The document summarizes the anatomy of the venous system in the upper and lower limbs. In the upper limbs, it describes the superficial cephalic and basilic veins and their tributaries, as well as the deep brachial, ulnar, and radial veins. In the lower limbs, it outlines the long and short saphenous veins and their tributaries in the superficial system, and the deep femoral, popliteal, tibial and other veins. It also discusses perforating veins that connect the superficial and deep systems and their clinical significance.

1. ANATOMY OF VENOUS
SYSTEM
anatom

2. Content
1) Venous system in upper
limb
2) Venous system in lower
limb

3. Venous System In Upper Limbs
Superficial veins
- Cephalic vein (preaxial)
- Basilic vein (postaxial)
- Median cubital veins
 Deep veins
- Brachial veins
- Ulnar veins
- Radial Veins

4. Lateral end of dorsal venous
arch
Winds round
↑
Continues upwards in front of
elbow
↑
Lateral border of biceps brachi
↑
Pierces deep fascia
↑
Runs in deltopectoral groove up
to infraclavicular fossa
↑
Pierces clavipectoral fascia
↑
Joins the axillary veins
↑
CEPHALIC VEINS
Medial end of dorsal venous arch
Along back of medial border of
forearm
↑
Winds round
↑
Medial margin of biceps brachi
↑
Pierces deep fascia
↑
Middle of arm
↑
Lower border of teres major
↑
becomes the axillary veins
↑
BASILIC VEINS

5. Cephalic vein
Axillary vein Axillary vein
Subclavian vein +
Jugular vein
Brachiocephalic vein
Superior vena cava
Basilic vein

6. MEDIAN CUBITAL VEIN
• Large communicating vein which shunts blood from
cephalic to the basilica vein
• Starts : from cephalic vein 2.5 cm below bend of elbow
• Runs obliquely upward and medially
• Ends : in the basilic vein 2.5 cm above medial epicondyle

7. Clinical and surgical correlation
1. These superficial veins are commonly used for
intravenous injection and for withdrawing blood
for transfusion or for testing.
2. Cannulation via basilic vein is more liable
compared to cephalic because basilic vein
becomes the axillary vein without angulation (will
not prone to obstruction)
3. Axillary vein thrombosis may occur due to
prolonged abduction of the arm above the head,
as in painting ceiling.

8. Deep vein
• Situated underneath the
deep fascia
• Venae comitantes:
• It refers to a vein that is
usually paired, with both
veins lying on the sides of
an artery.
Brachial veins
Ulnar veins
Radial veins

9. Venous system in lower limbs
• Superficial venous system
• Long ( Great ) Saphenous Veins (LSV/GSV)
• Short Saphenous Veins
• Deep venous system
• Iliac vein
• Femoral vein
• Popliteal vein
• Peroneal vein
• Tibial vein
• Soleal vein

10. LONG SAPHAENOUS VEIN
• Largest and longest superficial veins of the lower limb
• Starts : on dorsum of the foot by union of medial end of dorsal
venous arch with the medial marginal vein
• Ascends in front of medial malleolus
• Runs medial side of the leg
• Pass posterior of medial epicondyle of femur – behind knee
• Inclines forwards in thigh
• Reach saphenous opening where it pierces the cribriform fascia
• Ends : Saphenofemoral junction (located at 4 cm below and lateral
to pubic tubercle) by joining the femoral vein
• In lower part of LSV – associated with saphenous nerve

11. Tributaries of Long Saphenous Vein
• Superficial circumflex iliac vein
• Superficial epigastric vein
• External pudendal vein
• Superficial medial femoral vein
• Superficial lateral femoral vein

12. • Tributaries connect the long saphenous vein with short
saphenous veins
• Called as ‘Communicators’

13. SHORT(SMALL) SAPHENOUS VEIN
• Starts : on dorsum of the foot b union of lateral end of
dorsal venous arch with the lateral marginal vein
• Passing behind the lateral malleolus - to the back of leg
• Ascending along lateral margin of tendon calcaneus
(Achilles)
• Runs at middle of the back of legs
• continues until the lower part of popliteal fossa -
between two heads of gastrocnemius
• Pierces deep fascia
• Communicates with long saphenous via the tributaries
• Ends : Empty into popliteal veins
• Nerve : is accompanied by a cutaneous nerve (sural nerve)

14. DEEP VEINS
• Receive blood from superficial veins
through perforating veins
• Comprise of venae comitantes
• Anterior tibial vein
• Posterior tibial vein
• Peroneal veins
• They unite to form the popliteal vein
 femoral vein  external iliac veins
• These veins have more valves than
superficial veins. They are more
efficient channels than the superficial
veins because of the driving force of
muscular contraction

17. Salient features of deep vein:
• High pressure system, well-supported by powerful
muscles
• Powerful calf muscle contraction returns the blood
to the heart
• Connected to superficial veins by perforators
• Deep veins are also provided with valves except
soleal vein

18. Type of Perforators
THIGH PERFORATOR–
• Hunter’s perforator (proximal)
• Dodd’s perforators (distal) - Situated a palm-breadth above the
knee
KNEE PERFORATOR (Boyd’s) - Gastrocnemius perforators
• Situated just below the knee
LEG PERFORATORS (Cockett’s)
1. Below and behind medial malleolus
2. Middle perforator is 10 cm above the tip of medial malleolus
3. Upper perforator is 15cm above the medial malleolus
Ankle perforators (May or Kuster)
• A knowledge of perforators forms a basis of multiple tourniquet
test.
• Most of the perforators are provided with valves.
• Weakness of these valves or damage to valves results in varicosity.

19. References
• SRB’s Manual of Surgery, Bhat M, S. (2016). 5th ed. Jaypee
Brothers Medical Publishers
• Manipal Manual of Surgery, 4th Edition, K.Rajgopal Shenoy
• B D Chaurasia Human anatomy, 5th edition