Maintenance of the Body
Veins of the Upper Limbs and Thorax
(a) Schematic flowchart
Right and left posterior
Te deep veins of the upper limbs follow the paths of their com-
panion arteries and have the same names
However, except for the largest, most are paired veins that ﬂank
their artery. Te superﬁcial veins of the upper limbs are larger
than the deep veins and are easily seen just beneath the skin.
Te median cubital vein, crossing the anterior aspect of the el-
bow, is commonly used to obtain blood samples or administer
Blood draining from the mammary glands and the ﬁrst two
to three intercostal spaces enters the
However, the vast majority of thoracic tissues and the thorax
wall are drained by a complex network of veins called the
ĭ-gos). Te branching nature of the azygos sys-
tem provides a collateral circulation for draining the abdominal
wall and other areas served by the inferior vena cava, and there
are numerous anastomoses between the azygos system and the
inferior vena cava.
Description and Areas Drained
Deep Veins of the Upper Limbs
Te most distal deep veins of the upper limb are the radial and
ulnar veins. Te
of the hand empty into the
of the fore-
arm, which then unite to form the
of the arm. As
the brachial vein enters the axilla, it becomes the
which becomes the
at the level of the ﬁrst rib.
Superﬁcial Veins of the Upper Limbs
Te superﬁcial venous system begins with the
dorsal venous net-
(not illustrated), a plexus of superﬁcial veins in the dorsum
of the hand. In the distal forearm, this plexus drains into two
major superﬁcial veins—the cephalic and basilic veins—which
anastomose frequently as they course upward (Figure 19.28b).
bends around the radius as it travels supe-
riorly and then continues up the lateral superﬁcial aspect of
the arm to the shoulder, where it runs in the groove between
the deltoid and pectoralis muscles to join the axillary vein. Te
courses along the posteromedial aspect of the fore-
arm, crosses the elbow, and then joins the brachial vein in the
axilla, forming the axillary vein. At the anterior aspect of the
median cubital vein
connects the basilic and cephalic
median antebrachial vein
lies between the radial and
ulnar veins in the forearm and terminates (variably) at the elbow
by entering either the basilic or the cephalic vein.
The Azygos System
Te azygos system consists of the following vessels, which ﬂank
the vertebral column laterally.
Located against the right side of the vertebral
unpaired) originates in the
abdomen, from the
right ascending lumbar vein
most of the right abdominal cavity wall and from the
terior intercostal veins
(except the ﬁrst) that drain the chest
muscles. At the ±
level, it arches over the great vessels that run
to the right lung and empties into the superior vena cava.
Veins of the thorax and right upper limb.
clarity, the abundant branching and anastomoses of the superﬁcial
veins are not shown.