Жүрекке қан тасымалдайтын тамырлар

Blood vessels that carry blood towards the heart

Veins (/v//eɪ//n/) are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation, arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins. There are three sizes of veins: large, medium, and small. Smaller veins are called venules, and the smallest the post capillary venules are microscopic that make up the veins of the microcirculation. Veins are often closer to the skin than arteries. Veins have less smooth muscle and connective tissue and wider internal diameters than arteries. Because of their thinner walls and wider lumens they are able to expand and hold more blood. This greater capacity gives them the term of capacitance vessels. At any time, nearly 70% of the total volume of blood in the human body is in the veins. In medium and large sized veins the flow of blood is maintained by one way (unidirectional) venous valves to prevent backflow. Veins close to the surface of the skin appear blue for a variety of reasons. The factors that contribute to this alteration of color perception are related to the light scattering properties of the skin and the processing of visual input by the visual cortex, rather than the actual colour of the venous blood which is dark red.

The three layers of the vein wall are the outer tunica externa, the middle tunica media and the inner tunica intima. There are also numerous valves present in many of the veins. The outer tunica externa, also known as the tunica adventitia is a sheath of thick connective tissue. This layer is absent in the post capillary venules. The inner tunica intima is a lining of endothelium comprising a single layer of extremely flattened epithelial cells, supported by delicate connective tissue. This subendothelium is a thin but variable connective tissue. The tunica intima has the most variation in blood vessels, in terms of their wall thickness and relative size of their lumen. The endothelial cells continuously produce nitric oxide a soluble gas, to the cells of the adjacent smooth muscle layer. This constant synthesis is carried out by the enzyme endothelial nitric oxide synthase (eNOS). Other endothelial secretions are endothelin, and thromboxane (vasoconstrictors), and prostacyclin a vasodilator.

The development of the embryo is completely reliant on the vitelline circulation, the bidirectional flow of blood between the yolk sac and the embryo. The yolk sac is the first extraembryonic structure to appear. This circulation is critical in allowing the exchange of nutrients, prior to the full development of the placenta. By day 17 vessels begin to form in the yolk sac, arising from the splanchnic mesoderm of the yolk sac wall. The capillaries are formed during vasculogenesis, and they lengthen and interconnect to form an extensive primitive vascular network. Blood is supplied from the primitive aorta, and drained by vitelline veins from the yolk sac to the embryo. By the end of the third week the yolk sac, connecting stalk, and chorionic villi are entirely vascularised.

In the systemic circulation, veins serve to return oxygen depleted blood from organs, and tissues to the right heart. From here it passes to the pulmonary arteries for the pulmonary circulation to return oxygen rich blood to the left heart in the pulmonary veins, to be pumped back into the systemic circulation to complete the cycle. Veins have thinner walls than arteries, and a wider diameter that allow them to expand and hold a greater volume of blood. This gives them a functional role of capacitance that makes possible the accommodation of different pressures in the system. The venous system apart from the post capillary venules is a high volume, low pressure system. Vascular smooth muscle cells control the size of the vein lumens, and thereby help to regulate blood pressure. The medical speciality involved with the diagnosis and treatment of venous disorders is known as phlebology (also venology), and the specialist concerned is a phlebologist. There are a number of vascular surgeries and endovascular surgeries carried out by vascular surgeons to treat many venous diseases.

Venous insufficiency is the most common disorder of the venous system, and is usually manifested as either spider veins or varicose veins. Several treatments are available including endovenous thermal ablation (using radiofrequency or laser energy), vein stripping, ambulatory phlebectomy, foam sclerotherapy, laser, or compression. Postphlebitic syndrome is venous insufficiency that develops following deep vein thrombosis.

Venous thrombosis is the formation of a thrombus (blood clot) in a vein. This most commonly affects a deep vein known as deep vein thrombosis (DVT), but can also affect a superficial vein known as superficial vein thrombosis (SVT).

DVT usually occurs in the veins of the legs, although it can also occur in the deep veins of the arms. Immobility, active cancer, obesity, traumatic damage and congenital disorders that make clots more likely are all risk factors for deep vein thrombosis. It can cause the affected limb to swell, and cause pain and an overlying skin rash. In the worst case, a deep vein thrombosis can extend, or a part of a clot can break off as an embolus and lodge in a pulmonary artery in the lungs, known as a pulmonary embolism. The decision to treat deep vein thrombosis depends on its size, symptoms, and their risk factors. It generally involves anticoagulation to prevents clots or to reduce the size of the clot. Intermittent pneumatic compression is a method used to improve venous circulation in cases of edema or in those at risk from a deep vein thrombosis.

SVT is the development of a thrombus in a superficial vein. SVT is not normally clinically significant, but the thrombus can migrate into the deep venous system where it can also give rise to a pulmonary embolism. The main risk factor for SVT in the lower limbs is varicose veins.

Some disorders as syndromes result from compression of a vein. These include a venous type of thoracic outlet syndrome, due to compression of a subclavian vein; nutcracker syndrome most usually due to compression of the left renal vein, and May–Thurner syndrome associated with compression of the iliac vein which can lead to iliofemoral DVT. Compression of the superior vena cava most usually by a malignant tumor can lead to superior vena cava syndrome.

A vascular anomaly can be either a vascular tumor or a birthmark, or a vascular malformation. In a tumor such as infantile hemangioma the mass is soft, and easily compressed, and their coloring is due to the dilated anomalous involved veins. They are most commonly found in the head and neck. Venous malformations are the type of vascular malformation that involves the veins. They can often extend deeper from their surface appearance, reaching underlying muscle or bone. In the neck they may extend into the lining of the mouth cavity or into the salivary glands. A severe venous malformation can involve the lymph vessels as a lymphaticovenous malformation. Venography is an invasive procedure that uses a catheter to deliver a contrast agent in giving an X ray of veins. An augmented reality healthcare application is a near infrared vein finder that films subcutaneous veins, and projects their image either onto a screen or onto the person's skin.

Some imaging techniques using veins have been developed for identification purposes. These vein matching technologies, include finger vein recognition, and eye vein verification.

The Greek physician Herophilus (born 335 BC) distinguished veins from arteries, noting the thicker walls of arteries, but thought that the pulse was a property of arteries themselves. Greek anatomist Erasistratus observed that arteries that were cut during life bleed. He ascribed the fact to the phenomenon that air escaping from an artery is replaced with blood that entered by very small vessels between veins and arteries. Thus he apparently postulated capillaries but with reversed flow of blood. In 2nd century AD Rome, the Greek physician Galen knew that blood vessels carried blood and identified venous (dark red) and arterial (brighter and thinner) blood, each with distinct and separate functions. Growth and energy were derived from venous blood created in the liver from chyle, while arterial blood gave vitality by containing pneuma (air) and originated in the heart. Blood flowed from both creating organs to all parts of the body where it was consumed and there was no return of blood to the heart or liver. The heart did not pump blood around, the heart's motion sucked blood in during diastole and the blood moved by the pulsation of the arteries themselves. Galen believed that the arterial blood was created by venous blood passing from the left ventricle to the right by passing through 'pores' in the interventricular septum, air passed from the lungs via the pulmonary artery to the left side of the heart. As the arterial blood was created 'sooty' vapors were created and passed to the lungs also via the pulmonary artery to be exhaled. In addition, Ibn al Nafis had an insight into what would become a larger theory of the capillary circulation. He stated that "there must be small communications or pores (manafidh in Arabic) between the pulmonary artery and vein," a prediction that preceded the discovery of the capillary system by more than 400 years. Ibn al Nafis' theory, however, was confined to blood transit in the lungs and did not extend to the entire body. Finally, William Harvey, a pupil of Hieronymus Fabricius (who had earlier described the valves of the veins without recognizing their function), performed a sequence of experiments, and published Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus in 1628, which "demonstrated that there had to be a direct connection between the venous and arterial systems throughout the body, and not just the lungs. Most importantly, he argued that the beat of the heart produced a continuous circulation of blood through minute connections at the extremities of the body. This is a conceptual leap that was quite different from Ibn al Nafis' refinement of the anatomy and bloodflow in the heart and lungs." This work, with its essentially correct exposition, slowly convinced the medical world. However, Harvey was not able to identify the capillary system connecting arteries and veins; these were later discovered by Marcello Malpighi in 1661.