THE VEINS OF THE UPPER LIMB. 



either side with the radial and ulnar veins ; but not unfrequently it is large and 

 forms the principal outlet of the dorsal plexus of the hand on the outer side, in 

 which case the radial vein is proportionally reduced in size. It ascends to the 

 hollow in front of the elbow, and there terminates by dividing into the median- 

 basilic and median-cephalic veins, which diverge upwards from each other, lying 

 one on each side of the prominent tendon of the biceps muscle. Close to its 

 bifurcation this vessel receives a short wide branch, the deep median vein, which 

 pierces the fascia, and forms a communication between it and the deep veins 

 accompanying the arteries. 



The median-basilic vein, usually the larger of the two divisions of the median, 

 is directed inwards to join the commencement of the basilic vein. It passes in front 

 of the brachial artery, from which it is separated by the semilunar fascia of the 



Fig. 409. THE SUPERFICIAL VEINS AT THE BEND 

 OP THE ELBOW. (R. Quain. ) 3 



The full description of this figure will be found at p. 437. 

 At 1, the fascia is opened in front of the brachial artery and 

 its accompanying veins ; the inner vena comes has been divided, 

 the outer, marked 2, is entire ; +, median nerve ; 3, basilic 

 vein ; o', 3', ulnar veins ; 4, cephalic vein ; 4', radial vein ; 

 5, 5, median vein ; 5 to 4', median-cephalic ; 5 to 3', median- 

 basilic. 



biceps, and it is crossed by branches of the internal 

 cutaneous nerve. 



The median-cephalic vein inclines outwards 

 in the hollow between the biceps and the supinator 

 longus muscles, passing in front of the musculo- 

 cutaneous nerve, and joins the radial to form the 

 cephalic vein. 



The basilic vein, the largest of the veins of 

 the arm, ascends in the groove on the inner side of 

 the biceps muscle, lying internal to the situation 

 of the brachial artery ; it perforates the fascia 

 somewhat below the middle of the arm, and is con- 

 tinued upwards into the axillary vein. 



The cephalic vein is directed upwards in the 

 groove along the outer border of the biceps muscle, 



and then between the pectoralis major and the deltoid ; finally dipping in between 

 the last two muscles, it crosses the first part of the axillary artery, and opens into 

 the axillary vein between the pectoralis minor and subclavius muscles. 



Varieties. The superficial veins of the forearm are subject to great variation, both in the 

 disposition and size of their trunks, and in their arrangement at the bend of the elbow. The 

 radial vein may be very small or even absent, and in such cases the cephalic rein may also be 

 wanting, the branches from the outer side of the forearm being collected into the median 

 vein, which is continued directly into the median-basilic. It occasionally happens that the 

 anterior ulnar vein is larger than the posterior. The mediatt-ba&ilic rein is not unfrequently 

 double. 



The cephalic vein sometimes passes up over the clavicle and terminates in the external 

 jugular vein; or these two vessels may be united by a communicating branch (j-nyulo- 

 cephalie) in this situation. In two cases this communicating branch has been seen to 

 perforate the bone (Allen Thomson). The cephalic vein is occasionally found passing back- 

 wards between the subclavius muscle and the clavicle to join the lower end of tbe 

 subclavian vein. 



