49.1: Vessels of the Upper Limb

Arteries

Note that the axillary vessels are considered as part of the thorax for the purpose of ICD10. The subclavian vessels are located in the neck.

Brachial Artery


Arteries of the Forearm

Radial Artery

Ulnar Artery


Arteries of the Hand


Veins of the Upper Limb

Unlike the veins of the leg, the major veins of the upper limb are the superficial members (until the axilla).

Deep veins of the arm

Vena comitantes accompany all of the major arteries of the arm, and drain blood from the dorsal and plantar arches to the vessels accompanying the radial and ulnar arteries. These continue to the cubital fossa, where they unite to form vena comitantes of the brachial vein. These vena comitantes merge with the basilic vein in the axilla to form the axillary vein.

Superficial veins of the arm

The superficial veins begin with the dorsal venous network of veins, which lie on the dorsal surface of the hand.

They also make good IV cannula targets!

This network drains medially to the basilic vein and laterally to the cephalic vein, which immediately curve to the anterior side of the forearm. A third vein, the median vein of the forearm, collects blood from the superficial palmar arch and passes along the middle of the anterior forearm.
In the cubital fossa, there are communications between the superficial veins. The median cubital vein passes between the cephalic and the basilic vein. The median vein of the forearm typically drains into the basilic vein, but this is not constant. There are also significant communications between the deep and superficial network in the cubital fossa.
Above the cubital fossa, the basilic vein continues to ascend in the subcutaneous tissue, eventually entering the axilla to form the axillary vein in combination with the vena comitantes of the brachial vein. The cephalic vein follows a longer course, ascending lateral to the biceps brachii and then in between the deltoid and pectoralis major muscles. It then passes deep to pectoralis major to enter the axilla and empties into the axillary vein.

Axillary Vein

The axillary vein is the first deep vein of the arm to exist as a single vessel and not as vena comitantes. It lies anterior and medial to the axillary artery in the lateral axilla; passing to a more inferior position in the apex of the axilla. It is divided into three parts by the pectoralis minor muscle superficially. The cephalic vein typically empties into the proximal part (in the apex of the axilla). Once it passes over the first rib it becomes the subclavian vein.

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