M01.03.039 Venous Drainage

The venous system of the upper limb is responsible for draining deoxygenated blood from the arm, forearm, and hand. It is divided into two main systems: the superficial system and the deep system. This article provides an overview of the anatomy, structure, and clinical significance of the upper limb veins.

Superficial Veins of the Upper Limb

The major superficial veins of the upper limb include the cephalic vein and basilic vein. These veins are located within the subcutaneous tissue and have distinct anatomical pathways.

1. Basilic Vein

Origin: Dorsal venous network of the hand
Course:
- Ascends along the medial aspect of the upper limb
- Moves deep at the border of the teres major
- Joins the brachial veins to form the axillary vein
Clinical Relevance: Often used for venepuncture in the medial aspect of the arm.

2. Cephalic Vein

Origin: Dorsal venous network of the hand
Course:
- Ascends the antero-lateral aspect of the arm
- Passes anteriorly at the elbow
- Travels through the deltopectoral groove (between deltoid and pectoralis major)
- Enters the axilla via the clavipectoral triangle
- Drains into the axillary vein
Clinical Relevance: Commonly used for intravenous access due to its prominence and accessibility.

3. Median Cubital Vein

Connection: Connects the cephalic and basilic veins at the elbow
Clinical Relevance: Frequently used for venepuncture due to its fixed position and ease of access.

Table 1: Summary of Superficial Veins

Vein	Origin	Course	Clinical Relevance
Basilic Vein	Dorsal venous network of the hand	Medial aspect of the arm, joins brachial veins at teres major border	Venepuncture, medial arm access
Cephalic Vein	Dorsal venous network of the hand	Antero-lateral arm, deltopectoral groove, enters axilla	Venepuncture, IV access
Median Cubital Vein	Connects cephalic and basilic veins	Elbow region, fixed in place by perforating veins	Common site for venepuncture

Deep Veins of the Upper Limb

The deep venous system lies beneath the deep fascia and is formed by paired veins that accompany arteries. These veins are named after the arteries they accompany.

1. Brachial Veins

Structure: Paired veins that run alongside the brachial artery
Function: Assist in venous return through the pulsations of the brachial artery
Clinical Relevance: Essential for venous circulation in the arm and involved in conditions like deep vein thrombosis (DVT).

2. Vena Comitantes

These are veins that run in pairs, one on each side of an artery, and share the same name as the artery.

3. Perforating Veins

Function: Connect the deep and superficial venous systems, allowing for the exchange of blood between the two systems.
Clinical Relevance: Play a role in venous circulation and can be involved in conditions like varicose veins.

Table 2: Major Deep Veins

Vein	Associated Artery	Function	Clinical Relevance
Brachial Veins	Brachial artery	Carry blood from the arm to the axillary vein	Venous return, DVT involvement
Vena Comitantes	Arteries of the upper limb	Run parallel with arteries, aiding circulation	Important for arterial and venous blood flow
Perforating Veins	Superficial veins	Connect deep and superficial venous systems	Involved in venous return and varicose veins

Clinical Relevance of Upper Limb Veins

1. Venepuncture

Procedure: Venepuncture involves obtaining intravenous access, typically for fluids, medications, or blood samples.
Common Sites:
- Median cubital vein: Preferred due to its superficial location, ease of access, and fixed position, making it less prone to movement during insertion.

Points to Remember:

Basilic and Cephalic Veins: Primary superficial veins in the arm.
Median Cubital Vein: Connects the cephalic and basilic veins and is a key site for venepuncture.
Brachial Veins: Located alongside the brachial artery and play a significant role in venous return.
Perforating Veins: Connect deep and superficial venous systems, aiding circulation.

M01 Human Anatomy

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