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Great saphenous vein: Location, Course, Tributaries and Drainage

The great saphenous vein (GSV), also known as the long saphenous vein, is the longest vein in the body and is a major superficial vein of the leg.

Location and Course:
The great saphenous vein originates from the dorsal venous arch of the foot. From there, it courses up along the medial aspect of the foot and then ascends up the anteromedial side of the leg. In the lower third of the thigh, it courses posterior to the medial condyle of the femur. It continues to ascend in the medial part of the thigh. At its termination, it drains into the femoral vein in the femoral triangle at the saphenofemoral junction, which is located approximately 4 cm below the inguinal ligament.

Tributaries:
The GSV receives numerous tributaries along its course. Major tributaries include:

Small Saphenous Vein: It occasionally drains into the GSV but more commonly drains directly into the popliteal vein.
Posterior Arch Vein: Drains blood from the posterolateral aspect of the leg.
Anterior Femoral Cutaneous Veins: Drain the anterior thigh.
Venae Comitantes of Saphenous Artery: Drain the medial side of the leg and foot.
Various superficial veins from the lower leg, ankle, and foot also drain into the GSV.

Drainage:
The great saphenous vein drains into the femoral vein at the saphenofemoral junction. From there, the blood continues its journey upward into the external iliac vein, common iliac vein, and ultimately, the inferior vena cava, before returning to the right atrium of the heart.

It's noteworthy that because of the extensive venous plexus around the GSV, venous return from the leg can still occur even if the GSV is damaged or removed (as can occur in varicose vein surgery or for use as a bypass graft in coronary artery bypass surgery).

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