Veins - Anatomy and Pathophysiology

Definition

Veins are blood vessels that carry deoxygenated blood back to the heart.

Anatomy

• Veins are composed of three layers: tunica intima, tunica media, and tunica externa.
• They have one-way valves to prevent backflow of blood.
• Veins are divided into superficial and deep veins.
• Superficial veins are located just beneath the skin and are more prone to varicose veins.
• Deep veins are located deeper in the body and are more prone to thrombosis.

Types of Veins

• Superficial veins: subcutaneous veins that are close to the surface of the skin.
• Deep veins: located deeper in the body and are involved in the return of blood to the heart.
• Perforating veins: connect superficial and deep veins.
• Venous sinus: a group of veins in the brain that drain blood from the brain.

Pathophysiology

• Venous diseases occur due to obstruction or stenosis of veins.
• Obstruction can be due to thrombosis or external compression.
• Stenosis can be due to atherosclerosis or external compression.
• Venous valve failure can lead to varicose veins and chronic venous insufficiency.

Causes of Venous Diseases

• Thrombosis: formation of blood clots in veins.
• Atherosclerosis: narrowing of veins due to plaque buildup.
• External compression: compression of veins by external structures such as tumors or hernias.
• Venous valve failure: failure of venous valves to prevent backflow of blood.

Clinical Features

• Varicose veins: enlargement of superficial veins.
• Chronic venous insufficiency: failure of venous valves to prevent backflow of blood.
• Deep vein thrombosis: formation of blood clots in deep veins.
• Post-thrombotic syndrome: pain and swelling in the leg after deep vein thrombosis.

Investigations

• Ultrasound: to diagnose deep vein thrombosis and varicose veins.
• Duplex ultrasound: to diagnose venous valve failure.
• Venography: to diagnose venous obstruction.
• Blood tests: to diagnose thrombophilia.

Complications

• Deep vein thrombosis: can lead to pulmonary embolism.
• Varicose veins: can lead to chronic venous insufficiency.
• Chronic venous insufficiency: can lead to skin ulcers and gangrene.

Management

• Anticoagulation: to prevent further clot formation.
• Compression stockings: to improve venous return.
• Surgery: to remove thrombi or repair damaged veins.
• Endovenous ablation: to close off damaged veins.

Treatment

• Anticoagulation: to prevent further clot formation.
• Thrombolysis: to dissolve blood clots.
• Venous stenting: to repair damaged veins.
• Surgical removal of thrombi: to remove blood clots.

Homoeopathic Therapeutic Medicines

• Arnica: to treat varicose veins and chronic venous insufficiency.
• Hamamelis: to treat varicose veins and chronic venous insufficiency.
• Graphites: to treat skin ulcers and gangrene.
• Calcarea carbonica: to treat chronic venous insufficiency and varicose veins.

MUHS Relevant Points

• Deep vein thrombosis is a common cause of venous disease.
• Varicose veins are a common cause of chronic venous insufficiency.
• Anticoagulation is a common treatment for venous disease.
• Surgery is a common treatment for deep vein thrombosis.
• Homoeopathic medicines are used to treat venous disease.