The veins, which form from merging venules, drain
the head, limbs, and trunk. The major systemic veins are
shown in Figure 11.16. Although only one systemic artery,
the aorta, takes oxygenated blood away from the heart (left
ventricle), three systemic veins return deoxygenated blood
to the heart (right atrium). These three veins are as follows.
The coronary sinus is the main vein of the heart; it
receives almost all venous blood from the myocardium.
The superior vena cava (SVC) drains the head, neck,
chest, and upper limbs.
The inferior vena cava (IVC) is the largest vein in the
body and drains the abdomen, pelvis, and lower limbs.
We’ll start by identifying the veins that drain into the SVC
from the head and neck.
Keep in mind that these veins
and the others we will identify are named in a distal-to-
proximal direction, the same direction as the blood flows.
The right and left internal jugular veins drain the
brain (through the dural venous sinuses), face, and
neck. They pass inferiorly on either side of the neck
lateral to the internal carotid and common carotid
arteries. They then unite with the subclavian veins to
form the right and left brachiocephalic veins.
The right and left external jugular veins empty into
the subclavian veins and drain the scalp and superficial
and deep regions of the face.
The right and left vertebral veins empty into the
brachiocephalic veins in the neck. They drain deep
structures in the neck such as the cervical vertebrae,
cervical spinal cord, and some neck muscles.
Blood from the upper limbs is returned to the SVC by both
superficial and deep veins. The principal superficial veins that
drain the upper limbs originate in the hand and convey blood
from the smaller superficial veins into the axillary veins. •
The cephalic veins begin on the venous networks of
the hands that drain the fingers. The cephalic veins
drain blood from the lateral aspect of the upper limbs.
The basilic veins begin on the medial aspects of the
hands and drain blood from the medial aspects of the
upper limbs. Anterior to the elbow, the basilic veins are
connected to the cephalic veins by the median cubital
= elbow), which drain the forearm. If a
vein must be punctured for an injection, transfusion,
or removal of a blood sample, the median cubital vein
is preferred. The basilic veins ascend until they merge
with the brachial veins in the axillary area to form the
The median antebrachial veins begin in the veins on
the palms and ascend in the forearms to join the basilic
or median cubital veins, sometimes both. They drain the
palms and forearms.
Now to the deep veins that drain the upper limbs.
The paired radial veins drain the lateral aspects of
the forearms and pass alongside each radial artery. Just
below the elbow, the radial veins unite with the ulnar
veins to form the brachial veins.
The paired ulnar veins drain the medial aspect of the
forearms, pass alongside each ulnar artery, and join
with the radial veins to form the brachial veins.
The paired brachial veins accompany the brachial
arteries. They drain the forearms, elbow joints, and arms.
They join with the basilic veins to form the axillary veins.
The axillary veins ascend to become the subclavian
veins. They drain the arms, axillae, and upper part of
the chest wall.
The subclavian veins drain the arms, neck, and thoracic
wall. They are continuations of the axillary veins that unite
with the internal jugular veins to form the brachiocephalic
veins. The brachiocephalic veins unite to form the SVC.
Now we turn to the veins that drain the lower limbs into
the inferior vena cava. Again, we’ll start with the superfi-
cial veins, which originate in the foot.
The great saphenous veins, the longest veins in the
body, begin at the medial side of the dorsal venous
) of the foot, networks of veins on the
top of the foot that collect blood from the toes. The
great saphenous veins empty into the femoral veins and
drain the leg and thigh, the groin, external genitals,
and abdominal wall. Along their length, they have 10
to 20 valves, with more in the leg than the thigh. The
great saphenous veins are often used for prolonged
administration of intravenous fluids and as a source of
vascular grafts, especially for coronary bypass surgery.
The small saphenous veins begin at the lateral side
of the dorsal venous arches of the foot. They drain the
foot and leg and empty into the popliteal veins behind
the knee. Along their length, they have 9 to 12 valves.
Now to the deep veins that drain the lower limbs.
The paired posterior tibial veins drain the foot and
posterior leg muscles. The paired anterior tibial veins
drain the ankle joint, knee joint, tibiofibular joint, and
anterior portion of the leg and unite with the posterior
tibial veins to form the popliteal vein.
The popliteal veins, formed by the union of the
anterior and posterior tibial veins, drain the skin,
muscles, and bones of the knee joint.
328 CHAPTER 11
The Cardiovascular System: Heart, Blood Vessels, and Circulation