General
features of superficial veins of upper limb
1.
The superficial veins lie in the superficial
fascia
2.
The superficial vein have a tendency to run
away from the pressure sites , so they are absent in the palm along the ulnar
border of forearm and back of the elbow
3.
There are
two main superficial veins one along the pre-axial border and the other along
the post-axial border of the upper limb.
4.
Cephalic vein is the pre-axial vein which is
longer than the post-axial basilic vein but basilic vein drain more blood from
superior extremity
5.
Most of the blood of cephalic vein drain into
the basilic vein through the median cubital vein
6.
Superficial veins are accompanied by
cutaneous nerves and superficial lymphatics
Name
of superficial veins of upper limb
2.
Pre-axial cephalic vein
3.
Post –axial basilic vein
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Dorsal venous arch
The dorsal venous network of
the hand is
a network of veins in the superficial fascia on the dorsum of hand
formed by the dorsal metacarpal veins.
It is included in the
superficial venous system.
It is
an irregular arrangement of veins with transverse element which lies 2-3 cm
proximal to the heads of metatarsal bones
Tributaries :
three dorsal metatarsal veins
1.
A dorsal digital vein from the medial side of
little finger
2.
A dorsal digital vein from the lateral side
of index finger
3.
Two dorsal digital veins of the thumb
4.
Veins draining palm of hand
a)
veins that pass around the margins of the hand and
b)
perforating veins which pass dorsally through the interosseous spaces
1.
Its main function is the venous drainage of
the hand.
2.
It not only receives blood from the palm
around the borders of the hand, but also from veins that go through the
interosseous spaces.
3.
In practical terms, this means that even when
there is pressure on the palm from a gripping action, venous return does not
slow.
4.
In addition, the cephalic and basilic veins
come up from the dorsal venous arch. These are responsible for joining the deep
veins and the lymphatics.
It drains into cephalic and
basilica veins – the efferent vessels of dorsal venous arch but most of the blood from the entire hand
drains into the arch of the hand.
It begins as the
continuation of lateral end of the dorsal venous arch
·
It crosses the roof of anatomical snuff box
·
Then it ascends on the radial border of the
forearm , continues upwards in front of the elbow along the lateral border of
the biceps
·
It pierces the deep fascia at the lower
border of the pectoralis major , the deltopectoral groove up to the
infraclavicular fossa
·
In the infraclavicular fossa , it pierces the
clavipectoral fascia and drains into the axillary vein (deep vein of upper limb)
·
It is routinely used for giving intravenous
injections and for withdrawing blood from donors
·
The cephalic vein is preferred for
hemodialysis in patients with chronic renal failure to remove waste products
from blood
·
The cut down of cephalic vein in the
deltopectoral groove is preferred when superior vena caval infusion is necessary
·
Cephalic vein is not preferred for
cardiac catheterization due to the following reasons
1. Its diameter
does not increase as it ascends
2. It joins
the axillary vein at a right angle hence it is difficult ot maneuver the catheter
around sharp cephaloaxillary angle
3. In deltopectoral
groove it frequently divides into small branches
4. One of
the branches ascends over the clavicle and joins the external jugular vein
It is
begins as the continuation of the medial end of the dorsal venous arch of the
hand
·
It runs upwards along the back of the medial
border of the forearm winds round this border near the elbow to reach the
anterior aspect of the forearm
·
Then it continues upwards in front of the
elbow along the medial side of the biceps brachii up to middle of the arm
·
At the middle of the arm it pierces deep
fascia unites with the brachial veins and runs along the medial side of the
brachial artery
·
Then it continued with axillary vein at the
lower border of the teres major
·
It is routinely used for giving intravenous
injections and for withdrawing blood from donors
·
The basilic vein is preferred for cardiac
catheterization for the following reason
·
The diameter of basilic vein increases as it
ascends from cubital fossa to the axillary vein
·
It is in direct line with the axillary vein .
to enter the right atrium the catheter passes in succession as follows
·
Basilic vein > axillary vein >
subclavian vein > brachiocephalic vein > superior vena cava > right
atrium of heart
It is the communicating venous channel between cephalic and basilica
veins which shunts blood from cephalic vein to the basilic vein
·
It begins from the cephalic
vein 2.5 cm below the elbow bend runs obliquely upwards and medially to end in
the basilica vein 2.5 cm above the bend of elbow
·
The important features of
median cubital vein are as follows
·
It is separated from brachial
artery by bicipital apneurosis
·
It communicates with the deep
veins through a perforating vein which pierce the bicipital aponeurosis
·
It receives median vein of
the forearm
·
It shunts blood from cephalic
vein to basilic vein
·
It is routinely used for giving intravenous
injections and for withdrawing blood from donors
·
The median cubital vein is most preferred due
to the following reasons
·
It is the most superficial vein of the body
hence access is easy
·
It is well supported by the underlying bicipital
aponeurosis
·
It is well anchored to the deep vein by a
perforating vein hence it does not slip during procedure
Median vein of the forearm
It begins from palmar venous networks runs upwards in the midline
on the anterior aspect of forearm to end in any one of three veins in front of
elbow
Sometimes upper end of median vein of forearm bifurcates into
median cephalic and basilic veins respectively
In this situation the median cubital vein is absent
Common venous patterns in front of the elbow
The veins in front of the elbow commonly form two patterns
·
It is
routinely used for giving intravenous injections and for withdrawing blood from
donors
