Veins of the Upper Limbs

Veins of the Upper Limbs The deep veins of the upper limbs have similar courses and names as their companion arteries. The superficial veins are not paired with arteries, but provide an anastomotic network for draining the limbs. The large superficial veins in the upper limbs are visible just below the skin. Major Veins of the Upper Limbs: Deep (Some veins of the upper limbs also drain structures of the thorax.) Vein Area Drained Description Radial Lateral side of Paired radial veins begin at the veins forearms deep palmar venous arches that drain the palmar metacarpal veins in the palms Vein Area Drained Description Ulnar veins Medial side of Paired ulnar veins begin at the forearms superficial palmar venous arches, which drain the common palmar digital veins and proper palmar digital veins in the fingers Brachial Forearms, elbow Paired brachial veins merge with veins joints, upper the basilic veins to form limbs, humerus theaxillary veins Axillary Upper limbs, Continue as the subclavian veins veins axillae, superolateral chest wall Subclavian Upper limbs, Continuations of the axillary veins; veins neck, thoracic Merge with the internal jugular veins wall to form the brachiocephalic veins Major Veins of the Upper Limbs: Superficial (Some veins of the upper limbs also drain structures of the thorax.) Area Vein Drained Description Cephalic Lateral side The cephalic veins begin on the lateral veins of upper side of the dorsal venous arch, a limbs plexus of veins formed by the dorsal metacarpal veins that drain thedorsal digital veins of the fingers Basilic veins Medial At the crook of the elbow, the basilic veins aspects of are connected to the cephalic veins by upper the median cubital vein that drains the Area Vein Drained Description limbs forearm; The median cubital vein is often used to draw blood or inject intravenous medications; In the axilla, the basilic veins merge with the brachial veins to form the axillary veins Median Palms, The median antebrachial vein runs antebrachial forearms between the radial and ulnar veins in the vein forearm; Ends at the elbow by entering either the basilic or cephalic vein .

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DVT Upper Extremity
UT Southwestern Department of Radiology Ultrasound – Upper Extremity Deep Venous Thrombosis Evaluation PURPOSE: To evaluate the upper extremity superficial and deep venous system for patency. SCOPE: Applies to all ultrasound venous Doppler studies of the lower extremities in Imaging Services / Radiology EPIC ORDERABLE: • UTSW: US DOPPLER VENOUS DVT UPPER EXTREMITY BILATERAL US DOPPLER VENOUS DVT UPPER EXTREMITY RIGHT US DOPPLER VENOUS DVT UPPER EXTREMITY LEFT • PHHS: US DOPPLER VENOUS DVT UPPER EXTREMITY BILATERAL US DOPPLER VENOUS DVT UPPER EXTREMITY RIGHT US DOPPLER VENOUS DVT UPPER EXTREMITY LEFT INDICATIONS: • Symptoms such as upper extremity swelling, pain, fever, warmth, change in color, palpable cord • Suspected venous occlusion, or DVT based on clinical prediction rules (eg. Well’s score or D- Dimer) • Indwelling or recent PICC or central line • Chest pain and/or shortness of breath • Suspected or known pulmonary embolus • Follow-up known deep venous thrombosis (DVT) CONTRAINDICATIONS: No absolute contraindications EQUIPMENT: Preferably a linear array transducer that allows for appropriate resolution of anatomy (frequency range of 9 mHz or greater), capable of duplex imaging. Sector or curvilinear transducers may be required for appropriate penetration in patients with edema or large body habitus. PATIENT PREPARATION: • None EXAMINATION: GENERAL GUIDELINES: A complete examination includes evaluation of the superficial and deep venous system of the upper extremity including the internal jugular, innominate, subclavian, axillary, paired brachial, basilic, and cephalic veins. EXAM INITIATION: • Introduce yourself to the patient • Verify patient identity using patient name and DOB • Explain test • Obtain patient history including symptoms. Enter and store data page US DVT Upper Extremity 05-31-2020.docx 1 | Page Revision date: 05-31-2020 UT Southwestern Department of Radiology • Place patient in supine position with arm extended TECHNICAL CONSIDERATIONS: • Review any prior imaging, making note of any previous thrombus burden.
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Brachial Artery
VASCULAR Anatomy of the upper limb Dr Jamila EL M edany & Dr. Essam Eldin Salama Objectives At the end of the lecture, the students should be able to: • Identify the origin of the vascular supply for the upper limb. • Describe the main arteries and their branches of the arm, forearm & hand. • Describe the vascular arches for the hand. • Describe the superficial and deep veins of the upper limb Arteries Of The Upper Limb Right subclavian Left subclavian artery artery Axillary artery Brachial artery Ulnar artery Radial artery Palmar arches The Subclavian Artery The right artery originates from the brachiocephalic artery. The left artery Cotinues as originates from Axillary artery at the arch of the the lateral border aorta of the 1st rib The Axillary Artery Begins at the lateral border of the st 1 rib as continuation of the Subclavian artery subclavian artery. Continues as brachial artery at lower border of teres major muscle. Is closely related to the cords of brachial plexus and their branches Is enclosed within the axillary sheath. Is crossed anteriorly by the pectoralis minor muscle, and is st nd divided into three parts; 1 , 2 & Brachial artery Axillary artery 3rd. The 1st part of the axillary artery . Extends from the lateral st border of 1 rib to upper 1st part border of the pectoralis 2nd part minor muscle. Highest thoracic artery a. Related: 3rd part Pectoralis • Anterioly: to the minor pectoralis major muscle • Laterally: to the cords Teres of the brachial plexus. major . It gives; ONE branch: Highest thoracic artery The 2nd part of the axillary artery .
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Brachial Vein Transposition with Consecutive Skin Incisions in a Hemodialysis Patient with Absence of Adequate Superficial Veins: a Case Report
Original Article Case Report Case Vascular Specialist International Vol. 36, No. 4, December 2020 pISSN 2288-7970 • eISSN 2288-7989 Brachial Vein Transposition with Consecutive Skin Incisions in a Hemodialysis Patient with Absence of Adequate Superficial Veins: A Case Report Pouya Tayebi1, Fatemeh Mahmoudlou2, Yasaman Daryabari2, and Atefeh Shamsian3 1Department of Vascular and Endovascular Surgery, Rouhani Hospital, Babol University of Medical Sciences, Babol, 2Student Research Committee, Babol University of Medical Sciences, Babol, 3MSc student in nursing, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences,Tehran, Iran The creation of an arteriovenous fistula instead of a synthetic vascular graft is a Received September 24, 2020 Revised November 5, 2020 smart decision in hemodialysis patients who do not have a suitable superficial vein. Accepted November 30, 2020 Basilic vein transposition (BVT) is a viable option in most cases, except in patients who do not have a proper basilic vein. In patients with inadequate superficial veins, another source of the autogenous vein is the brachial vein, a deep vein of the up- per arm. Most surgeons choose a full medial arm incision to perform brachial vein Corresponding author: Pouya Tayebi exploration. We describe a patient in whom BVT was not possible and so brachial Department of Vascular and Endovascular Surgery, Rouhani Hospital, Babol University vein transposition using skip incisions was performed, with good results. of Medical Sciences, Keshavarz Boulevard,
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View, There Is No Doubt That the Elbow Should Be Reduced and Repositioned As Soon As the Diagnosis
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Vascular / Endovascular Surgery Vascular / Endovascular Surgery Combat Manual Combat Manual
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33. Vessels of the Upper Limb
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Of the Elbow Veins
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Upper Limb- Part II
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SVU GLOSSARY of TERMS Ampere: a Unit of Electromotive Force; One Volt Acting Against the Resistance of One Ohm (See Ohm’S Law)
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The Two-Stage Brachial Artery–Brachial Vein Autogenous Fistula for Hemodialysis
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector TECHNICAL NOTES The two-stage brachial artery–brachial vein autogenous fistula for hemodialysis: An alternative autogenous option for hemodialysis access Niren Angle, MD, and Ankur Chandra, MD, San Diego, Calif The optimal dialysis access for the patient with chronic renal failure is considered to be an autogenous fistula; this is reflected in the recommendations of the National Kidney Foundation–Disease Outcomes Quality Initiatives (NKF- DOQI). If adequate superficial veins at the wrist or the forearm are not available, the next option is usually a prosthetic arteriovenous graft. In this case series, we describe our experience with an autogenous fistula constructed using the brachial vein. There were 20 patients over a 14-month period who were operated on for dialysis access. In these patients, no adequate superficial veins were found at operation. Instead of using a prosthetic graft, we performed a brachial artery–brachial vein fistula in two stages. The first stage involved a forearm anastomosis and then subsequently, weeks later, this fistula was “superficialized.” Twenty patients underwent a brachial artery–brachial vein fistula. Of these patients, all had successful maturation of their fistula and after a minimum waiting period of 12 weeks for maturation; all but one were able to be successfully dialyzed through their fistula. One patient developed arm swelling due to previously placed subclavian vein pacemaker wires. None of the other patients developed arm swelling or vascular steal. The brachial artery–brachial vein fistula is a feasible option for hemodialysis access and we suggest that this option be considered before a prosthetic arteriovenous graft is inserted.
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Bones of Upper Limb
ARM, CUBITAL FOSSA & ELBOW JOINT Khaleel Alyahya, PhD, MEd King Saud University College of Medicine @khaleelya OBJECTIVES At the end of the lecture, students should: o - Describe the attachments, actions and innervations of: Biceps brachii Coracobrachialis Brachialis Triceps brachii o - Demonstrate the following features of the elbow joint: Articulating bones Capsule Lateral & medial collateral ligaments Synovial membrane o - Demonstrate the movements; flexion and extension of the elbow. o - List the main muscles producing the above movements. o - Define the boundaries of the cubital fossa and enumerate its contents. THE ARM THE ARM o An aponeurotic sheet separating various muscles of Lateral Medial the upper limbs, including intermuscul intermuscul lateral and medial humeral septa. ar septum ar septum o The lateral and medial intermuscular septa divide the Neurovascul distal part of the arm into two ski ar bundle compartments: n • Anterior compartments Fasci . also known as the flexor a compartment Humer • Posterior compartments us . also known as the extensor compartment ANTERIOR FASCIAL COMPARTMENT . Muscles: Biceps brachii, Coracobrachialis &Brachialis. Blood Vessels: Brachial artery & Basilic vein. Nerves: Musculocutaneous and Median. MUSCLES OF ANTERIOR COMPARTMENT Coracobrachialis Biceps Brachii Brachialis BICEPS BRACHII . Origin: Two heads: • Long Head from supraglenoid tubercle of scapula (intracapsular) • Short Head from the tip of coracoid process of scapula • The two heads join in the middle of the arm . Insertion: • In the posterior part of the radial tuberosity. • Into the deep fascia of the medial aspect of the forearm through bicipital aponeurosis. Nerve supply: • Musculocutaneous . Action: • Strong supinator of the forearm • used in screwing. • Powerful flexor of elbow • Weak flexor of shoulder CORACOBRACHIALIS .
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ARM and ELBOW Doctors Notes Editing File Notes/Extra Explanation Objectives
Color Code Important ARM AND ELBOW Doctors Notes Editing file Notes/Extra explanation Objectives ü Describe the attachments, actions and innervations of: • Biceps brachii • Coracobrachialis • Brachialis • Triceps brachii ü Demonstrate the following features of the elbow joint: • Articulating bones • Capsule • Lateral & medial collateral ligaments • Synovial membrane ü Demonstrate the movements; flexion and extension of the elbow. ü List the main muscles producing the above movements. ü Define the boundaries of the cubital fossa and enumerate its contents. Shoulder THE ARM: - An aponeurotic sheet separating various muscles A R M of the upper limbs, including lateral and medial Posterior Anterior humeral septa. view view Elbow - The lateral and medial intermuscular septa divide the distal part of the arm into two compartments: Arm Humerus Lateral Medial intermuscular intermuscular Posterior septum septum Anterior (flexor (extensor compartment) compartment) Neurovascular skin bundle Fascia Humerus Note: the radial and ulnar nerves begin in Anterior Fascial Compartment: the anterior compartment then pierce the intermuscular septum and enter the posterior compartment Radial Brachialis Basilic vein Median Biceps Ulnar brachii Brachial Musculocutaneous artery coracobrachiallis muscles Blood vessels Nerves Muscles Of Anterior Compartment: Coracobrachialis Biceps Brachii Brachialis Note: Brachi- means arm so any muscle with brachi in it’s name is related to the arm Coracoid Process BICEPS BRACHII: • Long Head from supraglenoid tubercle of scapula (intracapsular) Origin • Short Head from the tip of coracoid process of scapula The two heads join in the middle of the arm Insertion • In the posterior part of the radial tuberosity. • Into the deep fascia of the medial aspect of the forearm through bicipital aponeurosis.
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