to return blood to the heart. Neurogenic and hypovolaemic shock can also cause fainting. In these cases the smooth muscles surrounding the veins become slack and the veins fill with the majority of the blood in the body, keeping blood away from the brain and causing unconsciousness.
The arteries are perceived as carrying oxygenated blood to the tissues, while veins carry deoxygenated blood back to the heart. This is true of the systemic circulation, by far the larger of the two circuits of blood in the body, which transports oxygen from the heart to the tissues of the body. However, in pulmonary circulation the arteries carry deoxygenated blood from the heart to the lungs and veins return blood from the lungs to the heart. The difference between veins and arteries is their direction of flow (out of the heart by arteries, returning to the heart for veins), not their oxygen content. In addition, deoxygenated blood that is carried from the tissues back to the heart for reoxygenation in systemic circulation still carries some oxygen, though it is considerably less than that carried by the systemic arteries or pulmonary veins.
Veins are used medically as points of access to the blood stream, permitting the withdrawal of blood specimens (venipuncture) for testing purposes, and intravenous delivery of fluid, electrolytes, nutrition, and medications through injection with a syringe, or by inserting a catheter. In contrast to arterial blood which is uniform throughout the body, the blood removed from veins for testing can vary in its contents depending on the part of the body the vein drains; blood drained from a working muscle will contain significantly less oxygen and glucose than blood drained from the liver. However the more blood from different veins mixes as it returns to the heart, the more homogeneous it becomes.
If an intravenous catheter has to be inserted, for most purposes this is done into a peripheral vein near the surface of the skin in the hand or arm, or less desirably, the leg. Some highly concentrated fluids or irritating medications must flow into the large central veins, which are sometimes used when peripheral access cannot be obtained. Catheters can be threaded into the superior vena cava for these uses: if long term use is thought to be needed, a more permanent access point can be inserted surgically.
The pulmonary veins carry relatively oxygenated blood from the lungs to the heart. The superior and inferior venae cavae carry relatively deoxygenated blood from the upper and lower systemic circulations, respectively.
List of important named veins
Names of important venule systems