Upper extremities anatomy

A thorough understanding of the venous anatomic structures of the head, neck, and upper extremities are imperative for safe venous access (Fig. 4.2) (41). The precise location and orientation of the internal jugular, innominate, subclavian, and cephalic veins are important for safe venous access (42). Their anatomic relation to other structures is crucial in avoiding complications. The venous anatomy of interest from a cardiac pacing and ICD point of view starts peripherally with the axillary vein (43). 

The fact that the muscles, especially in the upper and lower extremities are in close proximity to each other, and there is more than one nerve supplying the muscles in the limbs, makes this goal extremely important. The proper technique for each muscle was obtained after many anatomical dissections. These dissections were performed at the Anatomy Laboratory of the Albert Einstein Collage of Medicine (A.E.C.O.M.) and were shared wit the residents of the Department of Rehabilitation Medicine and the Electrodiagnostic Laboratory at Jacobi Hospital and at the Albert Einstein Hospital. We arrived at the conclusion that these techniques were very useful. 

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