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Anatomy

Lower Limb

Question 135 of 180

A 65 year old woman presents to the ED with a tender left leg. She has been assessed by your Consultant colleague who feels she may have thrombophlebitis of the great saphenous vein.  Which of the following best describes the course of the great saphenous vein:

Answer:

The great saphenous vein passes anterior to the medial malleolus, travels up the medial side of the leg, knee and thigh to pass through the saphenous opening in the deep fascia covering the femoral triangle, and join with the femoral vein just below the inguinal ligament.

Saphenous Veins

Anatomy / Lower Limb / Anterior Thigh / Popliteal Fossa and Knee

Last Updated: 10th April 2019

The great and small saphenous veins originate from the medial and lateral sides respectively of the dorsal venous arch in the foot.

Great Saphenous Vein

The great saphenous vein passes anterior to the medial malleolus, travels up the medial side of the leg, knee and thigh to pass through the saphenous opening in the deep fascia covering the femoral triangle and join with the femoral vein just below the inguinal ligament.

Small Saphenous Vein

The small saphenous vein passes posterior to the lateral malleolus and up the back of the leg to pierce the deep fascia and join the popliteal vein in the popliteal fossa posterior to the knee.

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Great Saphenous Vein. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Small Saphenous Vein. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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