BAU-P1-VENOUS DRAINAGE OF UPPER LIMB-2023.pdf

VENOUS DRAINAGE OF THE UPPER LIMB Superficial Veins • The major superficial veins of the upper limb are the cephalic and basilic veins. • They are located within the subcutaneous tissue of the upper limb. Etymology • CephalicVein – Cephalic, in the case of this vein, is said to be unrelated to c...

VENOUS DRAINAGE OF THE UPPER LIMB Superficial Veins • The major superficial veins of the upper limb are the cephalic and basilic veins. • They are located within the subcutaneous tissue of the upper limb. Etymology • CephalicVein – Cephalic, in the case of this vein, is said to be unrelated to cephalic as pertaining to the head. • Rather, it derives from the Arabic word al-kifal meaning “outer”, its position on the arm. • In transition from the Arabic it mistakenly became “cephalic”. • Basilic Vein – In this case, basilic is derived, not from the Greek and Roman words related to royalty but from the Arabic al-basilik mean “inner” due to its location. Basilic Vein • The basilic vein originates from the dorsal venous network of the hand and ascends the medial aspect of the upper limb. • At the border of the teres major, the vein moves deep into the arm. • Here, it combines with the brachial veins from the deep venous system to form the axillary vein. Cephalic Vein • The cephalic vein also arises from the dorsal venous network of the hand. • It ascends the antero-lateral aspect of the upper limb, passing anteriorly at the elbow. • At the shoulder, the cephalic vein travels between the deltoid and pectoralis major muscles (known as the deltopectoral groove), and enters the axilla region via the clavipectoral triangle. Cephalic Vein • Within the axilla, the cephalic vein empties into axillary vein. • The cephalic and basilic veins are connected at the elbow by the median cubital vein. Deep Veins • The deep venous system of the upper limb is situated underneath the deep fascia. • It is formed by paired veins, which accompany and lie either side of an artery. In the upper extremity, the deep veins share the name of the artery they accompany. • The brachial veins are the largest in size, and are situated either side of the brachial artery. • The pulsations of the brachial artery assist the venous return. • Veins that are structured in this way are known as vena comitantes. • Perforating veins run between the deep and superficial veins of the upper limb, connecting the two systems. Clinical Relevance: Venepuncture • Venepuncture is the practice of obtaining intravenous access. • This is usually for the purpose of providing intravenous therapy (e.g. fluids, medications) or for obtaining a blood sample. • The median cubital vein is a common site of venepuncture. • It is a superficial vein that is located anteriorly to the cubital fossa region. • It is thought to be fixed in place by perforating veins, which arise from the deep venous system and pierce the bicipital aponeurosis. • Its ease of access, fixed position and superficial position make the median cubital vein a good site for venepuncture in many individuals. Lacertus fibrosus • Some individuals (about 3% of the population) have a superficial ulnar artery that runs superficially to the bicipital aponeurosis instead of underneath it. • These individuals are at risk for accidental injury to the ulnar artery during venipuncture.