Veins

Veins return blood to the heart. For coding purposes the upper and lower veins are categorized separately, in much the same way as the arteries. Fortunately, they share many of the names for the arteries, so remembering upper and lower is a bit easier than initially remembering all of those arteries. And, the same as for the arteries, the dividing line for upper and lower is the diaphragm.

In general, veins that are described as being “deep” are those that are far from the surface, while those that are “superficial” are those close to the surface.

Upper Veins

The upper veins (Fig. 9-13) return blood to the heart from the head, neck, arms, and chest cavity. If you remember that the word parts for many of the veins tell you where they are returning blood from, you just need to pay special attention to which ones drain into the larger veins that collect blood from several different ones (e.g., the jugulars, brachiocephalics, and subclavians). In the head and neck, the facial veins drain the superficial parts of the face while the intracranial veins (e.g., ophthalmic, cerebral) drain the deeper structures of the skull. The vertebral veins drain the blood from the brain near the bones of the neck. The external jugular veins drain the superficial veins of the head and neck, while the internal jugular veins drain blood from the deeper veins of the head and neck (including the intracranial veins). Both the internal and external jugular veins drain into the subclavian veins, located under the collarbones. The vertebral veins drain directly into the subclavian veins without a direct connection to one of the jugulars. The internal jugular joins the subclavian to form the brachiocephalic veins where the right and left sides merge to drain into the superior vena cava. Blood is drained from the veins of the arms starting with the fingers and hands (e.g., palmar/volar digital and metacarpal veins). The deeper drainage of the lower arms is handled by the radial (lower lateral forearm) and ulnar (lower medial forearm) veins that anastomose (join) at the brachial vein. The brachial vein drains the upper arm where it is eventually joined by the axillary vein, draining the area under the arm, and continuing to join the subclavian, then brachiocephalic (innominate) vein, and finally the superior vena cava. Superficial drainage of the arm is carried by the basilic veins that drain the hands and lower arm on the medial side of the arm and the cephalic veins on the lateral side. Both drain into the axillary vein and follow the same path back to the heart as the deeper veins described above. The median cubital vein (also referred to as the median basilic or antecubital vein) connects the basilic and cephalic veins and is often used as a site for blood draws. Note that the combining form cubit/o refers to the area of the elbow.

The chest area is drained by the azygos vein (azyg/o means “without a yoke,” meaning that it is a singular, not paired, vein) that resides in the thoracic cavity along with the hemiazygos vein and accessory hemiazygos vein that together collectively drain blood from the organs and tissues of the thoracic cavity. This includes the superior intercostal veins (draining the area between the upper ribs), the bronchial veins (draining the area around the airways of the lungs), and the pericardial veins (draining the sac surrounding the heart). The azygos vein drains the right side of the cavity, whereas the hemiazygos and accessory hemiazygos veins return blood from the left side of the same veins. These veins then drain back directly to the superior vena cava or through the brachiocephalic vein and then to the superior vena cava.

Exercise 5:

Upper Veins

A. Match the word parts with the meanings provided. ____
1. azyg/o ____
2. pericardi/o ____
3. cephal/o ____
. cubit/o ____
5. cost/o ____
6. axill/o ____
7. brachi/o ____
8. radi/o ____
9. jugul/o ____
10. uln/o ____
11. vertebr/o ____
12. clav/i ____
13. bronchi/o ____
14. crani/o

A. arm
B. airway, bronchus
C. rib
D. lower medial armbone
E. elbow
F. sac surrounding heart
G. armpit
H. lower lateral armbone
I. not yoked (singular)
J. head
K. backbone
L. collarbone
M. throat, neck
N. skull

B. Match the upper veins with the areas that they drain blood from...
____ 1. vertebral vein
____ 2. subclavian vein
____ 3. pericardial vein
____ 4. external jugular vein
____ 5. superior vena cava
____ 6. ulnar vein
____ 7. internal jugular vein
____ 8. radial vein
____ 9. brachiocephalic vein
____ 10. azygos vein
____ 11. brachial vein
____ 12. digital/metacarpal vein
____ 13. basilic vein
____ 14. cephalic vein
____ 15. axillary vein

A. superficial lateral side of lower arm and hands
B. armpit
C. thoracic cavity
D. deep vein of medial side of lower arm
E. brain, near neck bones
F. head, neck and upper extremity to superior vena cava
G. fingers and hands
H. sac surrounding the heart
I. superficial medial lower arms and hands
J. deeper veins of head and neck
K. deep vein of lateral side of lower arm
L. upper arm
M. superficial veins of head and neck
N. under the collar bone
O. upper veins of the body directly to the heart

End of Notes.