Anatomy
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Lower Limb
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](https://mrcemsuccess.com/wp-content/uploads/2017/01/Great-Saphenous-Vein.png)
Great Saphenous Vein. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
![By Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://mrcemsuccess.com/wp-content/uploads/2017/01/Small-Saphenous-Vein.png)
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 |
