phlebotomy related vascular anatomy

phlebotomy related vascular anatomy

1. PHLEBOTOMY-RELATED VASCULAR ANATOMY Dr Ahmed Aboamer MD Clinical pathology

2. PHLEBOTOMY-RELATED VASCULAR ANATOMY Antecubital Fossa shallow depression in the arm that is anterior to the elbow. It is the first-choice location for venipuncture because several major arm veins lie close to the surface, making them relatively easy to locate and penetrate These major superficial veins are referred as antecubital veins. The anatomical arrangement of antecubital veins varies slightly from person to person; however, two basic vein arrangements, referred to as the H- and M-shaped patterns

3. 4 median cubital vein The H-shaped pattern is displayed by approximately 70% of the population involves the cephalic vein on the lateral side of the arm connected to the basilic vein on the medial side by the median cubital vein just below the elbow crease The H-shaped pattern Located near the center of the antecubital area, it is the preferred vein for venipuncture in the H-shaped pattern. It is typically larger, closer to the surface, better anchored, and more stationary than the others, It the easiest and least painful to puncture and the least likely to bruise.

4. 5 Cephalic vein Located in the lateral aspect of the antecubital area, it is the second choice vein for venipuncture in the H-shaped pattern. It is often harder to palpate than the median cubital but is fairly well anchored and often the only vein that can be palpated (felt) in obese patients. accessory cephalic vein is lateral branch of The cephalic vein. The H-shaped pattern

5. 6 Basilic vein Basilic vein: A large vein located on the medial aspect of the antecubital area, it is the last-choice vein for venipuncture . It is generally easy to palpate but is not as well anchored and rolls more easily, increasing the possibility of accidental puncture of medial cutaneous nerve (a major nerve of the arm) or the brachial artery. Punctures in this area also tend to be more painful. The H-shaped pattern

6. 7 Represents about 20-30% of individuals the median antebrachial vein passes up to the centre of the forearm and gives 2 branches the median cephalic :connecting to the cephalic vein, the median basilic : connecting to the basilic vein The M-shaped pattern

7. 8 Median vein The M-shaped pattern Median vein ( antebrachial vein): The first choice for venipuncture in the M-shaped pattern because it is well anchored, tends to be less painful to puncture, Not close to major nerves or arteries as the others, making it generally the safest one to use.

8. 9 Median cephalic vein The M-shaped pattern Median cephalic vein The second choice for venipuncture in the M-shaped pattern it is accessible and located away from major nerves or arteries, making it generally safe to puncture.

9. 10 Median basilic vein The M-shaped pattern Median basilic vein The last choice for venipuncture in the M-shaped pattern (even though it may appear more accessible) Because it is more painful to puncture and, like the basilic vein, is located near the branches of the medial cutaneous nerve and the brachial artery.

10. 11 Forarm and Hand Veins The  dorsal digital veins drain into   dorsal metacarpal veins, which unite to form a  dorsal venous network. Drains into the cephalic vein laterally, and basilic vein medially Median antebrachial vein It empties into the basilic , median basilic , or median cubital vein

11. Dorsal venous arch Metacarpal plexus Hand Veins When the antecubital veins are not accessible. Hand veins are smaller and less anchored. can be very painful for the patient. Forarm and Hand Veins

12. Always chose a vein that is straight and has good bounce

13. 14 Leg, Ankle, and Foot Veins Because of the potential for significant medical complications such as phlebitis or thrombosis, veins of the leg, ankle, and foot) must not be used for venipuncture without permission from the patient’s physician. Puncture of the femoral vein is performed only by physicians or specially trained personnel.

14. 15 Selecting the Venipuncture Site Everybody will not have veins in the exactly same position. Some variations may exist. Always examine the antecubital area first Select a vein that is large and does not roll Preparing for Venipuncture

15. Chapter 2 16 Primary Veins Used For Phlebotomy The most commonly used veins for venipuncture are located in the antecubital fossa . 1st Choice Median cubital vein 2nd Choice Cephalic vein 3rd Choice Basilic vein Which vein is BEST for venipuncture?

16. Thank You !