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Other Terms: Innominate vein, Brachiocephalic venous tree, Vena brachiocephalica, Veines brachiocéphaliques
The brachiocephalic veins, right and left, are formed by the union of the subclavian and internal jugular veins of the corresponding side at the level of the sternoclavicular joint. They merge to form the superior vena cava, and are the major vessels bringing blood to the vena cava. They have no valves.
The left brachiocephalic vein, is longer and larger than the right, being about 7 1/2 centimeters (3 inches) in length, and passes from left to right behind the sternal end of the left clavicle, the manubrium, the sterno-hyoid and sterno-thyroid muscles, the remains of the thymus gland, and the process of the deep cervical fascia continuous with the pericardium. It crosses the left subclavian and left common carotid arteries, the trachea, and the brachiocephalic artery, as well as the left vagus, left phrenic, and cardiac nerves to unite with the right brachiocephalic and form the superior vena cava. It is posterior to the thymus, sternothyroid and sternohyoid muscles and the manubrium; anterior to the left common carotid and brachiocephalic arteries, trachea and pretracheal fascia which is behind and between the arteries; and superior to the aortic arch.
The right brachiocephalic vein is the shorter and smaller, being about 3 3/4 centimeters (1 1/2 inches) in length; it commences behind the medial end of the clavicle and descends vertically to unite with the left brachiocephalic vein behind the junction of the first right costal cartilage with the sternum, to form the superior vena cava. To the lateral side are the pleura and lungs, and the right phrenic nerve; to its medial side, and on a plane posterior to it, are the right subclavian and the brachiocephalic arteries, the right vagus nerve, and the trachea. In front of it are the remains of the thymus gland, the origin of the sternothyroid and the sternohyoid muscles, the sternal end of the clavicle, and the first costal cartilages. Behind it are the pleura and lungs in a groove of which it lies, so that these structures are slightly posterior as well as lateral and anterior, and overlap its termination.