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1.1.12 Veins of the shoulder region

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(3.09)

Let's start by looking at the veins. We can be quite brief about this since the veins parallel the arteries in most important respects. It'll be helpful to start on the outside and progress inward, removing some muscles as we go along.

Here, in the groove between pectoralis major and deltoid, is the cephalic vein, coming up from the arm. It's a vein that doesn't have an accompanying artery. To see where it's going, we'll remove pectoralis major.

Here's the cephalic vein. Together with other veins from the shoulder region, it joins the main vein of the upper extremity, the subclavian vein. We'll focus our attention on this important vein. The subclavian vein comes up from the arm and passes beneath pectoralis minor. Emerging from beneath pectoralis minor, it passes over the outer surface of the first rib (here's the first rib) and under the subclavius muscle and the clavicle. To follow the subclavian vein further, we'll remove the clavicle, the subclavius muscle, and this muscle, the sternocleidomastoid.

Here we are, behind the medial end of the clavicle, which went from here (this is the cut end of the clavicle) to here. This was the sterno-clavicular joint. Here's pectoralis minor. Here's the curve of the first rib, and here's scalenus anterior. These structures, the subclavian artery, and the brachial plexus, we'll be seeing in a minute. Let's follow the vein. Just as the subclavian vein reaches the medial border of the first rib, which is here, it's joined from above by the main vein of the head and neck, the internal jugular vein. Together the subclavian and internal jugular veins form the brachiocephalic vein.

The brachiocephalic vein passes medial to the first rib, and enters the chest. The dome of the pleura lies immediately behind it: here's the pleura. ...

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(3.09)

Let's start by looking at the veins. We can be quite brief about this since the veins parallel the arteries in most important respects. It'll be helpful to start on the outside and progress inward, removing some muscles as we go along.

Here, in the groove between pectoralis major and deltoid, is the cephalic vein, coming up from the arm. It's a vein that doesn't have an accompanying artery. To see where it's going, we'll remove pectoralis major.

Here's the cephalic vein. Together with other veins from the shoulder region, it joins the main vein of the upper extremity, the subclavian vein. We'll focus our attention on this important vein. The subclavian vein comes up from the arm and passes beneath pectoralis minor. Emerging from beneath pectoralis minor, it passes over the outer surface of the first rib (here's the first rib) and under the subclavius muscle and the clavicle. To follow the subclavian vein further, we'll remove the clavicle, the subclavius muscle, and this muscle, the sternocleidomastoid.

Here we are, behind the medial end of the clavicle, which went from here (this is the cut end of the clavicle) to here. This was the sterno-clavicular joint. Here's pectoralis minor. Here's the curve of the first rib, and here's scalenus anterior. These structures, the subclavian artery, and the brachial plexus, we'll be seeing in a minute. Let's follow the vein. Just as the subclavian vein reaches the medial border of the first rib, which is here, it's joined from above by the main vein of the head and neck, the internal jugular vein. Together the subclavian and internal jugular veins form the brachiocephalic vein.

The brachiocephalic vein passes medial to the first rib, and enters the chest. The dome of the pleura lies immediately behind it: here's the pleura. To follow the brachiocephalic vein into the chest, we'll remove these muscles, and we'll also remove this part of the anterior chest wall. We'll also remove the other clavicle.

Now we're looking inside the chest. Here are the divided ends of the two first ribs; and here's the divided end of the sternum. Here are the two brachiocephalic veins, the right, and the left. A little to the right of the midline they join together, to form the superior vena cava.

Apart from what we've just seen, the veins of the region correspond so closely to the arteries that we don't need to consider them separately.

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