Upper Limb: Blood supply and Lymphatics

Question 1

Describe where the subclavian artery starts and ends and the two important branches.

Answer 1

Starts - Brachiocephalic trunk (right artery) and aortic arch (left artery)
- Ends at the lateral border of the 1st rib
Two branches - Dorsal scapular and suprascapula

Question 2

Describe where the axillary artery starts, crosses, ends and the the number of branches

Answer 2

Starts at the lateral border of the first rib, crosses poteriorly to pectoralis minor and ends at the lower border of teres major.
It branches into 3, 
1st before pec. minor
2nd behind pec. minor
3rd after pec. minor

Question 3

Name the branches of the branches from the axillary artery

Answer 3

Branch one had 1 branch; Superior thoracic artery
Branch 2 has 2 branches; Thoraco-acromial artery and the Lateral thoracic artery
Branch 3 has 3 branches; Subscapular artery, the anterior circumflex humeral artery and the posterior circumflex humeral artery

Question 4

what arteries are the scapular anastamosis derived from?

Answer 4

Suprascapular artery, Dorsal scapular artery and the circumflex scapular.

Question 5

Describe where the brachial artery starts, ends and its three branches

Answer 5

Starts - Lower boarder of teres major
Ends - Elbow, where it bifurcates
Branches; Profunda Brachii, superior ulnar collateral and inferior collateral arteries which anatamose around the elbow.

Question 6

Where does the common interosseous artery arise from and what does it give rise too?

Answer 6

Origin - Ulnar artery

Gives rise to - Anterior and posterior interosseous arteries which run either side of the membrane

Question 7

How do the radial and unlar arteries pass through the wrist

Answer 7

radial - passes posteriorly to the carpal bones

Ulnar - passes anterior to the flexor Retinaculum

Question 8

What is allen’s test?

Answer 8

Used to asses the arterial blood supply to the hand. Involves pressing on both ulnar and radial artery and releasing one at a time

Question 9

The posterior interosseous artery supplies what anatamosis?

Answer 9

Dorsal carpal arch, which is also supplied by the radius

Question 10

The anterior interosseous artery supplies what anatamosis?

Answer 10

The palmar carpal arch which is also supplied by the ulnar artery

Question 11

What is important to consider with scaphoid fractures?

Answer 11

They may compromise the blood supply causing avascular necrosis

Question 12

Explain what happens when the ulnar artery enters the hand

Answer 12

It gives off a deep branch and a superficial branch which creates a superficial palmar arch which also gets a small supply from a branch of the radial artery.

Question 13

What does the superficial palmar arch give off and what comes off these branches?

Answer 13

It gives off 3 common palmar digital arteries. Each of these give off two proper palmar digital arteries and one of these travels up the side of each finger.

Question 14

The radius gives off two arteries that travel along the thumb and index finger, what are they?

Answer 14

Radialis indicis artery - Index finger

Princeps pollicis artery - thumb

Question 15

The deep radial artery anatamosis to form what?

Answer 15

It forms the deep palmar arch along with the deep ulnar artery

Question 16

Where is the dorsal venus network located and what does it give rise too?

Answer 16

It is located on the back of the hand and gives rise to the basilic (medial) and cephalic (lateral) vein.

Question 17

What vein connects the basilic and cephalic vein?

Answer 17

The median cubital vein

Question 18

What happens to the basilic vein as it travels up the lumb?

Answer 18

It enters deep fascia where it’ll join the venae comitantes of the brachial artery and will then join the axillary vein at the lower boarder of teres major

Question 19

Name the 5 main lymph nodes of the upper limb

Answer 19

Humeral nodes(lateral), Pectoral nodes (anterior), Subscapular (posterior) which all drain to the central nodes and eventually then onto the apical nodes

Question 20

Where do superficial and deep lymphatic vessels (LV) drain too?

Answer 20

The superficial LV running along the basilic vein will drain to the lateral/humeral nodes. LV running along the cephalic vein will drain to the apical nodes. And the LV running along deep veins will also drain to the lateral/humeral nodes