Superficial Venous Drainage – Cutaneous Innervation and Venous Drainage of Upper Limb

00:00 If we now move on to some venous drainage, then there are two important blood vessels that return venous blood to the heart from the upper limb. These are known as the cephalic and the basilic veins. And we can see these just briefly here on this anterior view of a right upper limb. We can see we've got the cephalic vein here and we have got the basilic vein.

00:26 This diagram on the opposite side of this picture here is indicating more deep veins and we'll just cover those briefly. So, two important veins are taking venous blood from the upper limb back to the heart, the cephalic and the basilic. Both of these veins originate from the venous network which is located on the dorsum of the hand. So this is the palmar surface of the hand. On the dorsum which is the posterior surface we have what's known as the venous network.

01:04 And this venous network gives rise to the cephalic and to the basilic veins. We can see them here a cephalic vein and we can see a basilic vein running up. This will pass all the way up to form the axillary vein and here we can see the cephalic vein which will run all the way up and pass into the axillary vein. These ascend up the upper limb within the subcutaneous tissue. So they runs superficial to the deep fascia and both of these join up with the axillary vein. We can see on this side of the slide, this picture, the deep veins.

01:48 I am not going to talk about these much because we can cover them throughout the course when we look at the musculature. But the deep veins all located deep to the deep fascia. So they are running within the muscular compartments and they run alongside the arteries of the upper limb.

02:06 So for example, an artery of the upper limb is the brachial artery, so we have brachial veins.

02:12 An radial and ulnar arteries, so we have radial and ulnar veins. And typically these veins run as pairs or threes and they are very small little channels that are running alongside the arteries. Because these veins have valves in, they used to contractile properties of the arteries to propel the blood through the venous system. But due to the presence of valves, the blood can only pass in one direction which is back to the heart. Due to these valves, it can't pass distally. It only passes proximally as it heads towards the heart. So just look at the deep veins quite briefly. Here we can see if we turn to the superficial veins again, we have got the cephalic vein and we have got the basilic vein. So on this diagram here, we can see the hand in this extreme over here. We can see the forearm in the middle and then we can see the arm in this opposite extreme on the screen. And what we can see in the hand region is this dorsal network. We can see we have this small lateral dorsal network here and we have a more medial dorsal network here. But these are all receiving veins coming from the digits.

03:25 The cephalic vein is formed from this lateral dorsal network and its going to run up the lateral aspects of the forearm. It ascends the anterolateral aspect of the forearm, so here we can see a forearm, the anterior surface and here is the posterior surface. So here we have got the lateral aspects, we can see the cephalic vein running up in this direction and then it is going to run up into the arm. And we can pick it up again here. This is the forearm here, this is the arm. So we can see the cephalic vein is running up and then it runs up along this side of the arm. You can see it is running in and it is piercing this deltoid fascia.

04:07 So as I said, these veins are running superficial to the deep fascia. But ultimately they have to pierce the deep fascia to then pass into and form the axillary vein. If we now turn to the basilic vein, this emerges from the medial dorsal network, so we can see it here coming from this medial dorsal network, and here we’ve got the basilic vein. This is going to ascend the medial forearm and then enter into the medial aspect of the arm. So here we can see it, just running up here, we can see it coming from the medial aspect of the basilic vein, And then running up, pick it up again here, we see the basilic vein running all the way up, and then it is passing all the way up into the arm.

04:54 Here again we can see it pierces the brachial fascia. We can see its piercing the brachial fascia now and it actually unites with the deep brachial vein to form the axillary vein. So it pierces the brachial fascia and emerges with the deep brachial vein to form the axillary vein. So the brachial vein has run alongside the brachial artery. Coming from deep, it receives the basilic vein, And these two veins uniting, form the axillary vein. The axillary vein then runs up the axilla where it receives the cephalic vein and then it becomes the subclavian, which passes back to the heart. So we can see we’ve got this superficial cutaneous venous drainage, primarily from the cephalic vein and from the basilic vein.

05:47 At the elbow joint there is a very important communication between the cephalic vein and the basilic vein. And this little communication here, it lies directly anterior to the elbow joint, and its known as the medial cubital vein. This runs across, joining the cephalic and the basilic vein. And this is an important location for venupuncture if blood is to be removed from the venous system. A communication anterior to the elbow, that connects the cephalic vein to the basilic vein, a very important communication.