The
inferior vena cava (or IVC) is the large
veinIn the circulatory system, veins are blood vessels that carry blood toward the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated blood...
that carries de-oxygenated
bloodBlood is a specialized bodily fluid that delivers necessary substances to the body's cells — such as nutrients and oxygen — and transports waste products away from those same cells....
from the lower half of the body into the
right atriumThe right atrium is one of four chambers in the human heart. It receives deoxygenated blood from the superior and inferior vena cava and the coronary sinus, and pumps it into the right ventricle through the tricuspid valve...
of the
heartThe heart is a muscular organ found in all vertebrates that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
.
It is posterior to the abdominal cavity and runs alongside of the
vertebral columnIn human anatomy, the vertebral column is a column usually consisting of 33 vertebrae, the sacrum, intervertebral discs, and the coccyx situated in the dorsal aspect of the torso, separated by spinal discs...
on its right side (i.e. it is a retroperitoneal structure). It enters the
right atriumThe right atrium is one of four chambers in the human heart. It receives deoxygenated blood from the superior and inferior vena cava and the coronary sinus, and pumps it into the right ventricle through the tricuspid valve...
at the lower right, back side of the heart.
Drainage patterns
The IVC is formed by the joining of the left and right
common iliac veinIn human anatomy, the common iliac veins are formed by the external iliac veins and internal iliac veins and together, in the abdomen at the level of the fifth lumbar vertebrae, form the inferior vena cava. They drain blood from the pelvis and lower limbs....
s and brings blood into the
right atriumThe right atrium is one of four chambers in the human heart. It receives deoxygenated blood from the superior and inferior vena cava and the coronary sinus, and pumps it into the right ventricle through the tricuspid valve...
of the heart. It also
anastomosesAn anastomosis is a network of streams that both branch out and reconnect, such as blood vessels or leaf veins. The term is used in medicine, biology, mycology and geology.-Medicine:...
with the
azygos veinThe azygos vein is a vein running up the right side of the thoracic vertebral column. It can also provide an alternate path for blood to the superior vena cava.-Structure:...
system (which runs on the right side of the vertebral column) and the venous
plexusA plexus is a network. In biology the term plexus has multiple meanings:-Nervous system:In many animals the processes of neurons join together to form a plexus or nerve net.-In vertebrates:...
es next to the
spinal cordThe spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain. The brain and spinal cord together make up the central nervous system. It is around 45 cm long in men and around 43 cm long in women. The length of the spinal cord is much shorter than...
.
The
caval openingThe caval opening is a hiatus in the diaphragm of humans through which passes the inferior vena cava, the wall of which is adherent to the margins of the opening, and some branches of the right phrenic nerve....
is at T8. The specific levels of the branches are as follows:
| Vein |
Level
>-
| inferior phrenic veinThe Inferior Phrenic Veins drain the diaphragm and follow the course of the inferior phrenic arteries;* the right ends in the inferior vena cava;* the left is often represented by two branches,** one of which ends in the left renal or suprarenal vein,...
|
|
>-
| hepatic veinIn human anatomy, the hepatic veins are the blood vessels that drain de-oxygenated blood from the liver and blood cleaned by the liver into the inferior vena cava....
|
>-
| suprarenal veinsThe Suprarenal veins are two in number:* the right ends in the inferior vena cava.* the left ends in the left renal or left inferior phrenic vein....
|
>-
| renal veinThe renal veins are veins that drain the kidney. They connect the kidney to the inferior vena cava.It is usually singular to each kidney, except in the condition "multiple renal veins".It also divides into 2 divisions upon entering the kidney:...
|
>-
| gonadal veinIn medicine, gonadal vein refers to the blood vessel that carrying blood away from the gonad toward the heart.* Females : ovarian vein* Males : testicular vein...
|
>-
| lumbar veinsThe lumbar veins are veins running along the inside of the posterior abdominal wall. They are the lumbar equivalent of the posterior intercostal veins.-See also:* Posterior intercostal veins* Subcostal vein* Ascending lumbar vein...
|
>-
| common iliac veinIn human anatomy, the common iliac veins are formed by the external iliac veins and internal iliac veins and together, in the abdomen at the level of the fifth lumbar vertebrae, form the inferior vena cava. They drain blood from the pelvis and lower limbs....
L5 |
Because the IVC is not centrally located, there are some asymmetries in drainage patterns. The
gonadal veinIn medicine, gonadal vein refers to the blood vessel that carrying blood away from the gonad toward the heart.* Females : ovarian vein* Males : testicular vein...
s and suprarenal veins drain into the IVC on the right side, but into the
renal veinThe renal veins are veins that drain the kidney. They connect the kidney to the inferior vena cava.It is usually singular to each kidney, except in the condition "multiple renal veins".It also divides into 2 divisions upon entering the kidney:...
on the left side, which in turn drains into the IVC. By contrast, all the
lumbar veinsThe lumbar veins are veins running along the inside of the posterior abdominal wall. They are the lumbar equivalent of the posterior intercostal veins.-See also:* Posterior intercostal veins* Subcostal vein* Ascending lumbar vein...
and hepatic veins usually drain directly into the IVC.
Note that the vein that carries de-oxygenated blood from the upper half of the body is the
superior vena cavaThe superior vena cava is a large diameter, yet short vein that carries deoxygenated blood from the upper half of the body to the heart's right atrium....
.
Pathologies associated with the IVC
Health problems attributed to the IVC are most often associated with it being compressed (ruptures are rare because it has a low intraluminal
pressurePressure is the force per unit area applied in a direction perpendicular to the surface of an object. Gauge pressure is the pressure relative to the local atmospheric or ambient pressure.- Definition :...
). Typical sources of external pressure are an enlarged
aortaThe aorta is the largest artery in the body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation....
(
abdominal aortic aneurysmAbdominal aortic aneurysm is a localized dilatation of the abdominal aorta exceeding the normal diameter by more than 50 percent. It is caused by degeneration of the aortic wall, but the exact etiology remains unknown...
), the gravid
uterusThe uterus is a major female hormone-responsive reproductive sex organ of most mammals, including humans. It is within the uterus that the fetus develops during gestation. The term uterus is used consistently within the medical and related professions; the Germanic term, womb is more common in...
(
aortocaval compression syndromeAortocaval compression syndrome, is compression of the abdominal aorta and inferior vena cava by the gravid uterus when a pregnant woman lies on her back, i.e. in the supine position...
) and abdominal maligancies, such as
colorectal cancerColorectal cancer, also called colon cancer or large bowel cancer, includes cancerous growths in the colon, rectum and appendix. With 655,000 deaths worldwide per year, it is the third most common form of cancer and the third leading cause of cancer-related death in the Western world. Many...
,
renal cell carcinomaRenal cell carcinoma is a kidney cancer that originates in the lining of the proximal convoluted tubule, the very small tubes in the kidney that filter the blood and remove waste products. RCC is the most common type of kidney cancer in adults, responsible for approximately 80% of cases...
and
ovarian cancerOvarian cancer is a cancerous growth arising from different parts of the ovary.The most common form of ovarian cancer arises from the outer lining of the ovary.. However, recent evidence shows cells that line the Fallopian tube also to be prone to develop into the same kind of cancer as seen in...
. Since the inferior vena cava is primarily a right-sided structure, unconscious pregnant females should be turned on to their left side (the
recovery positionThe recovery position, more technically the lateral recumbent position, is an airway management technique for assisting people who are unconscious, or nearly so, but are still breathing. It is frequently taught alongside CPR in first aid....
), to relieve pressure on it and facilitate venous return. In rare cases, straining associated with
defecationDefecation is the final act of digestion by which organisms eliminate solid, semisolid or liquid waste material from the digestive tract via the anus. Humans usually defecate from three times a week, up to three times a day...
can lead to restricted blood flow through the IVC and result in syncope (fainting).
Occlusion of the IVC is rare, but considered life-threatening and is an emergency. It is associated with
deep vein thrombosisIn medicine, deep vein thrombosis is the formation of a blood clot in a deep vein...
, IVC filters,
liver transplantationLiver transplantation or hepatic transplantation is the replacement of a diseased liver with a healthy liver allograft. The most commonly used technique is orthotopic transplantation, in which the native liver is removed and the donor organ is placed in the same anatomic location as the original...
and instrumentation (e.g.
catheterIn medicine a catheter is a tube that can be inserted into a body cavity, duct or vessel. Catheters thereby allow drainage, injection of fluids or access by surgical instruments. The process of inserting a catheter is catheterization. In most uses a catheter is a thin, flexible tube , although...
in the
femoral veinIn the human body, the femoral vein is a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor canal and is a continuation of the popliteal vein...
).
Embryology
In the
embryoAn embryo is a multicellular diploid eukaryote in its earliest stage of development, from the time of first cell division until birth, hatching, or germination...
, the IVC and right atrium are separated by the Eustachian valve, also known in
LatinLatin is an Italic language originally spoken in Latium and Ancient Rome. Through the Roman conquest, Latin spread throughout the Mediterranean and a large part of Europe...
as the
valvula venae cavae inferiore (valve of the inferior vena cava). In the adult, this structure typically has totally regressed or remains as a small endocardial fold.
See also
- Inferior vena cava filter
An inferior vena cava filter, also IVC filter a type of vascular filter, is a medical device that is implanted into the inferior vena cava to prevent fatal pulmonary emboli ....
- Inferior vena cava syndrome
Inferior vena cava syndrome is a result of obstruction of the inferior vena cava. It can be caused by invasion or compression by a pathological process or by thrombosis in the vein itself.-Frequency:...
- Recovery position
The recovery position, more technically the lateral recumbent position, is an airway management technique for assisting people who are unconscious, or nearly so, but are still breathing. It is frequently taught alongside CPR in first aid....
- Superior vena cava
The superior vena cava is a large diameter, yet short vein that carries deoxygenated blood from the upper half of the body to the heart's right atrium....
External links
- "Eustachian valve" - "Posterior Abdominal Wall: Tributaries to the Inferior Vena Cava"