May 18, 2012
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Veins Of The Heart

The systemic veins may be arranged into three groups: (1) The veins of the heart. (2) The veins of the upper extremities, head, neck, and thorax, which end in the superior vena cava. (3) The veins of the lower extremities, abdomen, and pelvis, which end in the inferior vena cava.

a. The Veins of the Heart

Coronary Sinus (sinus coronarius).—

(VV. Cordis)

—Most of the veins of the heart (Fig. 90556) open into the coronary sinus. This is a wide venous channel about 2.25 cm. in length situated in the posterior part of the coronary sulcus, and covered by muscular fibers from the left atrium. It ends in the right atrium between the opening of the inferior vena cava and the atrioventricular aperture, its orifice being guarded by a semilunar valve, the valve of the coronary sinus (valve of Thebesius).

Tributaries.—Its tributaries are the great, small, and middle cardiac veins, the posterior vein of the left ventricle, and the oblique vein of the left atrium, all of which, except the last, are provided with valves at their orifices.

1. The Great Cardiac Vein (v. cordis magna; left coronary vein) begins at the apex of the heart and ascends along the anterior longitudinal sulcus to the base of the ventricles. It then curves to the left in the coronary sulcus, and reaching the back of the heart, opens into the left extremity of the coronary sinus. It receives tributaries from the left atrium and from both ventricles: one, the left marginal vein, is of considerable size, and ascends along the left margin of the heart.

2. The Small Cardiac Vein (v. cordis parva; right coronary vein) runs in the coronary sulcus between the right atrium and ventricle, and opens into the right extremity of the coronary sinus. It receives blood from the back of the right atrium and ventricle; the right marginal vein ascends along the right margin of the heart and joins it in the coronary sulcus, or opens directly into the right atrium.

3. The Middle Cardiac Vein (v. cordis media) commences at the apex of the heart, ascends in the posterior longitudinal sulcus, and ends in the coronary sinus near its right extremity.

4. The Posterior Vein of the Left Ventricle (v. posterior ventriculi sinistri) runs on the diaphragmatic surface of the left ventricle to the coronary sinus, but may end in the great cardiac vein.

5. The Oblique Vein of the Left Atrium (v. obliqua atrii sinistri [Marshalli]; oblique vein of Marshall) is a small vessel which descends obliquely on the back of the left atrium and ends in the coronary sinus near its left extremity; it is continuous above with the ligament of the left vena cava (lig. venæ cavæ sinistræ vestigial fold of Marshall), and the two structures form the remnant of the left Cuvierian duct.

FIG. 90556– Base and diaphragmatic surface of heart.

The following cardiac veins do not end in the coronary sinus: (1) the anterior cardiac veins, comprising three or four small vessels which collect blood from the front of the right ventricle and open into the right atrium; the right marginal vein frequently opens into the right atrium, and is therefore sometimes regarded as belonging to this group; (2) the smallest cardiac veins (veins of Thebesius), consisting of a number of minute veins which arise in the muscular wall of the heart; the majority open into the atria, but a few end in the ventricles.