Cephalic vein !

The cephalic vein runs under the skin up the thumb side of the arm to the shoulder; it drains the skin and marks a surgical path to the shoulder.

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What it is

A surface vein up the thumb side of the forearm and arm, into the groove between deltoid and pectoralis major.

What it does

Drains the skin of the arm; marks the surgical path to the front of the shoulder.

Key facts

Drains: Lateral dorsal venous network of the hand, lateral forearm and arm
Into: Axillary vein, through the deltopectoral groove and clavipectoral fascia

Relations

Course: From the radial side of the back of the hand over the snuffbox, up the lateral forearm, in front of the elbow lateral to the biceps, along the lateral bicipital groove and into the deltopectoral groove and triangle
Deep: Branches of the superficial radial nerve at the wrist; the lateral forearm skin nerve (lateral antebrachial cutaneous) in the forearm; the deltoid branch of the thoracoacromial artery in the groove
Superficial: Only skin and subcutaneous fat along its length

How to find it

With a tourniquet it is seen or felt at the radial side of the wrist and along the lateral forearm. At the shoulder it lies in the furrow between the deltoid and pectoralis major, deepest at the infraclavicular fossa.

On imaging

Ultrasound shows it along the lateral forearm and arm and in the deltopectoral groove. It is mapped before creating a dialysis fistula (radiocephalic at the wrist or brachiocephalic at the elbow), checking its size and patency, and before using it for venous access. Doppler ultrasound shows thrombosis in superficial thrombophlebitis, often at an old cannula site.

Common problems

Common site for IV lines and for dialysis fistulas at the wrist.
Superficial thrombophlebitis: a tender, firm cord after an IV.
In shoulder surgery it marks the gap between deltoid and pectoralis major and is kept safe.

How it is diagnosed

Exam; ultrasound to check for clots.

Treatment

Warm compresses and anti-inflammatory medicines for superficial phlebitis.
Protected during the deltopectoral approach for shoulder replacement.

Clinical notes

IV lines at the radial wrist can injure the superficial radial nerve, causing numbness or burning over the back of the thumb
Brachiocephalic arteriovenous fistula at the elbow joins it to the brachial artery when the wrist veins are unsuitable
Cephalic arch stenosis: in dialysis fistulas a narrowing often develops where the vein turns through the clavipectoral fascia
The lateral antebrachial cutaneous nerve runs close to it at the elbow, a source of pain after venipuncture on the lateral side

Anatomical variants

It may be thin or absent in the arm, or drain into the external jugular or subclavian vein through a channel over the clavicle

Development

Develops from the vein that runs along the preaxial (thumb-side) border of the limb bud, which is why it stays on the lateral side from wrist to shoulder.

Test yourself

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

Through which groove does the cephalic vein run at the shoulder, and where does it end?

The deltopectoral groove, between deltoid and pectoralis major; it pierces the clavipectoral fascia to end in the axillary vein.

Which nerve can be injured by IV lines in the cephalic vein at the radial wrist?

The superficial radial nerve, causing numbness or burning over the back of the thumb.

What is cephalic arch stenosis?

A narrowing in dialysis fistulas where the cephalic vein turns through the clavipectoral fascia.

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

Its names

Official Latin (TA2): vena cephalica TA2 4964
Official Spanish (DeCS): Vena cefálica
English (TA2): Cephalic 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.

Cephalic vein highlighted on the Durgical 3D model