Phlebologie 2023; 52(03): 129-139
DOI: 10.1055/a-1969-1443
Curriculare Fortbildung

Physiologie des Venensystems der Extremitäten – Teil 1: Grundbausteine

Physiology of the Venous System of the Extremities – Part 1: Basic Elements
Uwe Wahl

Das Venensystem der Extremitäten ist ständigen hydrostatischen Druckveränderungen ausgesetzt. Es muss neben der Volumenspeicherung auch Funktionen im Stoffaustausch übernehmen. Die Kenntnis über diese physiologischen Mechanismen hilft im klinischen Alltag bei der Diagnostik von Venenerkrankungen und bei der Auswahl der Therapieform. Die Venenfunktion kann durch 4 Grundbausteine definiert werden: Venenanatomie, Herz-Kreislauf-System/Zwerchfellpumpe, Wadenmuskelpumpe und Fußpumpe.


The venous system is constantly subject to changes in hydrostatic pressure in the extremities as the body changes position. In addition to storing blood volumes, the venous system also plays an important role in the exchange of substances. In the first part of the training series, the function of the veins is defined by four basic elements: vein anatomy, cardiovascular system/diaphragmatic descent, the foot pump, and the calf muscle pump. Venous valves are duplications of the intima, and valve cycles consist of an opening, equilibrium, and closing phase. The vascular width of a vein is regulated by neural-humoral controls so that a sympathetically induced adrenergic stimulation mediates venous constriction. The calf muscle pump is divided into proximal and distal parts whose haemodynamic effects differ. In the foot there is a medial and a lateral plantar vein, with the lateral plantar vein playing a crucial role (foot pump) in mobilizing blood volume due to its size and venous capacity. The function of the diaphragmatic descent on the venous return in the supine position without movement of the lower extremity depends on the degree of filling of the inferior vena cava. In combination with the calf muscle pump and foot pump, this results in a complex functional unit. In everyday clinical practice, knowledge of the physiological mechanisms of venous return helps in the diagnosis of venous diseases, and in the selection of the correct therapeutic approach.

Publication History

Article published online:
02 June 2023

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