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24.13:

Venous Return

JoVE Core
Anatomy and Physiology
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JoVE Core Anatomy and Physiology
Venous Return

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Venous return refers to the volume of blood flowing back to the heart through systemic veins.

It is primarily driven by the pressure difference between the venules and the right ventricle.

In addition, the skeletal muscle pump and the respiratory pumps also assist in venous return.

In the skeletal muscle pump, contraction of the leg muscles while standing on the toes causes the proximal venous valve to open, pushing blood upward, an action called milking. After the muscles relax, the distal venous valve opens up to push blood upward. Such a sequential contraction and relaxation of muscles help regulate the venous return. 

The respiratory pump works based on alternating compression and decompression of veins during inhalation and exhalation.

When the diaphragm moves downward during inhalation, pressure decreases in the thoracic cavity and increases in the abdominal cavity, leading to vein compression and a greater volume of blood moving to the heart.

24.13:

Venous Return

The circulatory system plays a crucial role in ensuring the optimal functioning of the human body. One of its critical components is venous return – the process that completes the blood circulation cycle. This article will delve into the concept of venous return, how it works, and its significance to our health.

What is Venous Return?

Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system as it ensures the continuous flow of blood, which carries oxygen and nutrients necessary for various bodily functions.

Facilitating Venous Return: The Role of Pressure Difference

The primary facilitator of venous return is the pressure difference between the peripheral veins and the right atrium of the heart. Blood naturally flows from areas of higher pressure to those of lower pressure. The pressure in the veins is higher compared to the right atrium, prompting the blood to flow back towards the heart.

However, when this pressure difference is inadequate, venous return can be compromised. This can occur due to factors such as blood loss, dehydration, or heart conditions that reduce the heart's pumping capacity. When the venous return is insufficient, it can lead to reduced cardiac output, meaning the heart cannot pump enough oxygen-rich blood to meet the body's needs. This can ultimately result in symptoms such as fatigue, shortness of breath, and even organ damage if not promptly addressed.

Respiratory and Muscular Pumps: Ensuring Normal Venous Return

The body employs two main mechanisms to aid venous return – the respiratory and muscular pumps.

The respiratory pump is engaged during breathing. As we inhale, the pressure in the chest cavity decreases, and the pressure in the abdominal cavity increases. This pressure difference encourages blood to flow from the veins in the abdomen (where pressure is high) to the chest veins and eventually into the heart.

The muscular pump, on the other hand, involves the action of our skeletal muscles. As these muscles contract and relax during movement, they squeeze the veins running through them. This action pushes the blood towards the heart, aided by one-way valves in the veins that prevent backflow.

Clinical Significance and Conditions Affecting Venous Return:

Understanding venous return is essential in clinical practice, as alterations in this process can lead to various medical conditions.

For instance, heart failure can result in inadequate venous return due to the heart's reduced pumping capacity. Deep vein thrombosis (DVT), a condition characterized by blood clots in the deep veins of the legs, can also impede venous return, leading to swelling and pain.

In contrast, conditions such as varicose veins are a result of excessive venous return. In this case, the veins become enlarged and overfilled with blood, primarily due to faulty valves that allow backflow.

Moreover, understanding venous return is crucial in managing shock, an emergency condition where the blood pressure drops dangerously low. In such scenarios, treatments often aim to increase venous return to boost cardiac output and restore blood pressure.

In conclusion, venous return plays a vital role in maintaining our body's circulatory balance. Its importance underscores the need for regular exercise and healthy lifestyle choices that support optimal cardiovascular function. By understanding its mechanisms, we can better appreciate how our bodies work and how to take care of them.