English for doctors. Veins (most important)

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English for doctors. Veins (most important)

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25. Veins

Veins are low-pressure vessels that have larger lumina and thinner walls than arteries. In general, veins have more collagenous connective tissue and less muscle and elastic tissue than their arterial coun terparts. Although the walls of veins usually exhibit the three layers, they are much less distinct than those of the arter ies. Unlike arteries, veins contain one-way valves composed of extensions of the intima that prevent reflux of blood away from the heart. Veins can be divided into small veins or venules, medium veins, and large veins.

Venules are the smallest veins, ranging in diameter from approxi mately 15-20 mm (post-capillary venules) up to 1-2 mm (small veins). The walls of the smaller of these are structurally and functionally like those of the capillaries; they consist of an endothelium surrounded by delicate collagen fibers and some pericytes. In those vessels of increased diameter, circularly arranged smooth muscle cells occur surrounding the intima layer, but unlike in the small arteries, these cells are loosely woven and widely spaced. Venules are important in inflammation because their endothelial cells are sensitive to histamine released by local mast cells. This causes endotheli-al cells to contract and separate from each other, exposing a naked basement membrane. Neutrophils stick to the exposed collagen and extravasate (ie, move out into the connective tissue). Histamine also causes local arterioles to relax, affect ing a rise in venous pressure and increased leaking of fluid. This produces the classic signs of inflammation: redness, heat, and swelling.

Medium veins in the range of 1-9 mm in diameter have a well-developed intima, a media consisting of connective tissue and loosely organized smooth muscle, and an adventitia (usually the thickest layer) composed of collagen bundles, elastic fibers, and smooth muscle cells oriented along the longitudinal axis of the vessel. Venous valves are sheet-like outfoldings of endothelium and underlying connective tissue that form flaps to permit uni-directional flow of blood.

Large veins, such as the external iliac, hepatic portal, and vena cavae, are the major conduits of return towards the heart. The intima is similar to that of medium veins. Although a network of elastic fibers may occur at the boundary between the intima and media, a typical internal elastic membrane as seen in arteries is not present. A tunica media may or may not be present. If pre sent, smooth muscle cells are most often circularly arranged. The ad-ventitia is the thickest layer of the wall and consists of elastic fibers and longitudinal bundles of collagen. In the vena cava, this layer also contains well-developed bundles of longitudinally oriented smooth muscle.

new words

vein - vein

low-pressure - low pressure

collagenous - collagenous

intima - intimate

reflux - reflux

inflammation - inflammation

longitudinal - longitudinal

flaps

iliac - iliac

hepatic - hepatic

Author: Elena Belikova

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