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# Back-of-hand veins

The dorsal venous network is the web of veins visible on the back of the hand; it drains into the cephalic and basilic veins and is a common IV site.

Official name: Dorsal venous network of the hand

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## What it is

The visible web of veins on the back of the hand.

## What it does

Drains the hand into the cephalic and basilic veins; a common IV site.

## Key points

- Most of the palm's blood drains through to the back of the hand, so the veins are visible on the dorsum and hand swelling shows there first
- Its radial end becomes the [cephalic vein](https://durgical.com/en/anatomy/cephalic-vein/) and its ulnar end the [basilic vein](https://durgical.com/en/anatomy/basilic-vein/)
- The [superficial radial nerve](https://durgical.com/en/anatomy/superficial-branch-of-the-radial-nerve/) and the dorsal branch of the [ulnar nerve](https://durgical.com/en/anatomy/ulnar-nerve/) run among these veins

## Key facts

**Drains**
Dorsal digital and metacarpal veins

**Into**
Cephalic (lateral) and basilic (medial) veins

## Relations

**Course**
Dorsal digital veins join into dorsal metacarpal veins, which form an arch-like network over the metacarpals

**Deep**
[Extensor tendons](https://durgical.com/en/anatomy/extensor-digitorum-tendons/) and the [dorsal hand fascia](https://durgical.com/en/anatomy/dorsal-fascia-of-the-hand/)

**Superficial**
Thin, loose [skin](https://durgical.com/en/anatomy/skin/)

## How to find it

With the hand hanging down and the fist closed, or a tourniquet at the wrist, the veins stand out on the back of the hand.

## On imaging

Usually visible through the skin, so imaging is seldom needed; ultrasound helps find a vein for cannulation when it is hidden by fat or swelling, and Doppler shows thrombosis after a cannula. When contrast or fluid leaks around a cannula on the back of the hand, the assessment is clinical; radiographs show only radiopaque contrast or gas in the soft tissues.

## Clinical notes

- A common first site for IV cannulas; leaked infusions spread easily under the loose skin of the back of the hand
- Cannulas on the radial side near the snuffbox can irritate the superficial radial nerve
- Snuffbox arteriovenous fistula: the start of the cephalic vein, leaving the radial side of this network, is joined to the [radial artery](https://durgical.com/en/anatomy/radial-artery/) in the snuffbox as the most distal site for dialysis access

## Anatomical variants

- The pattern differs greatly between people and between the two hands

## Test yourself

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

## Why does hand swelling show first on the back of the hand?

Most of the palm's blood drains through to the dorsal venous network, under thin, loose skin.

## Which veins arise from the radial and ulnar ends of the dorsal venous network of the hand?

The cephalic vein from the radial end, the basilic vein from the ulnar end.

## Which nerve can be irritated by cannulas on the radial side of the back of the hand?

The superficial radial nerve, near the snuffbox.

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

## Its names

**Official Latin (TA2)**
rete venosum dorsale manus TA2 4967

**Official Spanish (DeCS)**
Red venosa dorsal de la mano

**English (TA2)**
Dorsal venous network of the hand

## Related

- [Cephalic vein](https://durgical.com/en/anatomy/cephalic-vein/)
- [Basilic vein](https://durgical.com/en/anatomy/basilic-vein/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Veins](https://www.ncbi.nlm.nih.gov/books/NBK546676/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/dorsal-venous-network-of-the-hand/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/dorsal-venous-network-of-the-hand/