Cephalic Vein at Shoulder

vena cephalica (pars humeralis)

The cephalic vein ascends in the deltopectoral groove between the deltoid and pectoralis major to pierce the clavipectoral fascia at the deltopectoral triangle (Mohrenheim's fossa) and drain into the axillary vein. At shoulder level it is the primary venous landmark of the anterior shoulder approach.

Region: Shoulder

Clinical Relevance

Clinical Notes

The cephalic vein in the deltopectoral groove is the key landmark of the deltopectoral approach to the shoulder, where it is retracted medially (with pectoralis major) to protect it while exposing the shoulder. Its sacrifice simplifies the approach but risks upper limb venous congestion in the short term. In total shoulder arthroplasty and ORIF of proximal humeral fractures, cephalic vein preservation is standard practice. It is the vessel of choice for cardiac pacemaker lead insertion via the cephalic vein cutdown approach.

Pathology

Common Injuries & Conditions

Cephalic Vein Injury in Deltopectoral Approach

Inadvertent division or avulsion of the cephalic vein in the deltopectoral groove during shoulder surgery, producing anterior shoulder bleeding and potentially compromising upper limb venous drainage.