A text-book of veterinary anatomy

The anterior tibial artery (A. tibialis anterior) is much the larger of the two terminal branches of the popliteal. It passes forward through the upper part of the interosseous space and descends with two satellite veins on the outer part, of the front of the tibia, under cover of the tibialis anterior. At the lower part of the leg it deviates to the outer border of the tendon of this muscle, passes on to the capsule of the hock joint, gives off the perforating tarsal artery, and is continued as the great metatarsal artery. It gives off muscular branches to the dorso-lateral group of muscles of the leg and articular branches to the hock. The peroneal branch (A. peronea) is a variable vessel which descends along the fibula under the lateral extensor; it gives off muscular branches and one which perforates the fascia and divides into ascending and descending cutaneous twigs.

The perforating tarsal artery (A. tarsea perforans) is given off under cover of the outer tendon of the peroneus tertius. It passes backward through the vascular canal of the tarsus with a satellite vein and unites on the upper part of the suspensory ligament with the plantar arteries (or only with the external plantar) to form the plantar arch.

In well-injected specimens it is seen that there is a fine arterial network (Rete tarsi dorsale) on the flexor surface of the hock, which is formed by twigs from the anterior tibial and lateral tarsal arteries. From it proceed two very slender dorsal metatarsal arteries. The inner one descends in the furrow between the inner small and large metatarsal bones, and anastomoses usually in the proximal part of the metatarsus with the internal superficial plantar metatarsal, uniting sometimes with the deep plantar metatarsal. The external vessel passes down under the periosteum on the anterior face of the large metatarsal bone and becomes lost or joins the large metatarsal artery.

Sometimes the anterior tibial artery passes undivided through the tarsus, gives off the internal deep plantar metatarsal, and is continued as a very large internal superficial plantar metatarsal along the deep flexor tendon, thus resembling the arrangement in the fore limb.

In a few cases the perforating tarsal is a large vessel, directly continuing the anterior tibial, and is continued by a large internal deep plantar metatarsal. The great metatarsal is then small. Other variations are common.

THE GREAT METATARSAL ARTERY

This artery (A. metatarsea dorsalis lateralis) is the direct continuation of the anterior tibial. It passes downward and outward under the extensor brevis and the tendon of the lateral extensor, at first on the joint capsule and then in the oblique vascular groove on the upper part of the large metatarsal bone. It then descends in the groove formed by the apposition of the large and external small metatarsals, inclines inward between the two, and divides on the lower part of the posterior face of the large metatarsal bone into the internal and external digital arteries. It is not usually accompanied by a vein. Beyond this the arterial arrangement is the same as in the thoracic limb.

THE VEINS^[168]

PULMONARY VEINS

The terminal pulmonary veins (Vv. pulmonales), usually seven or eight in number, return the aërated blood from the lungs and open into the left atrium of the heart. They are destitute of valves. Their tributaries arise in the capillary plexuses in the lobules of the lungs, and unite to form larger and larger trunks which accompany the branches of the bronchi and pulmonary arteries. A very large vein is formed by the union at an acute angle of a trunk from each lung, where the latter are adherent to each other.

SYSTEMIC VEINS

The Veins of the Heart (Figs. 426, 427)

The coronary sinus (Sinus coronarius) is a very short bulbous trunk which receives most of the blood from the wall of the heart. It is situated just below the termination of the posterior vena cava and is covered in part by a thin layer of ventricular muscle-fibers. It opens into the right atrium just below the posterior vena cava. It is formed by the union of two tributaries. The great cardiac or left coronary vein (V. cordis magna) begins at the left side of the apex of the heart, ascends in the left longitudinal groove and turns backward in the coronary groove, in which it winds around the posterior border of the heart to the right side and joins the coronary sinus. The middle cardiac or right coronary vein (V. cordis media) begins on the right side of the apex, ascends in the right longitudinal groove and joins the coronary sinus, or opens separately into the atrium just in front of the orifice of the left vein, so that a common trunk (coronary sinus) does not then exist.

The small cardiac veins (Vv. cordis minores), three to five in number, are small vessels which return some blood from the right ventricle and atrium; they open into the latter near the coronary groove in spaces between the musculi pectinati.

THE ANTERIOR VENA CAVA (Fig. 429)

The anterior vena cava (V. cava cranialis) returns to the heart the blood from the head, neck, thoracic limbs, and the greater part of the thoracic wall. It is formed at the ventral part of the thoracic inlet by the confluence of the two jugular and two brachial veins. Its origin is attached to the first pair of ribs. It passes backward in the anterior mediastinum, at first median and ventral to the common carotid trunk, then deviates to the right of the anterior aorta, and opens into the right atrium opposite to the third rib. The demarcation between vein and atrium is not very distinct. It contains no valves except at the mouths of its radicles. Its length is about five to six inches (ca. 12 to 15 cm.) and its caliber about two inches (ca. 5 cm.) in a subject of medium size. Its right face is crossed by the right phrenic nerve, and on the left it is related to the anterior aorta and brachiocephalic artery. It receives, in addition to small pericardial and mediastinal veins, the following tributaries:

1. The internal thoracic vein (V. thoracica interna) is a satellite of the artery of that name. It opens into the anterior vena cava at the first rib.

2. The vertebral vein (V. vertebralis) corresponds to the homonymous artery. On the right side it terminates either in front of the deep cervical vein or by a short common trunk with it. On the left side it almost always unites with the deep cervical and vertebral vein to form a common trunk.

3. The deep or superior cervical vein (V. cervicalis profunda) corresponds to the artery. On the right side it leaves the artery at the first intercostal space, crosses the right face of the trachea and opens into the vena cava; it may form a common trunk with the dorsal or vertebral. On the left side there is nearly always a common trunk for all three.

4. The dorsal vein (V. costo-cervicalis) corresponds to the artery. On the right side it leaves the artery on entering the thorax, crosses the right face of the trachea, and opens into the vena cava in front of the deep cervical or by a common trunk with it. On the left side it almost always joins the deep cervical and vertebral to form a short common trunk which crosses the left face of the intrathoracic part of the brachial artery opposite the second rib and opens into the anterior vena cava.

The Vena Azygos

The vena azygos (Fig. 429) is an unpaired vessel which arises at the level of the first lumbar vertebra by radicles coming from the psoas and the crura of the diaphragm; it is connected with the first lumbar vein. It passes forward along the right side of the bodies of the thoracic vertebræ, in contact usually with the thoracic duct, which separates the vein from the aorta. At the seventh vertebra it leaves the spine, curves downward and forward over the right side of the thoracic duct, trachea, and œsophagus, and opens into the right atrium opposite the third intercostal space. Its tributaries are:

1. The last fourteen intercostal veins (Vv. intercostales) of the right side. On the left side the last four to seven intercostal veins usually empty into the vena hemiazygos. This vessel runs on the left side of the aorta from the fourteenth to the eleventh thoracic vertebra, passes between the aorta and the spine, and joins the vena azygos. In its absence its tributaries join the vena azygos.

2. The œsophageal vein (V. œsophagea), satellite of the œsophageal artery, joins the vena azygos as it inclines downward.

3. The bronchial vein (Vena bronchialis) unites with the preceding to form a short common trunk (Ellenberger-Baum), or empties into the great coronary vein (Chauveau).^[169]

VEINS OF THE HEAD AND NECK

Jugular Veins

The jugular veins (Vv. jugulares), right and left (Fig. 431), arise behind the posterior border of the lower jaw about two and a half inches (ca. 6 to 7 cm.) below the temporo-maxillary articulation by the union of the superficial temporal and internal maxillary veins. Each passes downward and backward, at first embedded more or less in the parotid gland, and continues in the jugular furrow to the thoracic inlet, where it unites with its fellow and the two brachial veins to form the anterior vena cava. In the neck it is covered by the skin, fascia, and panniculus, and is superficial to the carotid artery, from which it is separated in the anterior two-thirds of the region by the omo-hyoideus muscle.^[170] It contains valves at the mouths of its tributaries and has several pairs of semilunar valves variably disposed along its course. Its tributaries are as follows:

1. The internal maxillary vein (V. maxillaris interna) is larger than the external maxillary. It may be considered to begin as the continuation backward of the buccinator vein where the vessel crosses the alveolar border of the mandible (about two inches (ca. 5 cm.) behind the last molar tooth). It runs backward on the inner surface of the ramus below the external pterygoid and covered by the internal pterygoid muscle for a distance of about three inches (ca. 7 to 8 cm.), then inclines a little downward and runs ventral to the artery for about an inch (ca. 2 to 3 cm.). It crosses the external face of the artery at the posterior border of the jaw, and is joined by the superficial temporal vein to form the jugular. Its principal radicles are:

(1) The dorsal lingual vein (V. dorsalis linguæ), which is a satellite of the lingual nerve.

(2) The inferior alveolar or dental vein (V. alveolaris mandibulæ), a satellite of the corresponding artery. It often unites with the preceding.

(3) Pterygoid veins (Rami pterygoidei).

(4) The deep temporal vein (V. temporalis profunda) is a large vessel which receives tributaries from the temporalis muscle and emissaries from the parieto-temporal canal. It is connected with the anterior cerebral vein and usually with the meningeal veins by its frontal branch. The latter drains chiefly the lacrimal gland and passes behind the supraorbital process.

2. The superficial temporal vein (V. temporalis superficialis) is a satellite of the corresponding artery. It is formed by the confluence of the anterior auricular and transverse facial veins. The former receives the superior cerebral vein (V. cerebralis dorsalis), which is the emissary of the transverse sinus of the dura mater; it emerges from the parieto-temporal canal behind the postglenoid process. The transverse facial vein (V. transversa faciei) runs at first above the artery of like name, then plunges deeply into the masseter and unites in front with the facial vein. It is connected with the vena reflexa.

3. The inferior masseteric or maxillo-muscular vein (V. masseterica) joins the jugular at the upper border of the sterno-cephalicus tendon. It is a short trunk formed by the confluence at the posterior border of the jaw of masseteric and pterygoid veins. The former is usually connected by a large branch with the buccinator vein.

4. The great auricular vein (V. auricularis magna) is a satellite of the posterior auricular artery above, but joins the jugular a variable distance below and behind the point of origin of the artery.

5. The inferior cerebral vein (V. cerebralis ventralis) is an emissary of the cavernous sinus of the dura. It is a satellite of the internal carotid artery, receives the condyloid vein, and joins the jugular near the occipital vein or by a common trunk with it.

6. The occipital vein (V. occipitalis) arises in the fossa atlantis by the union of muscular and cerebrospinal branches. The former comes from the muscles of the poll and passes through the foramen transversarium. The latter is connected with the occipital sinus of the dura mater and emerges from the spinal canal by the intervertebral foramen.

7. The external maxillary or facial vein (V. maxillaris externa) arises by radicles which correspond in general to the branches of the artery of like name. It passes down over the cheek along the anterior border of the masseter muscle behind the artery, crossing over the parotid duct, which lies behind the vein lower down. Thus on the ramus and as they turn around its lower border the artery is in front, the vein in the middle, and the duct posterior. In the submaxillary space the vein is ventral to the artery for some distance, then parts company with the artery, runs straight backward along the lower border of the parotid gland, and opens into the jugular vein at the posterior angle of the gland.^[171] The chief differences in the tributaries of the vein as compared with the branches of the corresponding artery are as follows:

The labial veins (Vv. labiales) form a plexus in the submucous tissue of the cheek from which two veins emerge. The upper one passes back and joins the buccinator vein. The lower one (V. labialis communis) joins the external maxillary vein.

Three veins connect with the external maxillary at the anterior border of the masseter.

The upper one is the transverse facial, which unites close to the end of the facial crest.

A little lower is the large valveless vena reflexa or alveolar vein. This passes back under the upper part of the masseter on the maxilla, turns around the tuber maxillare, perforates the periorbita, and joins the ophthalmic vein. It is relatively small at each end, but presents one or two large fusiform dilatations. It receives the following tributaries: (a) The palatine vein (V. palatina major), which separates from the palatine artery at the anterior palatine foramen and passes in the groove between the tuber maxillare and the palate bone. The palatine veins form a very rich plexus of valveless vessels in the submucosa of the hard palate, which consists of several layers anteriorly. (b) The sphenopalatine vein (V. sphenopalatina) forms a rich plexus of valveless vessels on the turbinal bones and the septum nasi. It is usually joined by the infraorbital vein (V. infraorbitalis) to form a short common trunk.

The venous plexuses are remarkably developed in certain parts of the nasal mucosa. On the septum a little below its middle and on the turbinals the veins are in several layers. The olfactory region does not share in this arrangement and the veins here are small and join the ethmoidal vein.

(c) The ophthalmic vein (V. ophthalmica) is a short trunk, connected in front with the vena reflexa and behind with the cavernous sinus through the foramen lacerum orbitale. It receives veins which correspond to the arterial branches.

The buccinator vein (V. buccinatoria) extends backward from the external maxillary along the lower border of the depressor labii inferioris and buccinator under cover of the masseter, passes between the ramus of the mandible and the tuber maxillare and is continued as the internal maxillary vein. It has a large fusiform dilatation and is valveless. It receives a large common labial vein from the labial plexus, and is usually connected with the masseteric vein.

The lingual vein (V. lingualis) is not a satellite of the artery. It is formed at the side of the lingual process of the hyoid bone by the confluence of several veins which come from the substance of the tongue. One or two considerable vessels run partly in the substance of the hyo-glossus, and another in the genio-hyoideus. The vein is at first covered by the mylo-hyoideus, perforates that muscle, runs back along the omo-hyoideus in relation to the submaxillary lymph glands, and joins the external maxillary near the posterior border of the jaw. Near its termination it receives the sublingual vein, or the latter may open into the external maxillary directly.

8. The thyroid vein (V. thyreoidea) is a large vessel which joins the jugular near the external maxillary vein. It receives anterior thyroid, laryngeal, and pharyngeal radicles, and sometimes a posterior thyroid vein.

9. Muscular, tracheal, and œsophageal veins.

10. The cephalic vein (Vena cephalica) enters the jugular near its termination. It will be described with the veins of the thoracic limb.

11. The inferior cervical vein (V. cervicalis ascendens) accompanies the artery. It may open into the brachial vein.

The Sinuses of the Dura Mater

These (Sinus duræ matris) are blood-spaces between the meningeal and periosteal layers of the dura mater and are lined with endothelium. In many places the lumen is crossed by fibrous strands. They receive the veins of the brain, communicate with the meningeal and diploic veins, and with veins outside of the cranium; their connections with the latter are by means of small emissary veins (Emissaria). They convey the blood directly or indirectly to the jugular veins. Some are paired, others unpaired. They may be divided into dorsal and basilar systems. The dorsal system comprises the following:

The superior longitudinal or sagittal sinus (S. sagittalis superior) is situated in the upper border of the falx cerebri along the internal sagittal crest. It begins at the crista galli and ends at the tentorium osseum by dividing into two transverse sinuses. It receives the superior cerebral veins. Along each side are small pouches (Lacunæ laterales) into which the veins open. The lumen of the sinus is traversed by fibrous bands and is partially divided by a longitudinal septum.

The transverse sinuses (S. transversi), right and left, pass outward in the transverse grooves of the parietal bones, enter the parieto-temporal canals, and are continued by the superior cerebral veins to the superficial temporal veins. The two sinuses are connected by the sinus communicans.

The inferior longitudinal or sagittal sinus (S. sagittalis inferior) runs backward on the upper surface of the corpus callosum along the concave edge of the falx cerebri and joins the great cerebral vein (of Galen) to form the straight sinus.

The straight sinus (S. rectus) passes upward and backward between the cerebral hemispheres and in the tentorium cerebelli and joins the superior sagittal sinus. The point of meeting is the confluence of the sinuses (Confluens sinuum).

The occipital sinuses (S. occipitales) lie on either side of the vermis cerebelli. They empty anteriorly into the sinus communicans and communicate behind with the spinal veins.

The superior petrosal sinuses (S. petrosi superiores) pass in the tentorium cerebelli to end in the transverse sinuses.

The basilar system consists of the following:

The cavernous sinuses (S. cavernosi) lie in the inner grooves of the root of the temporal wings of the sphenoid bone at either side of the sella turcica. The two are connected by a wide traverse branch (Sinus intercavernosus) behind and below the posterior part of the pituitary body. Each is continuous in front with the ophthalmic vein and below with the inferior petrosal sinus. The third, sixth, and the ophthalmic and maxillary divisions of the fifth nerve lie along the outer wall of the sinus. The internal carotid artery traverses the sinus and is connected with its fellow by a transverse branch which lies in the corresponding part of the sinus. An oval opening in the floor communicates with the inferior petrosal sinus and transmits the internal carotid artery.

The sinus is not subdivided by strands of fibrous tissue as in man, but a few delicate bands attach the artery to its wall.

The inferior petrosal sinuses (S. petrosi inferiores)^[172] lie along the borders of the basilar part of the occipital bone, inclosed in the thick dura which closes the foramen lacerum. The anterior part extends about half an inch (ca. 12 mm.) under the temporal wing of the sphenoid. Here communications exist with veins in the pterygo-palatine fossa. The posterior end is bulbous and lies in the condyloid fossa; it communicates with the condyloid vein issuing from the hypoglossal foramen and is drained by the inferior cerebral vein; it also receives an emissary vein from the parieto-temporal canal. The roof of the sinus is perforated by an oval opening at the carotid notch which opens into the cavernous sinus and transmits the internal carotid artery; the latter forms the first bend of its S-shaped curve in the petrosal and the second in the cavernous sinus.

The basilar plexus (Plexus basilaris) is a venous plexus situated on the upper surface of the basilar part of the occipital bone. It is connected through the hypoglossal foramen with the inferior petrosal sinus and communicates behind with the spinal veins.

The Veins of the Cranium

The veins of the brain (Venæ cerebri) do not in general accompany the cerebral arteries. They have very thin walls, no muscular coat, and no valves. They are arranged in two sets, superficial or cortical and deep or central. The superficial veins are more numerous and larger than the arteries. They lie on the surface of the brain in the pia mater and the subarachnoid space.

The superior cerebral veins drain the upper and outer part of the cerebral cortex. They receive veins from the medial surfaces of the hemispheres and open into the superior sagittal sinus. Their terminal parts are bulbous and their openings are directed obliquely forward, i. e., contrary to the direction of the bloodstream in the sinus.

The inferior cerebral veins lie on the inferior and external aspect of the hemispheres. They open into the inferior system of sinuses. The middle cerebral vein runs in the lateral fissure (of Sylvius) and opens into the cavernous sinus.

The deep cerebral veins issue from the central or ganglionic parts of the brain at the transverse fissure. They converge to form the great cerebral vein (of Galen) (V. magna cerebri). This passes upward and backward behind the splenium of the corpus callosum and is continued as the straight sinus to join the sagittal sinus.

The superior cerebellar veins ramify on the upper surface of the cerebellum. They open into the superior system of sinuses and the great cerebral vein. The inferior cerebellar veins are larger and go chiefly to the basilar plexus. The veins of the medulla and pons end in the inferior system of sinuses.

The meningeal veins (Venæ meningeæ) arise in capillary plexuses in the superficial and deep faces of the dura mater. Some end in the sinuses of the dura, others accompany the meningeal arteries.

The diploic veins (Venæ diploicæ) are anastomosing channels in the spongy substance of the cranial bones. Their walls are thin, consisting in many places only of the endothelium, and they have no valves. Some open inward into venous sinuses, others into extracranial veins.

Spinal Veins

Two longitudinal spinal veins or sinuses (Sinus columnæ vertebralis) extend along the floor of the vertebral canal, one on either side of the superior common ligament. They are continuous in front with the basilar plexus. They lie in the grooves on the bodies of the vertebræ and are connected by a series of transverse anastomoses which pass between the central part of the bodies of the vertebræ and the superior common ligament or in channels in the bone. They receive veins from the spinal cord, the dura mater, and the bodies of the vertebræ (Venæ basis vertebræ). Through the intervertebral foramina efferent vessels connect with the vertebral, intercostal, lumbar, and lateral sacral veins.

VEINS OF THE THORACIC LIMB

The brachial vein (V. brachialis) is a satellite of the extrathoracic part of the brachial artery. It arises at the inner side of the distal end of the shaft of the humerus and passes upward in the arm behind the artery under cover of a layer of fascia and the posterior superficial pectoral muscle. At the shoulder it is ventral to the artery, crosses the anterior border of the first rib, and concurs with its fellow and the two jugulars in the formation of the anterior vena cava. The roots of the vein are somewhat variable, but most often four radial veins in addition to a large oblique branch from the cephalic unite in its formation. Its tributaries correspond in general to the branches of the artery, but a few differences are worthy of notice. The thoracico-dorsal vein joins the brachial directly or opens into the deep brachial. The external thoracic or “spur” vein (V. thoracica externa) is a large vessel which arises in the ventral wall of the abdomen, passes forward (embedded more or less in the panniculus) along the outer border of the posterior deep pectoral muscle, and joins the brachial vein near the first rib. It often communicates with the subscapular vein.

The cephalic vein (V. cephalica) arises at the inner side of the carpus as the continuation of the internal superficial metacarpal vein. It runs upward on the deep fascia of the forearm at first in the furrow between the flexor carpi internus and the radius. Toward the middle of the forearm it inclines gradually forward on the inner surface of the radius, accompanied by a cutaneous branch of the median nerve, and arrives at the insertion of the biceps. Here it detaches a large branch (Ramus communicans) which passes upward and backward over the inner insertion of the biceps, the posterior radial artery, and the median nerve, and joins the brachial vein. The vein to this point is often termed the internal subcutaneous vein of the forearm (V. cephalica antebrachii). It is continued (as the V. cephalica humeri) in the furrow between the mastoido-humeralis and the anterior superficial pectoral with a branch of the inferior cervical artery, crosses the deep face of the cervical panniculus, and opens into the terminal part of the jugular or the brachial vein. It receives an accessory cephalic vein (V. cephalica accessoria), which arises from the carpal network, runs upward along the inner border of the extensor carpi, turns along the lower border of the brachialis, passes under the superficial tendon of the biceps and joins the cephalic.

The deep veins of the forearm are variable. Commonly two posterior radial veins (Venæ medianoradiales) accompany the artery of like name, one in front and one behind. A third vein arises by radicles emerging from the proximal part of the deep flexor; it joins the posterior satellite of the posterior radial artery or forms one of the roots of the brachial vein. The common interosseous vein joins the posterior satellite. The anterior radial vein (V. collateralis radialis) is a satellite of the artery. The ulnar vein is usually double at its proximal part, and communicates with the deep brachial vein.

There are three chief metacarpal veins. The internal metacarpal vein (V. metacarpea volaris superficialis medialis) arises from the volar venous arch above the fetlock. It is the largest vein of the region and lies in front of the large metacarpal artery. It separates from the artery at the proximal end of the metacarpus, passes upward on the inner part of the posterior surface of the carpus, under cover of the superficial layer of the posterior annular ligament, and is continued as the cephalic vein. It communicates at its proximal part with the origin of the posterior radial veins by a short but relatively large branch. The external metacarpal vein (V. metacarpea volaris superficialis lateralis) arises from the venous arch above the fetlock and passes upward behind the external border of the suspensory ligament in front of the external branch of the median nerve and accompanied by a small artery. At the proximal end of the metacarpus it is connected with the deep metacarpal vein by two transverse anastomoses which pass across the suspensory ligament. It then passes upward as a satellite of the external volar metacarpal artery and concurs in the origin of the ulnar and posterior radial veins. The deep metacarpal vein (V. metacarpea volaris profunda medialis) arises from the venous arch, passes forward between the two branches of the suspensory ligament, and ascends on the posterior surface of the large metacarpal bone. At the proximal end of the latter it communicates with the other metacarpal veins, ascends with the small metacarpal artery, and concurs in forming the radial veins.

The venous arch (Arcus venosus volaris), from which the metacarpal veins arise, is situated above the sesamoids of the fetlock between the suspensory ligament and the deep flexor tendon. It is formed by the junction of the two digital veins.

The digital veins, internal and external (V. digitalis medialis, lateralis), drain the venous plexuses of the foot. They arise at the upper edge of the lateral cartilages and ascend in front of the corresponding arteries.

It is convenient to recognize the following venous plexuses of the foot, which, however, communicate very freely:

1. The coronary plexus encircles the upper part of the foot. It is attached to the terminal part of the extensor tendon, the lateral cartilages, and the bulbs of the plantar cushion.

2. The dorsal (or laminal) plexus covers the dorsal or wall surface of the third phalanx in the deep layer of the matrix of the wall of the hoof. It forms the circumflex vein of the third phalanx or vein of the distal border of the third phalanx, which corresponds to the artery of like name.

3. The volar plexus is in the deep layer of the matrix of the sole of the hoof and on the deep surface of the lateral cartilages. It communicates around the inferior border of the third phalanx with the dorsal plexus and through the lateral cartilages with the coronary plexus.

The deep vein of the third phalanx accompanies the terminal part of the digital artery. It drains the intraosseous plexus.

THE POSTERIOR VENA CAVA (Figs. 270, 450)

The posterior vena cava (V. cava caudalis) returns almost all of the blood from the abdomen, pelvis, and pelvic limbs. It is formed by the confluence of the right and left common iliac veins at the fifth lumbar vertebra, above the terminal part of the aorta and chiefly to the right of the median plane.

The mode of origin is variable. In some cases there is a common trunk formed by the union of the two internal iliac veins so that the arrangement resembles the termination of the aorta. In other cases the internal iliac vein does not exist.

It passes forward on the ventral face of the psoas minor to the right of the abdominal aorta. At the last thoracic vertebra it separates from the aorta and runs forward between the right crus of the diaphragm and the pancreas till it reaches the liver. Here it inclines downward along the inner border of the right lobe and the parietal surface of the liver, largely embedded in the gland substance, and passes through the foramen venæ cavæ of the diaphragm. It then runs forward and somewhat downward between the mediastinal lobe and the main mass of the right lung at the upper margin of a special fold of the right pleura, accompanied by the right phrenic nerve, and opens into the posterior part of the right atrium. It receives the following tributaries:

1. The lumbar veins (Vv. lumbales) correspond to the arteries. Five pairs usually empty into the vena cava. Sometimes the corresponding veins of opposite sides unite to form a common trunk. The first communicate with the vena azygos.

2. The spermatic veins (Vv. spermaticæ internæ) (Fig. 450) accompany the arteries of like name. In the spermatic cord they form the pampiniform plexus about the artery and nerves. Their termination is variable. The right one commonly joins the vena cava near the renal vein, often by a common trunk with the left one. Frequently the left vein joins the left renal, and sometimes the right one ends similarly.

2a. The utero-ovarian veins are much larger than the preceding and are satellites of the arteries in the broad ligaments. The ovarian branch is plexiform near the ovary. The uterine branches form a rich plexus in the wall of the uterus. The trunk is very short.

3. The renal veins (Vv. renales), satellites of the arteries, are of large caliber and thin-walled. The right vein passes inward and backward on the ventral face of the kidney between the artery in front and the ureter behind. It joins the vena cava above the right adrenal. The left vein is somewhat longer. It passes inward at first like the right one, then bends around the posterior end of the adrenal, crosses the origin of the renal artery and opens into the vena cava a little further back than the right one. They receive veins from the adrenals, but some adrenal veins open directly into the vena cava.

4. The hepatic veins (Vv. hepaticæ) return the blood from the liver, and open into the vena cava as it lies in the groove in the liver. Three or four large vessels open into the vena cava just before it leaves the liver, and numerous small ones discharge into its embedded part.

5. The phrenic veins (Vv. phrenicæ), two or three in number, return the blood from the diaphragm. They are very large in comparison with the arteries, and join the vena cava as it lies in the caval opening.

In some cases there is a small middle sacral vein (V. sacralis media), a satellite of the artery. It opens into the angle of junction of the common iliac veins or into one of the latter.

THE PORTAL VEIN

The portal vein (V. portæ) is a large trunk which returns the blood carried to the viscera by the gastric, splenic, and mesenteric arteries. Its peripheral tributaries correspond closely with the branches of the arteries, but the terminal trunks do not. The vein is formed behind the pancreas and below the posterior vena cava by the confluence of the anterior and posterior mesenteric and splenic veins. It passes forward, traverses the posterior part of the pancreas very obliquely, inclines ventrally and a little to the right, and reaches the portal fissure of the liver. Here it divides into three branches which enter the liver and ramify in the substance of the gland like an artery, terminating in the lobular capillaries. From the lobules the blood passes into the hepatic veins and through these to the posterior vena cava. Thus the blood which is distributed to the stomach, nearly the entire intestinal tract, the pancreas, and the spleen, passes through two sets of capillaries prior to its return to the heart, viz., the capillaries of these viscera and of the liver.

1. The anterior mesenteric vein (V. mesenterica cranialis) is the largest of the portal radicles. It is situated to the right of the artery of like name, and its tributaries correspond in general to the branches of the artery. Usually a single colic vein corresponds to the two arteries of the right portions of the colon.

2. The posterior mesenteric vein (V. mesenterica caudalis) is the smallest of the radicles of the portal. It accompanies the artery in the colic mesentery and its rectal branches anastomose with those of the internal pudic vein.

3. The splenic vein (V. lienalis) is the very large satellite of the splenic artery. It is formed by the union of two radicles at the base of the spleen. On leaving the hilus of the spleen it passes inward between the anterior pole of the left kidney and the saccus cæcus of the stomach and above the left end of the pancreas, receives commonly the posterior gastric vein (V. gastrica caudalis), and unites with the anterior mesenteric at the posterior border of the pancreas.

The collateral tributaries of the portal veins are as follows:

(1) Pancreatic veins (Rami pancreatici).

(2) The gastro-duodenal vein (V. gastroduodenalis) corresponds mainly to the extrahepatic branches of the hepatic artery.

(3) The anterior gastric vein (V. gastrica cranialis) joins the portal at the portal fissure.

THE COMMON ILIAC VEINS (Fig. 456)

These (V. iliacæ communes) are two very large but short trunks which result from the union of the internal and external iliac veins of each side at the sacro-iliac articulation. The left one is the longer and crosses obliquely over the terminal part of the aorta. The chief tributaries of each are as follows:

1. The last lumbar vein.

2. The circumflex iliac veins (Vv. circumflexæ ilium profundæ) are the two satellites of each corresponding artery, on either side of which they are placed. They may open directly into the posterior vena cava or into the external iliac vein.

3. The ilio-lumbar vein (V. iliolumbalis) may open into the common iliac, the external iliac, or the internal iliac vein.

THE INTERNAL ILIAC VEINS

The internal iliac or hypogastric veins (Vv. hypogastricæ), right and left, are usually formed by the confluence of lateral sacral, gluteal, and internal pudic veins. The obturator vein may open into them also. They are short trunks and are smaller than the external iliac veins. The tributaries correspond in general to the branches of the three arteries of like names. The internal pudic veins receive affluents from the venous plexuses of the prepuce and penis in the male; of the mammary gland, vulva, vagina, and vestibular bulb in the female.

THE VEINS OF THE PELVIC LIMB

The external iliac vein (V. iliaca externa) (Figs. 450, 451) lies behind the corresponding artery at the brim of the pelvis. It is the upward continuation of the femoral vein, and unites at the sacro-iliac joint with the internal iliac to form the common iliac vein. Its tributaries are as follows:

1. The obturator vein (V. obturatoria) is a satellite of the artery and usually opens into the external iliac at the insertion of the psoas minor. Its radicles anastomose with those of the internal and external pudic veins (Figs. 451, 455).

2. The iliaco-femoral or external circumflex veins (Vv. circumflexæ femoris laterales) are the two satellites of the homonymous artery. They open a little higher than the obturator.

The femoral vein (Figs. 450, 451) lies behind the artery in the upper part of the thigh, external to it lower down. Its chief tributaries are:

1. A very large but short trunk formed by the union of the deep femoral and the external pudic vein. The deep femoral vein (V. profunda femoris) corresponds otherwise to the artery. The external pudic vein (V. pudenda externa) arises chiefly from a rich plexus of large veins situated above and along the sides of the penis and prepuce in the male, the mammary glands in the female. It passes through a foramen in the anterior part of the tendon of origin of the gracilis and runs outward in the subpubic groove behind the pectineus to unite with the deep femoral vein. The right and left veins are connected by a large transverse anastomosis and each has a large connection with the obturator vein. Each receives the posterior abdominal vein (V. epigastrica caudalis) which accompanies the artery of like name. The subcutaneous abdominal vein (V. abdominalis subcutanea) arises in the skin and panniculus of the ventral abdominal wall, anastomoses with the internal and external thoracic and deep abdominal veins, and joins the external pudic or posterior abdominal vein.

A small vein accompanies the external pudic artery in the inguinal canal.

2. The anterior femoral vein (V. femoris cranialis) accompanies the artery.

3. The saphenous vein (V. saphena) (Figs. 451, 458, 460) arises at the inner side of the flexion surface of the tarsus as the upward continuation of the internal metatarsal vein. Its course is distinctly visible. It ascends on the subcutaneous surface of the tibia and the popliteus muscle, inclosed between layers of the deep fascia, inclines a little backward to the proximal part of the leg, then deviates slightly forward, runs upward on the gracilis, passes between that muscle and the sartorius, and joins the femoral or the external pudic vein.^[173] On the upper part of the capsule of the hock joint it forms an arch with the anterior tibial vein. The vein has numerous valves. The satellite artery is relatively small and lies in front of the vein as far as the junction with the recurrent tibial vein, which it accompanies on the leg. It receives the recurrent tibial vein (V. recurrens tibialis)^[174] at the proximal fourth of the leg. This vessel arises at the inner surface of the tarsus and forms an arch with the posterior tibial vein at the level of the tuber calcis. It ascends in the furrow in front of the gastrocnemius tendon, inclines forward at the proximal third of the leg, and joins the saphenous vein at an acute angle. It has numerous valves. A smaller vein from the anterior face of the metatarsus joins the saphenous at the hock.

4. Muscular branches which correspond to the arteries.

5. The posterior femoral or femoro-popliteal vein (V. femoris caudalis) is a satellite of the artery. It receives the recurrent tarsal or external saphenous vein (V. tarsea recurrens), which arises at the outer side of the hock, ascends on the deep fascia of the external surface of the leg in front of the tendo Achillis, passes between the biceps femoris and semitendinosus, and joins the posterior femoral vein. It is connected with the recurrent tibial vein by a large anastomotic branch which crosses in front of the tuber calcis. Usually a branch from it ascends along the great sciatic nerve and anastomoses with the obturator vein.

The popliteal vein (V. poplitea) lies along the inner side of the artery (Fig. 459). It is formed by the confluence of anterior and posterior tibial veins.

Two anterior tibial veins (Vv. tibiales anteriores) usually accompany the artery of like name; the outer vein is much the larger. In other cases there is a single large vein in the proximal part of the leg, two lower down. They arise from a number of anastomosing radicles on the front of the capsule of the hock joint, chiefly as the continuation of the perforating tarsal vein. The origin of the chief vein is connected with the saphenous by a large anastomotic branch.

The posterior tibial vein (V. tibialis posterior) is commonly double (Fig. 458). It arises at the level of the tuber calcis, where it has a communication with the recurrent tibial vein. It is a satellite of the artery.

The internal or great metatarsal vein (V. metatarsea dorsalis medialis) (Figs. 458, 460) arises from the venous arch above the sesamoids at the fetlock, but is practically the upward continuation of the internal digital vein. It ascends along the inner border of the deep flexor tendon, then in the groove on the inner aspect of the proximal part of the large metatarsal bone to the capsule of the hock joint, and is continued by the saphenous vein.

The external metatarsal vein (V. metatarsea plantaris lateralis) arises from the venous arch above the fetlock, but appears to be the upward continuation of the external digital vein. It ascends along the outer border of the deep flexor tendon in front of the plantar nerve, and is connected with the deep metatarsal vein at the proximal part of the metatarsus by a transverse branch. It then passes upward along the deep flexor tendon in relation to the plantar nerves and the inner tarsal artery and is continued by the recurrent tibial vein.

The deep metatarsal vein (V. metatarsea plantaris medialis) arises from the plantar venous arch, passes forward between the branches of the suspensory ligament, and ascends on the posterior face of the large metatarsal bone. At the proximal end of the metatarsus it is connected with the external metatarsal vein by a transverse branch. It then passes (as the perforating tarsal vein) through the vascular canal of the tarsus and forms the chief radicle of the anterior tibial vein.

The plantar venous arch (Arcus venosus plantaris) and the digital veins are arranged like those of the thoracic limb.

The Lymphatic System

The lymphatic system (Systema lymphaticum) is subsidiary to the venous part of the circulatory system, from which it arises in the embryo. It consists of the lymph vessels and glands.

The lymph vessels (Vasa lymphatica) contain a colorless fluid, the lymph, which contains numerous lymphocytes.^[175] They resemble the veins in structure but have thinner walls and are provided with more numerous valves. The vessels are sacculated opposite the segments of the valves and have a characteristic beaded appearance when distended. The collecting lymph vessels do not usually form rich plexuses, as veins often do, their branching is more limited and less tree-like than that of the blood-vessels, and their caliber therefore increases less from the periphery toward their termination. All of the lymph is ultimately carried into the venous system by two trunks, the thoracic duct and the right lymphatic duct. Almost all of the lymph passes through at least one group of lymph glands before entering the blood-vascular system.

The lymph glands or nodes (Lymphoglandulæ) are intercalated in the course of the lymph vessels. They vary widely in size, some being microscopic, others several inches in length. In form they may be globular, ovoid and flattened, elongated, or irregular. In certain situations they are aggregated into groups, and a knowledge of the position of these and the territory drained into them is important. It is convenient, when possible, to indicate their position with regard to arteries on the course of which they are placed. In color they are usually gray or yellowish-brown in the dead subject, pink or reddish-brown during life, but this varies according to their position and functional state. The bronchial glands are often blackened by infiltration with carbon. The mesenteric glands are creamy or white while the chyle is passing through, but pink at other times. Vessels which carry lymph to a gland are called afferent; the efferent vessels which convey it away are larger and fewer. Each gland has a depression, the hilus, at which the blood-vessels enter and the efferent lymph vessels emerge.

Lymph nodules or follicles (Noduli lymphatici) are minute masses of lymphoid tissue which occur in certain mucous membranes. They may be solitary, as in the solitary glands of the intestine, or aggregated into masses or patches, as in the tonsils and the so-called Peyer’s patches.

The lymph nodule or follicle is the unit of structure of the lymph gland. It consists essentially of an artery surrounded by a reticulum of connective tissue, the meshes of which contain numerous lymphocytes. Surrounding this is a rich plexus of lymph vessels, forming the so-called sinus, inclosed in some cases by a fibrous capsule. The gland consists of a mass of follicles, inclosed in a fibrous capsule, from which trabeculæ pass in and unite the follicles. Beneath the capsule is the peripheral sinus, which consists of a very rich plexus of lymph vessels; to this the afferent vessels pass at various points of the surface. In the cortical substance the cells are in rounded masses, the cortical nodules, while in the medullary substance they lie around the arteries, forming the so-called medullary cords. The medulla is redder than the cortex, since it is more vascular; it contains the central lymph sinuses, which have a similar structure to the peripheral sinus.

The hæmolymph glands differ from the lymph glands in color and structure. They are of a deep red color, which is due to the high vascularity of the cortical substance. The peripheral sinuses especially are greatly developed and contain numerous red blood-cells. There is no clear division into cortical and medullary substance, and the trabeculæ contain smooth muscle-cells. Some have afferent and efferent lymph vessels and others do not. They resemble the spleen in some respects, but their significance is not yet clear. They are numerous in the ox and sheep, much fewer in the dog, and apparently are absent in the horse. They occur along the course of the aorta, in the perineal fat, at the portal fissure, and with the gastric and mesenteric lymph glands. In the ox they are also found under the trapezius muscle, under the skin of the upper part of the flank, and in other places less constantly.

The tissue or lymph-spaces are interstices of varying size between cells or in the meshes of connective tissue. They contain a fluid derived from the blood-plasma, which is usually called lymph. They are drained by the veins and lymph vessels. The large serous sacs are often included in this category.

The exact relationship between the lymphatic capillaries and the tissue spaces is still a matter of controversy. It is held by some that the lymph vessels are in direct communication with the tissue spaces, while others maintain that the lymphatics are complete closed tubes. Communication between the spaces and vessels is in general very free. Mall has shown that granules injected into the hepatic artery are returned by the lymphatics as well as by the veins, and intramuscular injections will enter the lymph vessels of the tendon in spite of the absence of lymphatics in muscle.

Lymphatic System of the Horse

THE THORACIC DUCT (Figs. 428, 429)

The thoracic duct (Ductus thoracicus) is the chief collecting trunk of the lymphatic system. It begins as an elongated irregular dilatation, the cisterna or receptaculum chyli, which is situated between the right side of the aorta and the right crus of the diaphragm at the first and second lumbar vertebræ. The duct enters the thorax through the hiatus aorticus and runs forward on the right of the median plane between the vena azygos and the aorta, covered by the pleura. At the sixth or seventh thoracic vertebra it inclines somewhat ventrally, crosses obliquely over the left face of the œsophagus, and passes forward on the left side of the trachea to the inlet of the thorax. The extrathoracic terminal part passes downward and forward a variable distance (3 to 4 cm.) on the deep face of the left scalenus muscle, bends inward and backward under the bicarotid trunk, and opens into the upper part of the origin of the anterior vena cava just behind the angle of junction of the jugular veins. The terminal bend is ampullate and sometimes divides into two very short branches which open close together.

Since the duct develops from a plexus of ducts in the embryo, considerable variation from the more usual course occurs. There is often a left duct which arises at the cisterna or at a variable point from the right duct, runs across the left intercostal arteries parallel to the latter, and unites with it over the base of the heart or further forward. The two are connected by cross-branches. In some cases the left duct is the larger, and there may indeed be none on the right side. Other variations are common.

The chief tributaries of the thoracic duct are as follows:

1. The two lumbar trunks (Trunci lumbales) are formed by the confluence of the efferent ducts of the lumbar glands, and commonly unite with each other and with the posterior intestinal trunk before opening into the cistern.

2. The intestinal trunks (Trunci intestinales), two or three in number, receive the efferents of the lymph glands of the intestine, stomach, liver, and spleen.^[176]

In its course through the thorax the thoracic duct receives efferents from the intercostal, mediastinal, and bronchial glands. At the thoracic inlet it is joined by ducts from the prepectoral and right axillary glands, and by the left tracheal duct. The duct is provided with several pairs of valves; the best developed are at its termination.