Superficial and deep veins of upper and lower extremities

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Upper venous system

The upper venous system drains deoxygenated blood from the upper extremities into the axillary vein further into subclavian and brachiocephalic veins.

Superficial veins of the upper limb

Superficial veins of the arm on the dorsal aspect of the hand

  1. Basilic Vein: The basilic vein originates from the dorsal venous network of the hand and ascends the medial aspect of the upper limb. However, halfway between the elbow and shoulder, it takes a deeper course by piercing the brachial fascia at the basilic hiatus to travel alongside the brachial vessels. At the border of the teres major, the vein moves deep into the arm. Here, it combines with the brachial veins from the deep venous system to form the axillary vein.
  2. Cephalic vein: The cephalic vein also arises from the dorsal venous network of the hand. It ascends the antero-lateral aspect of the upper limb, passing anteriorly at the elbow. At the shoulder, the cephalic vein travels between the deltoid and pectoralis major muscles (known as the deltopectoral groove), and enters the axilla region via the clavipectoral triangle. Within the axilla, the cephalic vein empties into axillary vein.
    Veins of the upper limb
  3. Median cubital vein: The cephalic and basilic veins anastomose at the elbow region to give the median cubital vein( a common site for intravenous puncture).
  4. Palmar digital veins: It supplies the palmar aspect of the digits and drains into the superficial venous palmar arch and the dorsal digital veins via oblique veins that pass between the metacarpal heads.
  5. Dorsal digital veins: They extend along the sides of the dorsal surface of the phalanges of the hands and unite at the base of the proximal phalanges to form three dorsal metacarpal veins (deep veins) and drain into these dorsal metacarpal veins.
  6. Dorsal venous network: The dorsal metacarpal veins and dorsal digital veins(1,4th digit) drain here. ( The palmar venous plexus is usually drains into the dorsum via intercapitular veins.)

Deep veins of the upper limb

  1. Brachial vein: The radial and ulnar veins come together to form the brachial vein within the cubital fossa. At the inferior border of the teres major, it drains into the axillary vein.
  2. Radial vein: The radial vein starts from the deep venous palmar arch in the hand, travels laterally to join with the ulnar vein draining into the brachial vein in the cubital fossa.
  3. Ulnar vein: The ulnar vein starts from the deep venous palmar arch in the hand, travels medially to join with the radial vein draining into the brachial vein in the cubital fossa.
  4. Anterior interosseus vein: This vein starts from the dorsal and palmar carpal veins. It travels along the anterior aspect of the interosseous membrane and drains into the ulnar vein near the elbow. The superficial and deep veins of the arm.
  5. Posterior interosseus vein: This vein starts from the dorsal venous carpal network. It travels along the posterior aspect of the interosseous membrane and ultimately drains into the ulnar vein.
  6. Axillary vein: The axillary vein courses alongside the axillary artery in the axilla and contributes to the drainage of the upper limb, axilla and superolateral chest wall. The axillary vein terminates at the lateral border of the first rib where it becomes the subclavian vein.
  7. Deep venous palmar arch: This arch is located in the hand and serves as the origin for both the radial and ulnar veins.
  8. Superficial venous palmar arch: It receives the palmar digital veins and drains partly to the median antebrachial vein, but mainly functions to shunt palmar blood towards the dorsal venous network via oblique intercapitular veins.
  9. Palmar metacarpal veins: They extend along either side of the metacarpals 2-4 and drain into both the dorsal metacarpal veins and into the deep venous palmar arch.
  10. Dorsal metacarpal veins: They are formed by the union of the dorsal digital veins and receive venous blood from the fingers. The dorsal metacarpal veins empty into the radial veins and/or the dorsal venous network over the metacarpus.

Lower venous system

The lower venous system drains deoxygenated blood from the lower extremities into the common iliac into the inferior vena cava.

Superficial veins of the lower limb

  1. The great saphenous vein: It starts at the dorsal venous arch of the foot, and the dorsal vein of the great toe. It ascends up the medial side of the leg, passing anteriorly to the medial malleolus at the ankle, and posteriorly to the medial condyle at the knee. As the vein moves up the leg, it receives tributaries from other small superficial veins. The great saphenous vein drains into the femoral vein(Can be a used in coronary bypass in a way the valve does not restrict flow).It also gives all the branches of the saphenous star.
  2. The small saphenous vein: It starts at the dorsal venous arch of the foot, and the dorsal vein of the little toe. It moves up the posterior side of the leg, passing posteriorly to the lateral malleolus. At the level of the knee, the small saphenous vein passes between the two heads of the gastrocnemius muscle and drains into the popliteal vein in the popliteal fossa.

Deep veins of the lower limb

  1. Femoral vein: The femoral vein is a continuation of the popliteal vein and accompanies the femoral artery. It begins at the opening of the adductor magnus muscle and ends posterior to the inguinal ligament as the external iliac vein. Its relationship to the femoral artery is variable. Within the distal adductor canal, it is located posterolateral to the artery, whilst in the proximal canal and in the apex of the femoral triangle, it lies posterior to the artery. Within the base of the femoral triangle, it is found medial to the femoral artery. It continues as the external iliac vein past the inguinal ligament.
    Veins of the lower limb
  2. Popliteal vein: The popliteal vein is located within the popliteal fossa and pierces the adductor magnus muscle, where it becomes the femoral vein. Distally it is medial to the popliteal artery. Between the two heads of the gastrocnemius muscle it is superficial to it and proximally it is posterolateral to it.
  3. Medial and lateral gastrocnemius veins: As their name suggests they supply the medial and lateral gastrocnemius heads and drain into the popliteal vein.
  4. Genicular veins: We have the superior medial genicular vein, superior lateral genicular vein, middle genicular vein, inferior medial genicular vein, and inferior lateral genicular vein supplying the knee draining into the popliteal vein.
  5. Anterior tibial vein: The anterior tibial vein originates from the dorsal venous arch of the foot. It ascends along the anterior compartment of the leg, between the tibia and fibula, and joins with the posterior tibial veins to form the popliteal vein.
  6. Posterior tibial vein: The posterior tibial veins originate from the union of the medial and lateral plantar veins of the foot. These veins then travel up the posterior compartment of the leg, following the course of the posterior tibial artery. They eventually unite with the anterior tibial veins to form the popliteal vein.
  7. Fibular vein: The fibular veins are also formed by the medial and lateral plantar veins and run with the fibular artery and drains into the popliteal vein.
  8. Medial and lateral plantar nerves: They start from the deep plantar nervous arch and drain into the posterior tibial and fibular vein.
  9. Deep plantar venous arch: The plantar veins form four plantar metatarsal veins which join to form the deep plantar venous arch.
  10. Plantar and dorsal veins: They supply the plantar and dorsal aspects of the foot.
  11. Dorsal venous arch: It is formed by the dorsal metatarsal veins, which are also formed by the dorsal and plantar digital veins.


Citations:

[1]https://teachmeanatomy.info/upper-limb/vessels/veins/

[2]https://www.kenhub.com/en/library/anatomy/veins-of-the-upper-limb

[3]https://www.kenhub.com/en/library/anatomy/veins-of-the-lower-limb

  1. ↑ https://teachmeanatomy.info/upper-limb/vessels/veins/
  2. ↑ https://www.kenhub.com/en/library/anatomy/veins-of-the-upper-limb
  3. ↑ https://www.kenhub.com/en/library/anatomy/veins-of-the-lower-limb
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