The veins of the upper body

The veins of the upper body

The veins of the upper limb are divided into a superficial group which lie in the superficial fascia, and a deep group which accompany the arteries. Both groups of veins have valves which allow proximal drainage (a fact which should be borne in mind when using massage) and drain into the axillary vein.

The deep veins

Apart from the axillary artery, which is accompanied by a single vein, all of the arteries are accompanied by two venae comitantes.

The axillary vein is the continuation of the basilic vein at the lower border of teres major. It ends by becoming the subclavian vein  at the lateral border of the first rib. Its course is identical to that of the axillary artery, which lies lateral to it.

The superficial veins

These are arranged in irregular networks in the superficial fascia. They are connected with the deep veins by inconstant perforating veins which pierce the deep fascia. The blood is drained from the superficial system principally by the basilica and cephalic veins.

The main superficial channels are as follows:

1) The dorsal venous arch

This would be better named the dorsal venous plexus, for its arch-like nature is seldom apparent. It lies on the back of the hand, its position and pattern being highly variable.

2) The basilic vein

This arises from the ulnar side of the arch and ascends along the ulnar side of the distal half of the forearm befoe inclining forwards to pass in front of the medial epicondyle and enetering the medial bicipital furrow. Opposite the insertion of coracobrachialis, it pierces the deep fascia to ascend along the medial side of the brachial vessels to become the axillary vein at the lower border of teres major. In the forearm it can usually be clearly seen, particularly in males. It is joined by tributaries from the forearm and by the median cubital vein in front of the elbow.

3) The cephalic vein

This arises from the radial end of the dorsal venous arch and receives the dorsal veins of the thumb. Inclining forwards, it ascends on the anterolateral part of the forearm as far as the elbow, and then along the lateral side of the biceps tendon to reach the groove in front of the shoulder between deltoid and pectoralis major(the deltopectoral groove). It ascends in this groove to the level of the coracoid process where it turns medially between pectoralis major and pectoralis minor. It pierces the clavipectoral fascia and ends in the axillary vein at a point just below the middle of the clavicle. It receives several tributaries in the forearm, and at the elbow is connected to the basilic vein by the median cubital vein.

4) The medial cubital vein

This is a short, wide vein, useful for venepuncture. It runs upwards and medially across the bicipital aponeurosis. The latter separates it from the underlying brachial artery. It joins the basilic vein just above the medial epicondyle.

5) The anterior median vein of the forearm

When present, this vein runs up the middle of the front of the forearm and may join the basilic or cephalic vein, or may divide at the cubital fossa into the median cephalic and median basilic veins.