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Shoulder veins !

The shoulder veins drain the shoulder into the axillary vein; they enlarge into detours if the main arm vein is blocked.

Official name: Veins around the shoulder

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What it is

Veins that run with the arteries around the shoulder and shoulder blade.

What it does

Drain the shoulder into the axillary vein.

Key facts

Drains
Shoulder and scapular muscles (circumflex humeral, subscapular, thoracodorsal, suprascapular veins)
Into
Axillary vein (suprascapular -> external jugular/subclavian)

Relations

Course
They follow their arteries: around the surgical neck of the humerus, through the quadrangular and triangular spaces and along the lateral border of the scapula; the suprascapular vein runs above the scapula toward the external jugular or subclavian vein

How to find it

Mostly found in surgery: the "three sisters" at the lower edge of subscapularis in the deltopectoral approach, the posterior circumflex humeral vessels in the quadrangular space behind the surgical neck, and the thoracodorsal vein on the deep surface of latissimus dorsi.

On imaging

In suspected axillary-subclavian obstruction, duplex ultrasound and CT or catheter venography show the block and the enlarged shoulder collaterals; venography with the arm raised can unmask compression at the thoracic outlet.

Clinical notes

  • Dilated collateral veins over the shoulder and upper chest are a visible sign of long-standing axillary-subclavian obstruction
  • In the deltopectoral approach the "three sisters" are tied or coagulated to avoid bleeding when subscapularis is released
  • The thoracodorsal vessels are preserved during axillary lymph node dissection

Test yourself

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

What do dilated veins over the shoulder and upper chest suggest?

Long-standing axillary-subclavian vein obstruction, with the shoulder veins enlarged as collaterals.

Which shoulder veins form part of the «three sisters» in the deltopectoral approach?

The two veins of the anterior circumflex humeral artery, at the lower border of subscapularis.

Which shoulder vein is part of the latissimus dorsi flap pedicle?

The thoracodorsal vein.

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

Its names

Official Latin (TA2)
vena circumflexa anterior humeri TA2 4976
Official Spanish (DeCS)
Venas circunflejas del húmero, subescapular, circunfleja de la escápula, toracodorsal y supraescapular
English (TA2)
Veins around the shoulder

Sources: Terminologia Anatomica (TA2); Anatomy, Shoulder and Upper Limb, Veins; 20.5 Circulatory Pathways (OpenStax (Rice University), 2022) · adapted, CC BY 4.0.

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Representative model, for educational purposes only.

Shoulder veins highlighted on the Durgical 3D model