Venous Anatomy

Venous Anatomy

1. Upper Extremity Superficial Veins

   • Cephalic vein
     • Courses along radial aspect of arm
     • Communicates with basilic vein via median cubital vein at level of elbow
     • Located in superficial fascia along anterolateral surface of biceps brachii muscle
     • Passes superiorly between deltoid and pectoralis major muscles in deltopectoral groove
     • Drains into axillary vein in arch-like configuration
   • Basilic Vein
     • Courses along ulnar aspect of arm
     • Ascends medially along biceps in upper arm
     • Frequently joins brachial vein in upper arm

2. Upper Extremity Deep Veins

   • Brachial Vein
     • Usually paired
     • Terminate in axillary vein
   • Axillary vein
     • Returns blood from lateral aspect of thorax, axilla, and upper extremity
     • Starts at border of teres major muscle as continuation of brachial vein; ends at outer edge of 1st rib
     • Tributaries include basilic and cephalic veins
   • Subclavian vein
     • Continuation of axillary vein
     • Courses from outer border of 1st rib to medial border of anterior scalene muscle
     • Subclavian vein lies anterior to anterior scalene muscle whereas artery lies posterior

3. Cervicothoracic Venous Anatomy

   • Internal jugular vein
     • Formed by union of sigmoid and inferior petrosal sinuses with common facial vein
     • Provides venous drainage for brain, face, and neck
   • External jugular vein
     • Formed by union of posterior retromandibular vein and posterior auricular vein
     • Courses superficial to sternocleidomastoid muscle
     • Provides venous drainage for exterior of cranium and deep parts of face
   • Thyroidal veins
     • Arise from venous plexus surrounding thyroid gland; often multiple in number
     • Superior & middle thyroidal
       • Direct tributaries to internal jugular vein
     • Inferior thyroidal
       • Drain into brachiocephalic veins
   • Vertebral Vein
     • Derived from small venous tributaries that form plexus around vertebral artery
     • Plexus ends in single trunk that exits from 6th cervical vertebral transverse foramen
     • Enters brachiocephalic vein posteriorly near origin

4. Thoracic Veins

   • Brachiocephalic vein
     • Formed by union of subclavian and internal jugular veins
     • Veins join at level of sternoclavicular joint
   • Superior vena cava
     • Formed by union of right and left brachiocephalic veins
     • Courses posterior to manubrium and sternum on the right
   • Azygos vein
     • Formed by union of ascending lumbar and right subcostal veins at 12th thoracic vertebral level
     • Ascends in posterior mediastinum; arches over right mainstem bronchus to join SVC
     • Drains posterior thorax and abdomen into SVC
   • Hemiazygos vein
     • Begins in left ascending lumbar or left renal vein Passes upward through left crus of diaphragm to enter thorax on left; mirrors lower azygos vein Begins in left ascending lumbar or left renal vein Passes upward through left crus of diaphragm to enter thorax on left; mirrors lower azygos vein Begins in left ascending lumbar or left renal vein Passes upward through left crus of diaphragm to enter thorax on left; mirrors lower azygos vein
     • 9th thoracic vertebra, courses rightward behind aorta and esophagus to enter azygos vein