examine the deep veins from the neck and brachiocephalic vein to the hand.
patient supine on bed, arms by their side. scan in transverse at the antero-lateral base of the neck. using colour doppler, find the jugular vein and follow inferiorly to the junction with the subclavian vein. follow the subclavian vein laterally using colour doppler in both longitudinal & transverse planes to exclude non occlusive filling defects.
patient still supine on bed with ipsilateral hand on their head, elbow flexed laterally to permit easy access to the axilla. find the distal subclavian artery and follow through the axilla with colour doppler and compressing using b-mode in the transverse plane
as you reach the proximal arm, the axillary vein will divide into the basilic and brachial veins.
upper arm veins (brachial & basilic)
the basilic vein is the larger and is more superficial. usually single but may be duplicated. continue from the axillary vein checking in transverse that the basilic and brachial veins of the upper arm are compressible.
this may be best achieved with the patient sitting on the side of the bed with their arm supinated.
at the antecubital fossa, the brachial vein will divide into the radial & ulnar veins.
forearm veins (radial & ulna)
still with the patient seated on the side of the bed, follow the radial and ulnar veins to the wrist confirming compressibility and flow.
as with the veins in the calf, the veins of the forearm genarally run in pairs (venous commantantes).