Veins of the upper extremity

There are superficial and deep veins of the upper limb. They are connected to each other by a large number of anastomoses and have numerous valves. Superficial (subcutaneous) veins are more developed than deep ones (especially on the back of the hand). The main venous pathways of the skin and subcutaneous tissue begin from them - the lateral and medial subcutaneous veins of the hand, which receive blood from the venous plexus of the back of the fingers.

Superficial veins of the upper limb

The dorsal metacarpal veins (vv. metacarpales dorsales, 4 in total) and the anastomoses between them form the dorsal venous network of the hand (rete venosum dorsale manus) on the dorsal surface of the fingers, metacarpus and wrist. On the palmar surface of the hand, the superficial veins are thinner than on the dorsal surface. They originate from the venous plexus of the fingers, in which the palmar digital veins (vv. digitales palmares) are distinguished. Through numerous anastomoses, located mainly on the lateral sides of the fingers, the blood flows into the dorsal venous network of the hand.

The superficial veins of the forearm, into which the veins of the hand continue, form a plexus, in which the lateral and medial subcutaneous veins of the hand are clearly visible.

The lateral saphenous vein of the arm (v. cephalica) begins from the radial part of the venous network of the dorsal surface of the hand, being a continuation of the first dorsal metacarpal vein (v. metacarpals dorsalis prima). It follows from the dorsal surface of the hand to the anterior surface of the radial edge of the forearm and, enlarging, goes to the cubital fossa. Here the lateral saphenous vein of the arm anastomoses through the intermediate vein of the elbow with the medial saphenous vein of the arm. Then the vein continues onto the shoulder in the lateral groove of the biceps brachii, then in the groove between the deltoid and pectoralis major muscles, pierces the fascia and flows under the clavicle into the axillary vein.

The medial saphenous vein of the arm (v. basilica) is a continuation of the fourth dorsal metacarpal vein (v. metacarpalis dorsalis, 4th) passes from the back of the hand to the ulnar side on the anterior surface of the forearm and follows to the cubital fossa, where it receives the intermediate vein of the elbow. Then the medial saphenous vein ascends along the medial groove of the biceps brachii muscle to the shoulder. At the border of its lower and middle thirds, it pierces the fascia and flows into one of the brachial veins.

The intermediate vein of the elbow (v. intermedia cubiti) has no valves and is located under the skin in the anterior elbow region. It runs obliquely from the lateral saphenous vein of the arm to the medial saphenous vein of the arm, also anastomosing with the deep veins. Often, in addition to the lateral and medial saphenous veins, the intermediate vein of the forearm (v. intermedia antebrachii) is located on the forearm. In the anterior elbow region, it flows into the intermediate vein of the elbow or divides into two branches, which independently flow into the lateral and medial saphenous veins of the arm.

Deep veins of the upper limb

Deep (paired) veins of the palmar surface of the hand accompany the arteries and form superficial and deep venous arches.

The palmar digital veins flow into the superficial palmar venous arch (arcus venosus palmaris superficialis), located near the arterial superficial palmar arch. The paired palmar metacarpal veins (vv. metacarpals palmares) go to the deep palmar venous arch (arcus venosus palmaris profundus). The deep, as well as the superficial palmar venous arches continue into the deep veins of the forearm - the paired ulnar and radial veins (vv. ulnares et vv. radiales), which accompany the arteries of the same name. The two brachial veins (vv. brachiales), formed from the deep veins of the forearm, before reaching the axillary cavity, at the level of the lower edge of the tendon of the latissimus dorsi muscle merge into one trunk - the axillary vein (v. axillaris). This vein continues to the lateral margin of the 1st rib, where it passes into the subclavian vein (v. subclavia). The axillary vein, like its tributaries, has valves. It is adjacent to the anteromedial semicircle of the axillary artery, collects blood from the superficial and deep veins of the upper limb. Its tributaries correspond to the branches of the axillary artery. The most significant tributaries of the axillary vein are the lateral thoracic vein (v. thoracica lateralis), into which the thoracoepigastric veins (vv. thoracoepigastricae) flow, anastomosing with the inferior epigastric vein - a tributary of the external iliac vein. The lateral thoracic vein also receives thin veins that connect with the I-VII posterior intercostal veins. The thoracoepigastric veins receive venous vessels that emerge from the areola plexus (plexus venosus areolaris), formed by the subcutaneous veins of the mammary gland.

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