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this video is going to be about the portal venous system. We're going to cover me. And that's me of the portal venous system on Highlight. The position in chemical significance of Porter systemic anastomosis is so firstly to talk about the anatomy of the portal venous system so we can see here, uh, course section through the abdomen. We're about to the veins here on removed some of the major arteries. So a lot of the veins follow a similar course to the arteries in the abdomen. Um, however, there's a a key difference in me and whether draining too. So the superior and inferior mesenteric veins. Instead of draining directly into the systemic circulation into the Vienna Cavor, they drain into the fatty portal vein. So the portal system is. I'm sure you're aware that the system that carries venous blood to the liver for processing uh, on the portal vein, which we can highlight here is ah, joining of splenic vein, which we can see here in a suit on the superior mesenteric vein. You can see here and then we can see it joint. All right, Thie possible too. From underneath the pancreas is this minute vein here on the inferior mesenteric vein. Actually drink into the splenic fame. Okay, We can see. Hear a brief overview of how this works. Uh, we're not gonna go. It's too much detail about the Bunches of the Veramyst. They're banker's. The same the Veramyst attack artery. You remember? Um, the superior rectal vein, the sigmoid veins on the left colon advance. And we can see them or here as well. Training. It's inferior mesenteric vein. Which strains of the splenic can also see superior mesenteric. Uh, they on the left hand side here. And if we just hired at labels, we can see all the branches that contribute to the superior mesenteric the judge in or veins the Eylea colic vein, the right chronic vein in the middle current weight, which will join into this superior recent terror. Right. Uh, and then these transgresses under the pancreas, and if we actually remove the pancreas will be able to see join, uh, the attic portal vein here. All right. Joining with this man that the classical to vein, And as we saw, it starts behind the pancreas. Um, on you could see it also behind the first part of the Georgia. Um, and it will say transgresses just posterior to this combo here for answering the liver. So But now guys talk about the points off portosystemic. Um, that's the most is. So we'll just extend an anastomosis. His connection, Uh, between the veins of the portal venous system and the veins of the systemic venous system import of the assistants separate genetics from the patio portal vein on a systemic system that over genes from the cave. Uh, so the first point of anastomosis we're gonna be talking about is the of the joints the most. He's so well, look here. Uh, branch of veins called the possibility or veins. Um, we just highlight them here. And then these these air point. As you can see as the name suggests, they wrap around the esophagus here. Now, these are a point of connection between the two systems. This is if we go back here, we can see that Originates is something called the Last Gastric band. Last gastric vein being a direct, uh, tributes tree into Patrick portal vein here. All right. However, if we go on the other side of the surgery vans, you can see that they drink. They also draining too, because I A system, if you remember, that is like a system then drains into the superior vena cave up some of the heart here so we can see how he's off the jovenes branch. The, uh, systemic circulation on the venous circulation. Um, So when blood flow is obstructed in the portal system on, that could be due to multiple reasons. Generate a problem with the liver, back cirrhosis or portal with on basis. Pressure on the portal system increases. Right. Then you have something called portal Hypertension. Uh, and you can imagine that there's a place higher pressure in the portal venous system. Blood is gonna be redirected to a place and lower pressure on is gonna try on the low pressure, obviously, in systemic circulation. So if we can imagine what we said, the portal vein has a high pressure. It's going to try really pressure by training into the systemic circulation via the's. A soft events, right? Nothing nasty vein. And then the sulfa Diovan's what? These grades there is these sort of events. You can see a very, uh, small and delicate um, and this increasing pressure causes them to dilate. And if they're, uh, abnormally dilated for a longer period of time, they're they're known as viruses. Um, and these are very susceptible to rupture and can leads Teo blood loss friends, I show you here this is a and this comic and the scopic image of the esophagus. And we can see clearly these softened your varicies on the very prone. It's bleeding. What's going on with TB problem? Well, you go to other points of, uh, clinical significance. So another point of anastomosis is the rectal, and that's the most. He's where, as we said, the superior rectal vein originates from the inferior me since, uh in the middle and inferior mesenteric a rectal vein. Sorry, region eights, uh, from the common area. Right. Then they join in this plexus here burned portal hypertension here dilation off this rectal venous plexus and lead to Vettel a rectal Paris's on which on that colonoscopy image, Miss the rectum also looks similar to a special Paris's. They're finally going to talk about that the, um parent the like, oh, once fasting disease. So we went here to this events with paraumbilical vents. These, uh, drain directly into the uh, that's equal to a vein so you can see where he's originally from the patio portal vein, all right, but they also have a connection. It's this little hand, this stuff and to the epigastric fans in Syria Superior epigastric veins. They also connect to the parent a lot of pains and the know if you're asleep. Superior epigastric events obviously relates to the systemic circulation. Eso again. If there's a high pressure in the portal venous system due to poor little hypertension, uh, cause a backlog, and then these sets off power on the Liable veins can become distended because that's superficial location. You'll be able to see them on examination. Um uh, presents, yes, and that is known as capital Do see I.