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Basilic vein !

The basilic vein runs under the skin up the inner side of the arm; it is used for long IV lines (PICC) and dialysis access.

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What it is

A surface vein on the inner arm that dives deep halfway up; used for PICC lines and moved to build dialysis fistulas.

What it does

Drains the skin of the arm; used for long IV lines (PICC) and dialysis access.

Key facts

Drains
Medial dorsal venous network, medial forearm
Into
Brachial veins -> axillary vein (pierces the deep fascia mid-arm)

Relations

Course
From the ulnar side of the dorsal venous network up the back and inner side of the forearm, turning forward below the elbow, in front of the medial epicondyle, where it receives the median cubital vein, then up the medial bicipital groove
Deep
In the upper arm, once under the fascia: the brachial artery, the brachial veins and the median nerve
Superficial
At the elbow, branches of the medial antebrachial cutaneous nerve cross in front of or behind it

How to find it

With a tourniquet it is seen on the inner side of the forearm and elbow. In the upper arm it lies under the fascia and is found on ultrasound as a compressible vein medial to the brachial artery.

On imaging

Ultrasound follows it up the medial forearm and arm until it pierces the deep fascia in the middle of the arm and joins the brachial veins to form the axillary vein. It is mapped before a brachiobasilic fistula, which needs the vein moved to the surface because it lies deep, and it is the usual vein for ultrasound-guided PICC insertion. Doppler shows thrombosis, often around a catheter.

Clinical notes

  • Venipuncture on the inner side of the elbow is close to branches of the medial antebrachial cutaneous nerve and, deeper, the brachial artery and median nerve
  • Basilic vein transposition: for dialysis it is freed and brought to the surface so it can be needled, because its natural course is too deep
  • Superficial thrombophlebitis after a cannula shows as a tender cord along the inner forearm

Anatomical variants

  • Its forearm tributaries and its link with the median cubital vein vary widely; it may join the brachial veins higher or lower than mid-arm

Development

Comes from the vein of the postaxial (little-finger) border of the limb bud, which continues proximally into the axillary vein; this is why the basilic, not the cephalic, leads straight into the deep axillary drainage.

Test yourself

Think of the answer, then tap the question to see it.

Where does the basilic vein pierce the deep fascia, and which nerve comes out nearby?

Near the middle of the arm, close to where the medial forearm skin nerve comes out.

Why is the basilic vein transposed for dialysis access?

Its natural course is too deep to needle, so it is freed and brought to the surface.

Why are basilic vein punctures in the upper arm made under ultrasound?

Above the elbow it lies close to the brachial artery and median nerve.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2)
vena basilica TA2 4979
Official Spanish (DeCS)
Vena basílica
English (TA2)
Basilic vein

Sources: Terminologia Anatomica (TA2); Anatomy, Shoulder and Upper Limb, Elbow Cubital Fossa; Anatomy, Shoulder and Upper Limb, Veins.

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Representative model, for educational purposes only.

Basilic vein highlighted on the Durgical 3D model