Venous Drainage of the Upper Limbs

00:01 Now, let's have a look at the superficial venous drainage of the upper limb.

00:05 So, let's just start introducing some muscles that you may well be familiar with.

00:09 We have the pectoralis muscles over the chest. We can see some biceps.

00:12 And then, we can see some muscles on the anterior compartment of the arm.

00:17 What we have lying superficial to these structures are superficial veins and you can see them there on the right-hand side and these are draining the skin of this region.

00:27 What you also have are deeper veins.

00:29 And these often run alongside the arteries that supply the upper limb so the brachial arteries, for example.

00:36 And these are running deeper within those compartments that I spoke about a moment or two ago.

00:42 So, we have both superficial and we have deep veins.

00:45 Let's have a look at this superficial venous drainage.

00:49 There's an important - a couple of important veins which we can see here.

00:53 We have the cephalic and the basilic veins.

00:56 The cephalic sits on the lateral aspect of the upper limb, pretty much within the arm.

01:01 And the basilic veins sits on the medial aspect of the arm.

01:05 And these two are going to form the main venous drainage from the antebrachium, the forearm, as it receives its blood from the hand and the forearm.

01:14 So, here, we can see a posterior view where we have prominent venous drainage.

01:18 We can see some various dorsal arches which receiving the venous drainage that's coming from the posterior surface of the hand.

01:26 These are beginning to form the cephalic vein which is then going to start running up on the lateral aspect to the forearm. And we can see immediately, we have the basilic vein.

01:35 And these are going to course up towards the elbow joint.

01:39 Within the elbow region, we have a really important network of veins.

01:43 We can see the cephalic vein running laterally and we can see the basilic vein is going to run medially.

01:49 This cephalic vein is going to run within a groove between the brachioradialis and the biceps brachii muscle.

01:57 And it runs up that groove superiorly towards the elbow, towards the shoulder joint.

02:03 As it does so, it passes through the deltoid fascia which we spoke about previously.

02:07 It then, round in the deltopectoral groove, a prominent landmark between the deltoid muscle and the pectoralis major muscle.

02:15 And as it does that, it then turns medially, to ultimately run into the axillary vein which we'll come to later.

02:22 As it does this, it passes through the clavipectoral fascia.

02:27 There, we can see the axillary vein where the cephalic vein drains into.

02:31 Now, let's have a look at the basilic vein which was also formed, this time, from the medial aspect on the dorsal surface of the hand.

02:38 And this is going to run up on the medial border of biceps brachii in the bicipital groove, which you can just put your hand on, on the inferior surface of biceps.

02:48 And the basilic vein is going to run up, penetrating past the brachial fascia and that is going to then, unite with the brachial artery.

02:58 Doesn't specifically go to the brachial artery, surrounding the brachial artery of what are called venae comitantes. And these are small veins that are associated with the brachial artery.

03:08 So, the basilic vein merges with these venae comitantes that are taking venous blood from the deep structures of the arm.

03:16 They piggyback alongside the arteries and help that flow of venous return back to the heart as the arteries contract.

03:24 We can see, again, that the basilic vein is then, going to ultimately go into the axillary vein which is then, going to pass towards the subclavian vein.

03:33 On the anterior surface of the elbow, we have a really interesting connectivity between the cephalic vein and the basilic vein.

03:40 And this is usually called the median cubital vein or there can be some variations in how it's formed.

03:46 And on the screen in the moment, you can see how the median cubital vein is connecting branch between the cephalic and the basilic vein can actually have some variation.

03:56 Here, we have what's known an M-shaped version. And here, we have an H-shaped version.

04:01 It's the median cubital vein that is usually approached during venipuncture when people need to have venous blood taken from them for testing and examination.

04:11 The deep venous drain is just going to very much follow that of the arterial supply which we'll cover in a moment or two.

04:18 So, here, we have the brachial artery, passing all the way down from the subclavian artery which gives rise to the axillary artery which gives rise to this brachial artery.

04:27 Run alongside the brachial artery, we have brachial veins.

04:30 Here, we can see the ulnar artery and alongside the ulnar artery, we'll have ulnar veins.

04:36 Similarly, for the radial artery where we have radial veins. So, the brachial artery divides into the ulnar and radial arteries and each of those have a venous version running alongside them. But obviously, going in the opposite direction, taking venous blood.

04:52 The direction of blood flow is important obviously here as the contractility and the pulsatile nature of the arteries and the valves which are located within the veins help to aid venous return.

05:05 So, actually, the venous blood is going to return up from the distal aspect of the upper limb, from the hand, passes all the way up the forearm, into the arm region, before it then moves all the way over back towards the heart.

05:19 So, here, we can see it coming from the cephalic vein. We can see it coming from the basilic vein.

05:23 The deep veins are joining those as the basilic vein hits the venae comitantes of the brachial artery which is surrounding it.

05:31 And we'll see the axillary in that vein then passes underneath the clavicle to become the subclavian vein which will be receiving of a venous drainage from the head and neck region.

05:41 The subclavian vein is then, going to run into the superior vena cava which passes into the right atrium of the heart.

05:49 So, the venous drainage of the upper limb is relatively straightforward if you're familiar with the arterial supply.

05:55 We'll come to the arterial supply later on in another topic but those two, venous and arterial supply structures are very, very similar.