The Anatomy of the Cephalic Vein

A Major Vein of the Hand, Forearm, and Arm

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One of the two primary veins of the upper limb, the cephalic vein carries blood from the hand, forearm, and arm back to the heart. “Cephalic” is derived from the Latin and Greek for “head,” which refers to the pathway it takes up the arms and shoulders, before draining into the axillary vein.

Since it runs along a superficial course just beneath the skin, one of its branches, the median cubital vein of the forearm, is most often used by healthcare professionals to collect samples for blood tests. In addition, it’s considered a secondary option as a means to insert a pacemaker into the heart or to place a venous catheter (or central line) for surgery.

Anesthetic nurse puncture cephalic vein - stock photo

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Anatomy

Structure and Location

As one of the main superficial veins of the arm along with the basilic vein, the cephalic vein is larger and sometimes visible through the skin. Since it runs along the surface, it also “communicates” (the clinical term for “connects”) with deep veins. To prevent backflow, the small connecting veins have specialized valves in them.

What does the course of the cephalic vein look like? Here’s a quick breakdown:

Origin in the anatomical snuffbox: The cephalic vein arises as a convergence of superficial veins on the back (or “dorsum”) of the hand in the anatomical snuffbox, which is the triangular depression at the base of the thumb.

From there it runs along the surface just above the radial styloid process, which is the projection of the wrist at the end of the radius (one of the two main bones of the forearm).

Course to the elbow: After crossing into the forearm, the cephalic vein runs through the superficial fascia (the surface tissue) of the inner arm. On its way, it emits the median cubital vein, which connects to the basilic vein. It then crosses the crease of the elbow joint.

Terminus just below the clavicle: Via a crease between the bicep and elbow flexor muscles, it travels along the inside of the upper arm towards the shoulder. As it progresses, it stays just under the surface of the skin and accesses a groove between the pectoralis major (the chest) and deltoid (shoulder) muscles.

Just beneath the clavicle, the cephalic vein drains into the axillary vein, which bends downwards towards the heart.

Anatomical Variations

As with all veins in the body, congenital differences in the anatomy of the cephalic vein have been observed clinically. These primarily fall into two categories:

  • Variations in the number and structure of the small branches that connect the cephalic vein with veins deeper in the body: These represent the most common variations.
  • Size differences: The typically smaller cephalic vein occasionally is larger than the basilic vein.
  • Accessory cephalic veins: In some cases, the cephalic vein has two additional branches that emerge either close to its origin in the hands, or from a portion of the forearm. These then rejoin the main branch near the elbow.

 

Function

One of the main tasks of the circulatory system is to deliver oxygen, carried by blood cells, to the rest of the body. Oxygen is added to the blood in the heart. In contrast to arteries, which take the blood out, veins like the cephalic vein bring it back.

This vein is one of the main pathways that deoxygenated blood from the hands and arms takes on its way to the heart. Specifically, this vein conveys blood from the radial part of the hand (around the thumb), the inner forearm, and upper arm.   

Clinical Significance

In the clinical and medical setting, the cephalic vein—like other superficial veins in the arm—plays a few different roles and can be impacted by a number of health conditions. Here’s a quick breakdown:

  • Blood sample collection: This vein—or even more often the median cubital vein that branches from it—is used as a site of blood sample collection. This has primarily to do with the ease of access it provides in its position just under the skin.
  • Cephalic vein cutdown: Some treatments, such as implantation of a heart pacemaker, or a venous catheter (to deliver medication, drain blood, or provide other assistance to surgery) require a healthy, safe vein. When central veins in the body are insufficient, the cephalic vein is used, via a cephalic vein cutdown procedure
  • Varicose veins: In some cases, blood pools in the veins, causing them to become swollen and painful. When it’s seen in the cephalic vein, it occurs due to insufficient activity of the valves in the short veins connecting surface to deeper veins. These primarily occur in the lower limbs, but cases have occurred in the arms 
  • Superficial vein thrombophlebitis: A blood clot in a surface vein, such as the cephalic vein, can result from cancer, genetics, injury, excess weight, smoking, or other causes. If blood-thinning drugs or lifestyle changes like elevation don't correct it, surgical approaches such as sclerotherapy or endovenous ablation may be considered.
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  1. Shahid S. Cephalic vein. Kenhub. Published 2020.

  2. Matsuo M, Honma S, Sonomura T, Yamazaki M. Clinical anatomy of the cephalic vein for safe performance of venipuncture. JA Clin Rep. 2017;3(1). doi:10.1186/s40981-017-0121-6

  3. Nguyen J, Duong H. Anatomy, shoulder and upper limb, veins. Statpearls. Updated 2020.

  4. Hoskins A, Hacking C. Cephalic vein: radiology reference article. Radiopaedia. Published 2019.

  5. Cleveland Clinic. Superficial thrombophlebitis: symptoms, causes. Published 2019.