Basic Principles of Medicine 1
Module: Musculoskeletal System
DLA
Summary of blood supply, venous and lymphatic
drainage of the Upper and Lower Limbs
Dr. Kazzara Raeburn
St George’s University ©
1
Summary
of the
Arterial
Supply of
the Upper
Limb
Axillary vein
Venous Drainage of the
Upper Limb
• Venous drainage can be divided into
superficial and deep drainage
• Deep veins:
• Located in and drains the compartments
of the upper limb
• Runs with the corresponding arteries
(same name and usually paired)
• Superficial and deep palmar venous
arches in the hand drain into the paired
ulnar and radial veins in the forearm
• Ulnar and radial veins in the forearm drain
into the paired brachial veins in the arm
• The paired brachial veins joins with the
basilic vein to form the axillary vein at the
lower border of the teres major.
• The axillary vein becomes the subclavian
vein at the lateral border of the first rib.
Axillary vein
Venous Drainage of the
Upper Limb
• Superficial veins:
• Located in the skin and superficial
fascia of the upper limb
• Usually visible to the naked eye
• On the dorsum of the hand, the
dorsal venous network coalesces on
the medial side of the wrist to form
the basilic vein and on the lateral side
of the wrist to form the cephalic vein
• Basilic vein runs superficially in the
skin and drains the medial side of the
forearm and the medial side of the
arm. It then dives deep to join the
paired brachial veins forming the
axillary vein at the lower border of
the teres major.
• Cephalic vein runs superficially in the
skin and drains the lateral side of the
forearm and the lateral side of the
arm. It continues laterally in the
deltopectoral groove, joining the
axillary vein at the apex of the axilla.
Lymphatic drainage
of Upper Limb
Lateral axillary
nodes
• Like venous drainage, lymphatic
drainage can be divided into
deep and superficial
• Follows the path of the venous
drainage of the upper limb
• All lymphatics drain to the
axillary nodes
• Deep drainage: within the
compartments
• Lymphatic fluid from the
compartments of hand, forearm
and arm will go to lateral
(humeral) nodes, then to central
then finally to apical
• All lymph then pass from apical
to subclavian trunk to
lymphatic/thoracic duct
5
Lymphatic drainage
of Upper Limb
• Superficial drainage:
within the skin and
superficial fascia
Lateral axillary
nodes
• Medial hand, forearm and
arm
• Lymphatic fluid will go to lateral
(humeral) axillary nodes, then to
central axillary nodes, then finally
to apical axillary nodes
• Lateral hand, forearm and
arm
• Lymphatic fluid will go directly to
the apical axillary nodes (small
amount to central, then apical
axillary nodes)
• All lymph then pass from
apical to subclavian trunk to
lymphatic/thoracic duct
6
Summary of the Arterial
Supply of the Lower Limb
Venous Drainage of
the Lower Limb
• Venous drainage can be divided
into superficial and deep drainage
• Deep veins:
• Located in and drains the
compartments of the lower limb
• Runs with the corresponding
arteries (same name and usually
paired)
• Lateral and medial plantar veins in
the foot drain into the posterior
tibial veins
• Then, anterior and posterior tibial
veins in the leg forms the popliteal
vein in the popliteal fossa
• The popliteal vein becomes the
femoral vein at the adductor hiatus
• The femoral vein becomes the
external iliac vein at the inguinal
ligament vein
Venous Drainage of
the Lower Limb
• Superficial veins:
• Located in the skin and
superficial fascia of the lower
limb
• Usually visible to the naked eye
• On the dorsum of the foot, the
dorsal venous arch coalesces
on the medial side to form the
great saphenous vein and on
the lateral side to form the
small saphenous vein
• Great saphenous vein runs
superficially in the skin and
drains the medial and anterior
side of the foot and leg, and
the thigh. It then empties into
the femoral vein at the femoral
triangle
• Small saphenous vein runs
superficially in the skin and
drains the lateral and posterior
side of the leg and empties
into the popliteal vein at the
popliteal fossa
Lymphatic drainage of
the lower limb
popliteal
horizontal
group
• Like venous drainage, lymphatic
drainage can be divided into deep
and superficial
• Follows the path of the venous
drainage of the limb
• All lymphatics drain to the inguinal
nodes
vertical group
• Deep drainage: within the
compartments
• Lymphatic fluid from the leg and foot will
go to the popliteal nodes, then to deep
inguinal
• Lymphatic fluid from the thigh will go to
the deep inguinal nodes
• All lymph then pass to the iliac nodes
then to the cisterna chyli
Lymphatic drainage of
the lower limb
popliteal
horizontal
group
vertical group
Superficial drainage: within the
skin and superficial fascia
• Lateral foot and posterior
lateral leg
• Lymphatic fluid will go to the
popliteal nodes then to the
deep inguinal nodes
• Antero-medial foot, anteromedial leg, thigh
• Lymphatic fluid will go to the
vertical group of the superficial
inguinal nodes then to the deep
inguinal nodes
• All lymph then pass to the iliac
nodes then to the cisterna chyli