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What are 9 arterial flow to the arm?
- brachiocephalic trunk
- brachial (1 in. below antecubital fossa)
Where is the brachial artery and what does this mean?
- Just beneath the median basilic vein in antecubital fossa. (medial to midline).
- Medial antecubital fossa =last choice.
Which veins do we want to aim for?
a. Deep veins
b. Superficial veins
b. Superficial veins
List veins from dorsal/palmar digital veins to axillary veins.
- Dorsal/palmar digital v.
- intercapitular v.
- dorsal venous network (back of hand)
- 1. cephalic v.(radial side)
- 2. basilic v.(ulnar side)
- axillary v.
Which veins can be visible from the antecubital fossa (l-->m)
- cephalic v.
- median cephalic v.
- median v.
- median basilic v.
- basilic v.
2 advantages of placeing IV in dorsom of hand.
- 1. rare to find arteries here
- 2. superficial with easy access
4 disadvantages to placing IV in dorsum of hand.
- 1. veins smaller in size
- 2. veins tend to be mobile
- 3. phlebitis more common
- 4. more painful
5 recommended sites for venipuncture.
- 1.Dorsum of hand
- 2. Lateral antecubital fossa
- 3. Ventral forearm
- 4. Dorsal wrist
- 5. Medial antecubital fossa
How do you select a venipuncture site?
- 1. Select one that is straight/visible/unused.
- 2. Use larger veins for irritating drugs (valium).
- 3. If long period of time NOT in joint area
- 4. Infant/children/obese are challenging
3 Advantages of antecubital fossa?
- 1. Veins larger than other parts of arm
- 2. Veins not as mobile
- 3. Lateral aspect is anatomically safe
3 disadvantages of antecubital fossa.
- 1. v. may not be as superficial
- 2. Medial aspect has avoidable anatomy
- 3. must immobilize if left in place
what 5 avoidable anat in medial side?
- 1. Central biceps tendon
- 2. bipipital aponerosis
- 3. median cutaneous nerve
- 4.median nerve
- 5. brachial artery
Adv and disadv of forearm.
- larger than wrist and hand
- less mobile
- no nerves close to venipuncture site
- veins may not be as superficial
- 1. basilic and cephalic vein accessible
- 2. median vein runs midline of ventral arm
- 1. Ventral NOT GOOD PLACE - small/mobile
- 2. Radial wrist--> "intern's vein"
- 3. dorsal/ulnar wrist-->superficial but mobile
- immobilize if long time