Lower limb
Perforating veins of lower limb (Cockett, Boyd, Dodd perforators)
Venae perforantes membri inferioris (Cockett, Boyd, Dodd)
- Origin
- Transfascial communicating veins connecting the superficial saphenous system to the deep venous system
- Insertion
- Cockett's perforators (distal medial calf into posterior tibial veins), Boyd's (proximal medial calf), Dodd's (thigh/adductor canal into femoral vein)
- Function
- Direct blood unidirectionally from superficial to deep venous systems via one-way bicuspid valves
- Innervation
- Sympathetic vasomotor fibers
- Movement & chain
- Valves close during muscular contraction preventing high deep compartment pressures from transmitting to the skin
- Palpation
- Incompetent perforators are palpable as soft fascial 'buttonhole' defects along the medial leg
- Clinical
- Perforator incompetence causes localized venous hypertension, lipodermatosclerosis, and recalcitrant venous leg ulceration (stasis ulcers)
- Segmental innervation
- Transfascial venous network
- In clinical practice
- Duplex ultrasound mapping of pathological reflux; targeted treatment with ultrasound-guided foam sclerotherapy or subfascial endoscopic perforator surgery (SEPS)
- Region in the model
- Lower limb