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Anatomy of veins and lymphatics
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
Paired ulnar and radial venae comitantes join at the elbow to become the brachial veins. On each side, these become the axillar y vein at the inferior border of the teres major muscle, and the axillary vein becomes the subclavian vein at the first rib. Each subclavian vein joins the internal jugular vein to become the brachiocephalic trunk (innominate vein) just behind the sternal end of the clavicle (Figure 2.3).
Development and anatomy of the venous system
Published in Peter Gloviczki, Michael C. Dalsing, Bo Eklöf, Fedor Lurie, Thomas W. Wakefield, Monika L. Gloviczki, Handbook of Venous and Lymphatic Disorders, 2017
The axillary vein begins at the lower border of the teres major, which corresponds with the lateral border of the scapula on an anteroposterior chest roentgenogram. At the outer border of the first rib, it becomes the subclavian, which ends at the medial border of the scalenus anterior muscle, where it joins the internal jugular vein to form the brachiocephalic vein. The brachiocephalic (innominate) vein begins behind the sterno-clavicular joint. The left brachiocephalic vein descends obliquely to join the right one. Constant tributaries of the brachiocephalic vein are the vertebral, internal thoracic, and inferior thyroid veins. The superior intercostal vein drains the upper intercostal veins and opens into the brachiocephalic vein on the left, whereas on the opposite side it joins the azygos vein.
The Heart (HT)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
The axillary vein ends lateral to the 1st rib and becomes the subclavian vein. The axillary vein connects, either directly or indirectly, with the inguinal region via the lateral thoracic vein and thoracoepigastric vein(s). The lateral thoracic vein is a tributary of the axillary vein and the thoracoepigastric veins arise from the anastomoses of superficial veins draining the groin. This connection between veins of the groin and the axillary vein creates a collateral channel through which venous blood returns to the heart in cases of inferior vena caval obstruction.
A simple method of axillary venipuncture using single landmark for pacemaker leads implantation
Published in Acta Cardiologica, 2023
Peng Zhao, Ying Wang, Shan Zeng
The patient was placed in supine position. Skin was cleaned and drape applied in the conventional fashion. Connecting point of medial to middle third of clavicle was located as the sole external anatomical landmark and puncture guiding point. Deflected lateral 45° from sagittal line, an 18-gauge needle was laid on the point, tip tangential to upper border of clavicle. The site of needle hub was identified as puncture entry point. Axillary vein was punctured by advancing the needle attached to syringe from entry site towards the landmark, with continuous suction and at approximately 30–45°relative to body surface. If not touching the vein, the needle was withdrawn and the procedure was repeated with slight lateral or medial variations to the landmark. Care was taken to not cross intercostal space in order to avoid pneumothorax. Upon blood aspiration, antero-posterior fluoroscopic view was used to confirm venous access site below the inferior border of clavicle and a guide wire was inserted from axillary vein into inferior vena cava, which counted as a successful procedure. If blind puncture failed after a maximum of five times, an alternative fluoroscopic assisted method was applied. Using antero-caudal fluoroscopic view with no cranio-caudal tilt orientation, the needle was inserted from entry point towards the first rib and outside the inferior margin of clavicle, as a modified version of the technique by Antonelli [7]. After successful venipuncture, a skin incision was made at the puncture site Figure 1. The remainder of subcutaneous pocket and device implantation was carried out in a routine manner.
Intravascular Papillary Endothelial Hyperplasia in the Coronary Artery: An Unusual Cause of Massive Myocardial Infarction in Hypoplastic Left Heart Syndrome
Published in Fetal and Pediatric Pathology, 2019
Raya Safa, Richard Garcia, Ralph Delius, Gunjanpreet Kaur, Lara Youssef, Janet Poulik, Bahig M. Shehata
To our knowledge, papillary endothelial hyperplasia in the coronary artery has not been previously reported in the literature. The etiology of the deep venous thrombosis of the left axillary vein and four extremities distal necrosis despite full central ECMO support and appropriate anticoagulation remains a dilemma in our patient. The autopsy permit was restricted therefore we could not examine the upper and the lower extremity vessels. The histopathology findings confirmed that the patient had multifocal papillary endothelial hyperplasia in the left coronary artery and its branches, in the superior and inferior mesenteric arteries branches suggesting a systemic phenomenon that might have also affected the arteries of both upper and lower extremities resulting in ischemia and necrosis. The causative agent leading to the multifocal IPEH described in our patient remains unknown.
Superficial location of the brachial plexus and axillary artery in relation to pectoralis minor: a case report
Published in Southern African Journal of Anaesthesia and Analgesia, 2018
The axillary artery is a continuation of the subclavian artery once it has passed over the first rib. The pectoralis minor muscle is located superficial to the axillary artery and it is this relationship that is used to divide the artery into three parts. The first part of the axillary artery is situated between the first rib and the superior border of pectoralis minor, the second part is deep to pectoralis minor, and the third part is located between the inferior borders of pectoralis minor and teres major muscles, after which it is known as the brachial artery.5 The axillary artery is accompanied by the axillary vein, a continuation of the brachial vein at the inferior border of teres major. The axillary vein is superficial to the axillary artery and becomes the subclavian vein as it crosses over the outer border of rib one.6