A middle-aged man with a history of chronic duodenal ulcer was seen in the emergency department in a state of severe shock. He was pale, restless, and sweating, and his blood pressure was $80 / 60 \mathrm{~mm} \mathrm{Hg}$. The resident made a diagnosis of internal hemorrhage, probably due to the erosion of the gastroduodenal artery or one of its branches, and decided to set up a blood transfusion immediately. Based on your knowledge of anatomy, into which superficial vein of the upper limb would you perform the transfusion: in the elbow region or in the forearm? If the veins were too collapsed to be identified, where, in an emergency, could you cut down on a superficial vein in the upper limb?

Question

Quizplus · Accepted Answer

The Answer is The cephalic, basilic, and median cubital veins, and their tributaries, are located in front of the cubital fossa and may be used for transfusion (see text Fig. 7-19). In the forearm, the cephalic and basilic veins can be seen as they wind around the lateral and medial borders of the forearm, respectively. The cephalic vein lies in a constant position behind the styloid process of the radius (see text Fig. 7-18), and it is here that it may be exposed through a small skin incision.

A Middle-Aged Man with a History of Chronic Duodenal Ulcer 80/60 mmHg80 / 60 \mathrm{~mm} \mathrm{Hg}80/60 mmHg

A Middle-Aged Man with a History of Chronic Duodenal Ulcer $80 / 60 \mathrm{~mm} \mathrm{Hg}$