Thermal Physiology and Thermoregulation
James Stewart Campbell, M. Nathaniel Mead in Human Medical Thermography, 2023
In the feet, non-exercise glomus dilation appears less often and less intense than in the hands (Figure 5.12a). The foot veins, while initially located in the subdermal fat over the metatarsals and tarsals, dive deep at the ankle to accompany the anterior tibial artery. This deep venous system is invisible to infrared imaging until reaching the groin. The subdermal great saphenous vein progresses up the medial leg from just in front of the medial malleolus of the ankle to the groin, where it meets the larger femoral vein. The small saphenous vein starts behind the lateral malleolus of the ankle and runs subdermally up the back of the leg to the knee. Both saphenous veins may be seen by infrared occasionally, and these veins frequently generate varicosities that are thermally visible, smaller superficial leg veins may also become varicose (Figure 5.12b).
Pre-, intra-, and post-treatment use of duplex ultrasound (thermal and non-thermal)
Joseph A. Zygmunt in Venous Ultrasound, 2020
Once you have progressed past the basic vein map concept as noted previously, a more advanced mapping process will reveal and document more information that will be invaluable for the treatment process. When scanning any saphenous vein, first focus only on the saphenous vein in its compartment. Realize that several diameter measurements are required along the course of the vein, and this is the first clue to pathology. A simple example of how to draw a vein map is broken down here going from ultrasound image to vein map. A saphenous vein that changes size dramatically is an indication of reflux entering or leaving the vein. Figure 9.3 shows the GSV (a) in the upper thigh and (b) at the knee. Note how there is a significant change in the diameter of the GSV. This indicates that reflux has left the compartment, since the GSV is smaller.
Management of the Surgical Complications of Penile Carcinoma
Kevin R. Loughlin in Complications of Urologic Surgery and Practice, 2007
The procedure starts with a bilateral pelvic lymphadenectomy, as is done for prostate cancer. After the pelvic nodes have been removed, vertical incisions are made over the femoral triangles up to the inguinal creases. A Scott ring retractor with disposable skin hooks facilitates exposure and minimizes the handling of the skin edges (5). The saphenous vein is utilized as a landmark and is dissected down to the femoral vein. In cases of bulky nodes, the saphenous vein almost always needs to be divided, whereas in cases of nonpalpable nodes, the saphenous vein can often be spared. Many surgeons feel that sparing the saphenous vein may minimize the risk of postoperative lymphedema.
Sentinel lymph node biopsy based on anatomical landmarks and locoregional mapping of inguinofemoral sentinel lymph nodes in women with vulval cancer: an operative technique
Published in Journal of Obstetrics and Gynaecology, 2023
Fong Lien Kwong, Miski Scerif, Jason KW Yap
Surgical technique: We start by identifying the anterior superior iliac spine and pubic tubercle to map the course of the inguinal ligament. We then palpate the femoral artery to identify its location and a handheld Doppler may be used in obese women. Situated on its medial side in the femoral triangle is the femoral vein and the latter is joined on its medial side by the saphenous vein at the saphenofemoral junction. We make a 3-4cm incision inferior to and parallel to the inguinal ligament. The incision extends over the femoral vein and slightly above the saphenous vein (Figure 1). Radiolocalisation of the SLN was achieved after identifying and excising the node with the highest signal count using a handheld gamma counter. The groin was re-examined and dissection continued until there was no residual radioactivity. All histological specimens were analysed using ultrastaging with immunohistochemistry. Ipsilateral unilateral inguinal SLN biopsies were conducted for lateral tumour and bilateral excisions for central tumours. The long saphenous vein was preserved in all cases.
Clipping inguinal lymphatics decreases lymphorrhoea after lymphadenectomy following cancer treatment: results from a randomized clinical trial
Published in Scandinavian Journal of Urology, 2021
Palaniappan Ravisankar, Kanuj Malik, Anand Raja, Kathiresan Narayanaswamy
The standard inguinal lymph node dissection was performed as described below. Briefly, an 8- to 14-cm lazy-S incision was made, 3–4 cm below the groin crease. After the incision, the skin flaps were raised to the level of the Scarpa fascia using electrocautery, which was also used to seal any visible leaking lymphatic vessels. The boundaries of the dissection of lymphatic tissue were the inguinal ligament superiorly, the sartorius muscle laterally, the adductor longus muscle medially, and the apex of femoral triangle inferiorly. The floor of the dissection was the femoral vessels and the pectineus, with the superficial and deep nodes removed. The saphenous vein inside the femoral triangle was ligated and dissected. The sartorius muscle transposition was done to cover the exposed femoral vessels.
Numerical study of hemodynamics in a complete coronary bypass with venous and arterial grafts and different degrees of stenosis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Shila Alizadehghobadi, Hasan Biglari, Hanieh Niroomand-Oscuii, Meisam H. Matin
A three dimensional coronary bypass model is considered to investigate the effect of the graft material on the hemodynamics of the coronary bypass. Two different grafts are considered with the properties of saphenous vein and thoracic artery. The schematic of the geometry along with the dimensions are represented in Figure 1. The artery and vein are modeled as a single layer tissue and the geometry is generated using SOLIDWORKS software. Since the flow in each part of the arteries is axisymmetric, one half of the geometry is drawn in order to be more efficient in terms of CPU time and data saving. Solving this problem requires a coupled fluid-structural analysis of the blood-vessel system that takes into consideration the interfacial interaction between the thoracic artery (or saphenous vein) wall and the blood. The blood is assumed to behave like a Newtonian fluid with constant properties and be at the same temperature as the vessel and hence the flow is isothermal. Since the Reynolds number is in the laminar range (Re < 2300) the incompressible Navier-Stokes equations are governing the blood flow:
Related Knowledge Centers
- Malleolus
- Palpation
- Superficial Vein
- Thigh
- Leg
- Foot
- Deep Femoral Vein
- Femoral Triangle
- Toe
- Dorsal Venous Arch of The Foot