Venipuncture sites diagram8/28/2023 ![]() ![]() The radial artery lies on the lateral aspect of the ventral surface of the forearm, the ulnar on its medial aspect. The brachial artery is located just medial of the midline in the antecubital fossa and is the primary reason that the medial aspect of the antecubital fossa is low on my list of preferred venipuncture sites for the neophyte phlebotomist.Īpproximately 2.5 cm (1 inch) below the antecubital fossa, the radial and ulnar arteries arise from the brachial artery. Within the antecubital fossa, the brachial artery is commonly found beneath the median basilic vein, usually the most prominent vein in the antecubital fossa. The location of these arteries has great clinical significance. There it forms the deep palmar arch, which is completed by a small branch from the ulnar artery, the deep palmar branch.įigure 23-2 Relative location of major arteries in upper arm. The radial artery crosses the bottom of the so-called snuffbox (the hollow at the base of the thumb), reaching the dorsum of the hand and then entering the palm. The ulnar artery forms the superficial palmar arch, which travels to the level of the web of the thumb, where it is completed by a small branch arising from the radial artery, the superficial palmar branch. ![]() ![]() Approximately 1 inch below the antecubital fossa, the brachial artery bifurcates into the radial and ulnar arteries ( Figure 23-2), which travel distally in the forearm and terminate in the palm as an arterial arch. The axillary artery leaves the axilla at the lower border of the teres major muscle to enter the arm or brachium as the brachial artery. At this point, it is termed the axillary artery. 2Īt the outer border of the first rib, the subclavian artery turns laterally to enter into the axilla. From this point onward, the arteries of the two sides are symmetric. On the left side, the subclavian artery is a direct branch of the arch of the aorta. The usual preference is the arm, with the leg used when arm veins are inadequate or in emergency situations in which the arm may be unavailable or unsuitable for use.īlood to the right upper limb leaves the aortic arch through the short, wide brachiocephalic (innominate) trunk, which divides into the right common carotid and right subclavian arteries, the latter delivering arterial blood to the upper limb. In practice, however, elective venipuncture is usually confined to one of the patient’s extremities. Figure 23-1 illustrates the major superficial veins in the human body. In theory, venipuncture may be attempted in any superficial vein of a size sufficient to accommodate the needle. Once learned, knowledge of the technique remains with the dentist forever yet because it is an acquired skill, if not used regularly, the level of the dentist’s ability will diminish. 1 However, proficiency requires practice. Indeed, Malamed demonstrated that the initial attempt at venipuncture by untrained dental students had a greater than 90% success rate. Venipuncture is not a difficult technique to learn. All health care professionals should become proficient with this route of drug administration whether IV sedation is practiced or not because the ability to establish an IV line may prove to be important in emergency situations. Venipuncture is a technique separate and distinct from intravenous (IV) sedation. ![]()
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