Question

Because of scarring of a patient's median cubital vein, the technician chooses to insert an infusion needle into her basilic vein at the level of the medial epicondyle. Despite the certainty that the needle does not pass through the deep (investing) fascia, there is still a chance that it might nick or impale which of the following?

A. Brachial artery
B. Lateral antebrachial cutaneous nerve
C. Medial antebrachial cutaneous nerve
D. Median nerve
E. Radial nerve

Answer 1

Despite not passing through the deep fascia, if the technician inserts an infusion needle into the basilic vein at the medial epicondyle, there's a risk of impaling the median nerve, since it runs close to this vein.

Step-by-step explanation:

If a technician inserts an infusion needle into the basilic vein at the level of the medial epicondyle, and is careful not to pass through the deep fascia, there is still a possibility that the needle might come into contact with certain structures in the vicinity. Since the basilic vein runs medially along the arm, the structures closest to it that could be affected if the needle penetrates too deeply or deviates include nerves and vessels that are also found medially in the arm. Given the location specified - near the medial epicondyle - the structure with the greatest likelihood of being nicked or impaled would be the median nerve, as it runs along a path that is fairly close to the basilic vein and medial epicondyle. However, the other options listed such as the lateral antebrachial cutaneous nerve, medial antebrachial cutaneous nerve, and radial nerve are located more laterally and are therefore less at risk in this scenario. The brachial artery is also in close proximity but it is relatively deep, shielded by the fascia that has not been penetrated.