This is a tutorial on some of the important veins of the body. I’m going to start at the heart and then work outwards and talk you through some of the important veins that you should know.
This is the right atrium and this is the right ventricle of the heart. Deoxygenated blood returns to the heart, to the right side of the heart via the venous system. This vessel superior to the right atrium is called the superior vena cava and below, you’ve got the inferior vena cava. You can see the inferior vena cava running all the way down to the pelvic region where it splits.
The superior vena cava forms from these two branches. You can see that these vessels lie behind the clavicle. This and the breastbone, which I’ve removed here, would lie anteriorly here.
The superior vena cava is formed from these two veins which drain into it and this is the brachiocephalic veins. You’ve got the right and the left brachiocephalic veins. This vein, which arches over here and runs underneath the clavicle is called the subclavian vein because it runs underneath the clavicle. Sub- meaning ‘under’, -clavian referring to clavicle. you’ve got the subclavian vein draining into the brachiocephalic vein, which joins with the other brachiocephalic vein to form the superior vena cava.
And then you’ve got these two vessels here, these two veins, which are coming down from the brain and the head. This one, which is more medial is the internal jugular vein and this one, which is more lateral is the external jugular vein. The internal jugular vein drains the vein and the external jugular vein drains the head and face. This external jugular vein comes and drains into the subclavian vein and where the internal jugular vein drains into becomes the brachiocephalic vein. Where it drains into the subclavian, it becomes the brachiocephalic brain.
You’ve got the subclavian vein here running underneath the clavicle becoming the brachiocephalic vein, which joins with the other side to form the superior vena cava. And then you’ve got the jugular vein, the internal and external jugular veins.
Following the veins over, we come to look at the veins which join the upper limbs. You can see this vein here, this joins into the axillary vein. This region, in the armpit region is the axillary vein. You’ve got this vein, the cephalic vein draining into the axillary vein.
Where the cephalic vein joins the axillary vein, it becomes the subclavian vein. This is the axillary vein here.
Also draining into the axillary vein, you’ve got these two veins. This one is the brachial vein, this middle one here and this is a deep vein. This one here is the basilic vein. Where these two veins meet, you get the axillary vein. The axillary vein runs from here to the point where the cephalic vein drains into it.
If I just put in the muscle layer, you can see what I mean by this vein being deep. You can see this vein here is the deep brachial vein. You’ve got the two superficial veins, the basilic vein and the cephalic vein. I’ll just put the muscle layer in so you can see that. You’ve got the cephalic vein, which runs superficially and this basilic vein which is also superficial. But the brachial vein here runs deeply, so this deep brachial vein.
Just working our way down the limb, you can see this vein which joins the cephalic and the basilic veins. This is the median cubital vein. This links up the cephalic and the basilic vein.
Just to put the muscular system in again to give an idea of where these veins run, you can see this is a superficial vein, which connects the superficial cephalic and the superficial basilic veins. When you’re taking blood from a patient, these are often the veins you take blood from, the cephalic vein here, the median cubital vein and this basilic vein.
Just removing the muscular system again, this is the brachial vein, the vein that branches off the axillary and runs deeply. You can see that it has two tributaries. You’ve got the radial vein and the ulnar vein and these are deep veins also. They run deep under the muscle layer.
The brachial vein is formed by the joining of the radial and the ulnar vein, which run on the radial side. The radial vein runs down the radial bone and the ulnar vein runs down the ulnar bone, hence the name.
Just to quickly go over that again, you’ve got the subclavian vein which has the cephalic vein which drains blood from the axillary vein. You’ve got the axillary vein going into the subclavian vein, going into the brachiocephalic vein, going into the superior vena cava.
Joining the axillary vein, you’ve got the three branches. You’ve got the cephalic vein, which is a superficial vein and you’ve got the basilic vein, which is a superficial vein. And then you’ve got this deep vein, which is the brachial vein.
The cephalic and the basilic veins run all the way down the arm. You can see it running all the way down here and they’re superficial along their entire course and the basilic vein on the medial side running all the way down and it’s superficial. The brachial vein which runs deep splits here. It’s formed from the radial and the ulnar veins which are deep. The radial and ulnar veins run down their respective bones (the radial and ulnar bones) and they join to form these palmar arches. You’ve got a deep and a superficial palmar venous arch, which are formed by the radial and the ulnar veins.
You’ll be able to see which one is superficial if I rotate it around. You can see this arch here. And if I rotate it around, you can see that it’s closer to the surface, so it’s the superficial venous arch and you’ve got the deep palmar arch, palmar venous arch.
If I just put in the muscle layer again, you can see this superficial palmar venous arch formed from the deep radial and ulnar veins. And then you’ve got the deeper palmar venous arch here.
The superficial veins, which I’ve showed you, the basilic vein, which runs all the way down and it winds onto the back of the hand, the dorsum of the hand, the same happens with the cephalic vein. This cephalic vein which comes all the way down the arm and then winds around onto the back of the hand. You could see that course. The medial vein here, which is the basilic vein and the lateral one, the cephalic vein, they form this dorsal venous plexus on the hand. This is often the site for cannulation of patients.
That’s the venous drainage of the upper limbs. It’s a little bit more complicated than the arterial supply, but I hope it was clear, the difference between the superficial and deep system. Just moving back centrally to the heart, I’m now going to work my way downwards to look at the blood supply from the venous drainage from the lower limbs.
I’ve shown you the superior vena cava and the inferior vena cava leading into the right atrium. I’ve removed a lot of vessels here. There are a lot of branches on the inferior vena cava, which I’ve removed and we’ll talk about in future tutorials on the digestive system and the blood supply and drainage of those various organs.
Just down here, we’re now at the level of the L5 lumbar vertebra. This is where the inferior vena cava bifurcates into its branches. You’ve got the common iliac veins. You’ve got the right and left common iliac veins.
These split into two. You’ve got the external and the internal iliac veins. The external and the internal iliac veins join to form the common iliac vein. That converges with its counterpart with the inferior vena cava. You’ve got the common iliac vein which splits into the external and internal iliac vein.
Just before I go any further, I just need to point out another important vein. You can see running on the anterior surface of these vertebral bodies, you’ve got a vein running up and draining into the superior vena cava. You can see it running up the anterior surface of the vertebral bodies and then draining into the superior vena cava here.
This is the azygos vein. The azygos venous system drains blood from the posterior walls of the abdomen, of the thorax and abdomen and it drains into the superior vena cava. This is the azygos vein. That runs on the right side. And you’ve got the accessory and hemiazygos veins, which run up the left side of the vertebra. That’s the azygos system, which runs on the anterior surface of the vertebral bodies and drains into the superior vena cava. You’ve got the azygos vein on the right size and you’ve got the hemiazygos and accessory azygos veins running up the left side.
Just moving back to where we were, we’ve got the common iliac veins, which are formed from the external and internal iliac veins merging. Working our way down, the external iliacs are formed from the femoral vein and this long vein which runs down the entire length of the leg on the medial aspect. This is called the long saphenous vein. It runs all the way down the medial aspect of the leg to join the dorsal venous plexus of the foot.
Just going back up again, you’ve got the external iliac being formed from the femoral vein and the long saphenous vein.
The long saphenous vein is a superficial vein. The femoral vein is a deep vein. If I just put in the muscle layer, you can see this. You can see the femoral vein. It just runs deep into the muscle layer and then the long saphenous vein runs superficially all the way down the inner leg. It’s medial. It runs medially all the way down to the foot where it joins the dorsal venous arch of the foot. That’s the long saphenous vein. The long saphenous vein and the femoral vein join into the external iliac vein.
Just working our way down to the back of the knee now, we’re now in the popliteal fossa region. That’s the back of the knee is called the popliteal fossa. The vessels at the back of the knee are popliteal vessels. You’ve got a popliteal artery here and you’ve got the popliteal vein here, which joins into the femoral vein. This is the popliteal vein and you can see the long saphenous vein here running all the way down the medial side.
The popliteal vein has a branch, the anterior tibial vein, which goes here down the anterior aspect of the aspect (just like the anterior tibial artery). And then you’ve got these two veins. You’ve got the peroneal vein, which is also known as the fibular vein because it runs on the fibula side, so the peroneal muscle group or the lateral muscle group of the lower leg. This vein which comes off the popliteal vein is the peroneal vein and this runs on the lateral side. It’s also known as the fibular vein, so it runs on the side of the fibula, which is lateral.
And you’ve also got the posterior tibial, the counterpart to the anterior tibial vein. This runs down the posterior aspect of the tibia.
And then you’ve got another superficial vein. This is the short saphenous vein. Remember the long saphenous vein which runs all the way up the medial aspect of the leg, the short saphenous vein runs centrally down the back of the leg and it’s superficial.
It’s quite hard to understand, to see and judge the depth. The deep veins are these posterior tibial veins and the peroneal veins and the superficial veins are the saphenous veins, the long saphenous which runs all the way down the medial aspect and the short saphenous which comes off the popliteal vein here. The short saphenous vein runs down the back of the calf muscle and then it winds around laterally and joins to form the dorsal venous arch of the foot, this arch here.
Remember the long saphenous vein which runs down the medial side join to form the venous arch, the other side of the venous arch is formed by the short saphenous vein, which runs down the middle of the calf and then winds around laterally.
In the lower leg, you’ve got superficial and deep veins. A deep vein thrombosis occurs in the deep veins of the legs. A deep vein thrombosis can occur all the way up into the femoral vein, which is also a deep vein – so this vein, this thick vein here.
An important thing to be aware of isn’t actually shown in these models is that you have veins which connects the deep and superficial veins, perforator veins which contain the deep to the superficial veins. Blood flows from superficial to deep. If valves become incompetent in the veins of the leg, blood may then accumulate in the superficial veins, so in the long and short saphenous veins, which then become swollen and torturous and you get varicose veins. That’s what varicose veins are.
Those are the important veins of the body that you should be aware of.