Ultrasound anatomical study of the median nerve and the brachial vessels during routine drawing blood and intravenous injection in the cubital fossa

DOI
  • Terajima Miho
    Ex. Health Innovation of Nursing, Faculty of Medicine, University of Tsukuba
  • Gomi Toshiaki
    Tokyo Ariake University of Medical and Health Science, Faculty of Nursing, Department of Nursing
  • Jean-Pierre Timmermans
    Laboratory of Histology and Cell Biology, Department of Biomedical Sciences, University of Antwerp
  • Naruse Hideo
    Tokyo Ariake University of Medical and Health Science, Faculty of Health Sciences, Department of Judo-seifuku therapy
  • Hirata Miwa
    Tokyo Healthcare University, Chiba Faculty of Nursing, Division of Nursing
  • Koyama Koji
    Tokyo Ariake University of Medical and Health Science, Faculty of Health Sciences, Department of Judo-seifuku therapy
  • Tejima Ryota
    Tokyo Ariake University of Medical and Health Science, Faculty of Health Sciences, Department of Judo-seifuku therapy
  • Kunisawa Naoko
    Saitama Prefectural University School of Health and Social Welfare, Department of Nursing
  • Nishihara Ken
    Saitama Prefectural University School of Health and Social Welfare, Department of Physical therapy
  • Sasaki Seizo
    Clinic attached to the Oriental Medicine Research Institute Foundation
  • Kimura Akihiko
    Ex. Tokyo Ariake University of Medical and Health Science, Faculty of Health Sciences, Department of Judo-seifuku therapy
  • Hayashi Hiroyuki
    Ex. Saitama Prefectural University School of Health and Social Welfare, Center for University-Wide Education

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Other Title
  • 肘窩での日常的な採血および静脈注射に関する正中神経と上腕動静脈の超音波解剖学的研究

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Abstract

<p>  Drawing blood and intravenous injection are often performed at the cubital fossa. However, nerve and arterial damage occurs frequently during these interventions due to ambiguity in anatomical descriptions of nerves and blood vessels near the cubital fossa. Using an ultrasound diagnostic device, we examined the distances of the median nerve（N）, brachial artery（A）and brachial veins（V）from the midpoint of Hüter’s line on the ulnar side of the cubital fossa and the depth from that point in 428 adults（129 men and 299 women） to elucidate the region in which venipuncture would be safe. </p><p>  Distance analysis showed that N, A and V were significantly longer in men than in women. Of these three distances, N was longest in 76.6% of all participants, while A was in 3.2%, and V was in 20.1%. There was no significant difference between men and women in depth. Of the three depths for N, A, and V, N was deepest in 75.9% of all participants, while A was 10.3%, and V was 13.8%. </p><p>  This study clarified the positional relations of the median nerve and brachial vessels. The results may prove useful for healthcare workers when drawing blood or performing an intravenous injection.</p>

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