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vein

vein

[veyn]
vein, blood vessel that returns blood to the heart. Except for the pulmonary vein, which carries oxygenated blood from the lungs to the heart, veins carry deoxygenated blood. The oxygen-depleted blood passes from the capillaries to the venules (small veins). The venules feed into larger veins, which eventually merge into the superior and inferior vena cavae, large vessels that consolidate the blood flow from the head, neck, and arms and from the trunk and legs, respectively (see also circulatory system). The vena cavae direct the blood back into the heart. The walls of a vein are formed of three layers like the walls of an artery. However, these layers are thinner and less muscular and collapse when empty. With such notable exceptions as the portal system, most veins contain valves, formed by pouches in their inner coats, that keep the blood from flowing backward. Valves are most numerous in the veins of the extremities, and are absent in the smallest veins. Veins are subject to inflammation, dilatation or enlargement (as in a varicose vein), rupture, and blockage by blood clots (thrombosis).

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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or varix

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.

Anatomy

Veins function to return deoxygenated blood to the heart, and are essentially tubes that collapse when their lumens are not filled with blood. The thick, outer-most layer of a vein is made of collagen, wrapped in bands of smooth muscle while the interior is lined with endothelial cells called intima. Most veins have one-way flaps called venous valves that prevent blood from flowing back and pooling in the lower extremities due to the effects of gravity. The precise location of veins is much more variable from person to person than that of arteries. Veins are located on close to the surface, mean while arteries are located towards the center of the body.

Function

Veins serve to return blood from organs to the heart. In systemic circulation oxygenated blood is pumped by the left ventricle through the arteries to the muscles and organs of the body, where its nutrients and gases are exchanged at capillaries, entering the veins filled with cellular waste and carbon dioxide. The de-oxygenated blood is taken by veins to the right atrium of the heart, which transfers the blood to the right ventricle, where it is then pumped through the pulmonary arteries to the lungs. In pulmonary circulation the pulmonary veins return oxygenated blood from the lungs to the left atrium, which empties into the left ventricle, completing the cycle of blood circulation.

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.

In a functional analogy, the term "venous" in economics refers to recycling industries, in contrast to "arterial" or production industries.

Medical interest

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.

Common diseases

The most common vein disorder is venous insufficiency, usually manifested by spider veins or varicose veins. A variety of treatments are used depending on the patient's particular type and pattern of veins and on the physician's preferences. Treatment can include radio-frequency ablation, vein stripping, ambulatory phlebectomy, foam sclerotherapy, lasers or compression.

Deep vein thrombosis

Deep vein thrombosis is a condition where a blood clot forms in a deep vein, which can lead to pulmonary embolism and chronic venous insufficiency.

Phlebology

Phlebology is the medical discipline that involves the diagnosis and treatment of disorders of venous origin. Diagnostic techniques used include the history and physical examination, venous imaging techniques and laboratory evaluation related to venous thromboembolism. The American Medical Association has added phlebology to their list of Self-Designated Practice Specialties. The American College of Phlebology is a professional organization of physicians and health care professionals from a variety of backgrounds. ACP Meetings are conducted to facilitate learning and sharing of knowledge regarding venous disease. The equivalent body for countries in the Pacific is the Australasian College of Phlebology, active in Australia and New Zealand.

Notable veins and vein systems

The Greater Saphenous vein (GSV) is the most important superficial vein of the lower limb. First described by the Persian physician Avicenna, Saphenous derives its name from Safina, meaning hidden. This vein is 'hidden' in its own fascial compartment in the thigh and only exits the fascia near the knee. Incompetence of this vein is an important cause of varicose veins of lower limbs.

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.

A portal venous system is a series of veins or venules that directly connect two capillary beds. Examples of such systems include the hepatic portal vein and hypophyseal portal system.

Color

The blood carried by veins is dark red due to its high percentage of CO2 as it returns to the heart (in contrast to the high levels of O2 in arterial blood, which is bright red). Veins appear blue because the subcutaneous fat in the skin absorbs lower-frequency light, permitting only the highly energetic blue wavelengths to penetrate through to the dark vein and reflect off. This physical effect is also present in the iris of blue eyes (pigmentless iris in the front, dark retina in the back) and is called Rayleigh scattering.

Types of veins

Veins can be classified into:

List of important named veins

Names of important venule systems

See also

References

External links

Scientific publications

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