Ann Rehabil Med.  2014 Feb;38(1):52-56. 10.5535/arm.2014.38.1.52.

Ultrasonographic Findings of Superficial Radial Nerve and Cephalic Vein

• Kim KH
• Byun EJ
• Oh EH

• KMID: 2266540
• DOI: http://doi.org/10.5535/arm.2014.38.1.52

Abstract

OBJECTIVE
To investigate the anatomic relationship between the superficial radial nerve (SRN) and the cephalic vein (CV) through ultrasonography due to the possibility of SRN injury during cephalic venipuncture.
METHODS
Both forearms of 51 healthy volunteers with no history of trauma or surgery were examined in proximal to distal direction using ultrasonography. We measured the distance between the radial styloid process (RSP) and the point where the SRN begins contact with the CV, and measured the distance between the RSP and the point where the SRN is separated from the CV. The point where the SRN penetrates the brachioradialis fascia was also evaluated.
RESULTS
The SRN came in contact with the CV at a mean of 9.35+/-1.05 cm from the RSP and separated from the CV at a mean of 6.29+/-1.17 cm from the RSP. The SRN pierced the brachioradialis fascia at a mean of 10.31+/-0.89 cm from the RSP and horizontally 1.35+/-0.36 cm medial to the radius margin. All parameters had no significant differences in gender or direction.
CONCLUSION
The SRN had close approximation to the CV in the distal second quarter of the forearm. We recommend for cephalic venipuncture to be avoided in this area, and, if needed, it should be carried out with care not to cause injury to the SRN.

Keyword

Radial nerve; Forearm; Ultrasonography

MeSH Terms

Fascia
Forearm
Healthy Volunteers
Phlebotomy
Radial Nerve*
Radius
Ultrasonography
Veins*

Figure

• 

  Fig. 1 Distribution of superficial radial nerve (A) and cephalic vein (B) in the forearm. A, point at which the superficial radial nerve pierced brachioradialis fascia; B, contact point of superficial radial nerve with cephalic vein; C, separating point of superficial radial nerve with cephalic vein; BR, brachioradialis; LACN, lateral antebrachial cutaneous nerve; SRN, superficial radial nerve; EPB, extensor pollicis brevis; APL, abductor pollicis longus; ECRB, extensor carpi radialis brevis; ECRL, extensor carpi radialis longus; FCR, flexor carpi radialis.

• 

  Fig. 2 Ultrasonographic images of the forearm where (A) the superficial radial nerve (arrow) begins to contact the cephalic vein and (B) the superficial radial nerve is separated from the cephalic vein. V, cephalic vein; R, radius.

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