Flashcards in Arterial Supply of Upper Limb_MSB Deck (135):
Name the components that are the part of the arterial system of upper limb
6) Palmar Arches
7) Dorsal and Palmar Digital Arteries
Where does the arterial supply to the upper limb begin with?
With the subclavian artery
Where does the right subclavian artery come from?
From the brachiocephalic trunk
Where does the left subclavian artery come from?
Directly from the arch of aorta
Where does the subclavian arteries cross? What does it become?
Cross the lateral border of the 1st rib to become axillary arteries
What does the arterial system connect to? What does it form?
Subclavian and axillary arteries
Forming circulatory anastomosis around scapula
Name the arteries found in the posterior scapular regions
1) Suprascapular Artery
2) Circumflex Scapular Artery
3) Thoracordorsal Artery
4) Dorsal Scapular Artery
What do the arteries in the posterior scapular region contribute to?
To an interconnected vascular network around the scapula
Where does the Suprascapular Artery originate in?
Originates in the base of the neck
Where can the the Suprascapular artery arise from?
1) Directly from subclavian artery
2) Indirectly via Thyrocervical Trunk
Where does the Suprascapular Artery enter?
1) Enters the posterior scapular region superior to the Suprascapular notch
2) Enters supraspinous fossa running between scapula and supraspinous muscle
Where does the Suprascapular nerve run through?
Runs through the Suprascapular notch
Where does the Suprascapular artery descend to?
Descends to reach infraspinous fossa
When the Suprascapular artery descend to reach infraspinous fossa, what does it supply?
Supplies 1) supraspinatus and 2) infraspinatus muscle
Where does the Suprascapular Artery send articular branches to?
Sends articular branches to AC and shoulder joints
What is the Circumflex Scapular Artery?
Branch of the subscapular artery
Where does the subscapular artery originate from?
From 3rd part of the axillary artery
Where does the Circumflex Scapular Artery enter?
Enters the posterior scapular region
When the Circumflex Scapular Artery enters the posterior scapular region, where does it pass through
Passing through the origin of the theres minor muscle
What does the Circumflex Scapular Artery form?
Forms anastomotic connections with other arteries in the region
What is anastomosis?
anastomosis is a surgical connection between two structures
What is the Thoracodorsal Artery?
Branch of the subscapular artery
What does the Thoracodorsal Artery do?
Continues the course of the Subscapular artery
Where does the Thoracodorsal artery descend to and with?
Descends with thoracordorsal nerve to the Latissimus Dorsi muscle
What is the Dorsal Scapular Artery?
Branch of the Subclavian artery
Where does the Dorsal Scapular Artery enter?
Enters the posterior scapular region
Where does the Dorsal Scapular pass through when it enters the posterior scapular region? Where does it reach?
Passing through trunks of brachial plexus, deep to leaver scapula to reach superior scapular angle
Where does the Dorsal Scapular Artery descend under?
Descends under rhomboids along medial border of scapular to inferior angle of scapula
What does the Dorsal Scapular Artery do?
2) Latissimus Dorsi
What is the Axillary Artery?
Subclavian artery in the neck continues as Axillary Artery
What does the Axillary Artery do?
Supplies walls of the axilla and related regions
Where does the Axillary Artery start at?
At lateral border of first rib
Where does the Axillary Artery pass through?
Passes through Axilla
Where does the Axillary Artery end at? What does it become?
Ends at lateral border of Teres Major
- Becomes Brachial Artery when it comes to the arm
How many parts is the Axillary Artery divided into by Pectoralis Minor?
Why is Axillary Artery divided into 3 parts?
Axillary artery passes posterior to pectoralis minor muscle therefore is divided by it
Where is the first part of the Axillary Artery?
1) Proximal to Pectoralis Minor
2) Lateral margin of 1st rib to upper border of Pectoralis Minor
Where is the second part of the Axillary Artery?
1) Posterior to Pectoralis Minor
Where is the third part of the Axillary Artery?
1) Distal to Pectoralis Minor
2) Lower border of Pectoralis Minor to termination at Teres Major
[Until it gets to the brachial artery of the arm]
How many branches arise from the axillary artery?
Generally, six branches.
1 from 1, 2 from 2, 3 from r3
How many branches arise from the first part of the Axillary Artery?
What is the branch that arise from the first part of the Axillary Artery?
Superior Thoracic Artery
How many branches arise from the second part of the Axillary Artery?
What are the branches that arise from the second part of the Axillary Artery?
1) Thoracoacromial Artery
2) Lateral Thoracic Artery
How many branches arise from the third part of the Axillary Artery?
What are the branches that arise from the third part of the Axillary Artery?
1) Subscapular artery
2) Anterior circumflex humeral artery
3) Posterior circumflex humeral artery
Name the Axillary artery branches from proximal to distal.
"Send The Lord To Say A Prayer"
1) Superior thoracic
3) Lateral Thoracic
5) Anterior circumflex humeral
6) Posterior circumflex humeral
Name the Thoracoacromial artery branches
2) Breast (pectoral)
What is the length of the Superior Thoracic Artery
Where does the Superior Thoracic Artery originate from
From anterior surface of the 1st part of the axillary artery
What does the Superior Thoracic artery supply
1) Upper regions of the medial and axillary walls
2) Pectoral Muscles
3) Thoracic Walls
What is the length of the Thoracacromial artery
Quite short artery
Where does the Thoracacromial Artery originate from?
From the anterior surface of 2nd part of the axillary artery just posterior to the medial margin of the pectoralis minor muscle
Where does the Thoracacromial Artery curve around?
Around the muscle
Where does the Thoracacromial Artery penetrate?
The clavipectoral fascia
Where does the Lateral Thoracic Artery originate from?
From the anterior surface of 2nd part of the axillary artery posterior to the lateral margin of the pectoralis minor
What does the Lateral Thoracic Artery follow?
the margin of the muscle to the thoracic wall
What does the Lateral Thoracic Artery supply
1) Medial and anterior walls of the axilla
2) Pectoral muscle
3) Serratus Anterior muscle
In women, what else does the Lateral Thoracic Artery contribute to?
To the vascular supply of the breast
What is the Subscapular Artery?
1) Largest branch of the axillary artery
2) Major blood supply to the posterior wall of the axilla
What does the Subscapular Artery contribute to?
To the blood supply of the posterior scapular region
What does the Subscapular Artery follow?
Follows the inferior margin of the subscapularis muscle and divides into 2 terminal branches (circumflex scapular artery ; thoracodorsal artery)
What does the Anterior Circumflex Humeral Artery supply branches to?
1) glenohumeral joint
2) Head of humerus
Where does the Anterior Circumflex Humeral Artery pass?
The anterior circumflex humeral artery passes anterior to the surgical neck of the humerus and anastomoses with the posterior circumflex humeral artery.
Where does the Posterior Circumflex Humeral Artery leave from and pass through?
With the axillary nerve, it leaves the axilla by passing through the quadrangular space
What is the quadrangular space?
Between teres major & minor, long head of the triceps brachii muscle & surgical neck of the humerus.
Where does the Posterior Circumflex Humeral Artery curve around?
Around the surgical neck of the humerus
Where does the Posterior Circumflex Humeral Artery supply?
Supplies surrounding muscles and glenohumeral joint
What does the Axillary artery become and at where?
Become the Brachial Artery
At the lateral border of Teres Major
What is the Brachial Artery?
Main source of blood for the arm
Where is the Brachial Artery found?
In the anterior compartment
Where does the Brachial artery begins as and where at?
Begins as continuation of Axillary artery at the lateral border of Teres Major
Where does the Brachial artery terminate
Terminates just distal to the elbow joint
What happens after Brachial artery terminates
Bifurcates into radial & ulnar arteries
What does the Brachial artery do within the arm
Gives off several branches:
1) 2 ulnar collateral vessels
2) The profunda brachii artery
3) Nutrient arteries to the humerus
What does the 2 ulnar collateral vessel contribute to?
To network of arteries around the elbow joint
Where does the brachial artery descend in?
In the arm posterior to the median nerve
In the proximal arm, where does the brachial artery lie?
lies on the medial side
In the distal arm, where does the brachial artery move?
moves laterally midway between lateral epicondyle & medial epicondyle of the humerus
Where does the brachial artery cross?
Crosses anterior to elbow joint
How does the brachial artery bifurcates into the radial and ulnar arteries?
As it crosses the cubital fossa underneath brachialis
What does the brachial artery give rise to?
To the profounda brachii
What is the profunda brachii?
- Deep artery of the arm
- largest branch of the brachial artery
What does the profunda brachii do?
Supplies structures in the posterior arm
Where is the profound brachii found?
Posterior surface of the humerus in the radial groove
Where does the Profunda Brachii terminate?
Terminates at elbow joint
What are the two arterial supply for the forearm
1) Radial artery
2) ulnar artery
What does the radial artery supply?
Supplies the posterior aspect of the forearm
What does the ulnar artery supply?
Supplies the anterior aspect of the forearm
Where does the radial artery originate from?
From brachial artery at the neck of the radius
Where does the radial artery pass along?
Passes along the lateral aspect of the forearm
In the distal forearm, how can the radial artery be located?
Using the flexor carpi radialis muscle as a landmark.
How do you use the flexor carpi radialis muscle as a landmark?
The radial pulse can be felt by gently palpating the radial artery against the underlying muscle and bone.
Where does the radial artery leave?
Where does the radial artery pass around?
Passes around the lateral side of the wrist
What does the radial artery penetrate?
Penetrates the posterolateral aspect of the hand between the bases of metacarpals I & II
What does branches of the radial artery in the hand provide?
Provide the major blood supply to the thumb and lateral side of the index finger
What are the other branches of the radial artery originating in the forearm include?
1) Radial recurrent artery
2) A small palmar carpal branch
3) A larger superficial palmar branch
What does the radial recurrent artery of the radial artery contribute to?
To an anastomotic network around the elbow
What does the small palmar carpal branch of the radial artery contribute to?
To an anastomotic network of vessels that supply the carpal bones and joints
Where and how does the larger superficial palmar branch enter the hand?
By passing through the thenar muscle at the base of the thumb
Which is larger: Ulnar artery or Radial artery?
Ulnar artery larger than radial artery
Where does the ulnar artery pass down?
Passes down the medial side of the forearm
Where does the ulnar artery pass through?
Passes through the forearm in the fascial plane between the flexor carpi ulnaris and flexor digitorum proudness muscles
How does the ulnar artery enter the hand?
By passing lateral to the pisiform bone and superficial to the flexor retinaculum of wrist
What is the ulnar artery used for?
Major blood supply to the medial 3 1/2 digits (half of index, middle, ring and little digits)
Name the branches of the ulnar artery that arise in the forearm?
1) Ulnar recurrent artery
2) Numerous Muscular arteries
3) Common interosseous artery
4) 2 small Carpal arteries
What is the Ulnar recurrent artery with? What does it contribute to?
Ulnar recurrent artery with anterior and posterior branches, which contribute to an anastomotic network of vessels around the elbow joint
What does the muscular arteries supply to?
Supply surrounding muscles
What does the Common Interosseous artery divide into?
Into anterior and posterior interosseous arteries
What are the 2 small carpal arteries?
1) Dorsal carpal branch
2) Palmar carpal branch
What does the 2 small carpal arteries do?
Supply the wrist
Where does the blood supply to the posterior compartment of the forearm occur?
Occurs predominantly through branches of the radial, posterior interosseous and anterior interosseous arteries
What do the radial and ulnar arteries form?
Form two interconnected vascular arches
What are the two interconnected vascular arches the radial and ulnar arteries form?
1) Superficial Palmar Arch
2) Deep Palmar Arch
Vessels to the digits, muscle and joints originate from where?
From the two arches and the parent arteries
Where does the radial artery supply in the palmar hand?
Thumb and lateral side of the index finger
Where does the ulnar artery supply in the palmar hand?
Medial side of the index finger and remaining digits
What is the Arterial supply dorsal of hand?
Dorsal Carpal Arch which contains the radial artery and is anastomosis with the ulnar artery to form the dorsal carpal branch
Name the pulse points
1) Axillary pulse
2) Brachial pulse in mid arm
3) Brachial pulse in the cubital fossa
4) Radial pulse in distal forearm
5) Ulnar pulse in distal forearm
6) Radial pulse in the anatomical snuffbox
What is the Allens test?
Tests adequate anastomoses between the radial and ulnar artery
- test if there is occlusion of arteries
How is the Allens test conducted?
1) Compress both radial and ulnar arteries at the wrist
2) Patient asked to open and close hand into fist while arteries are compressed. Hand appears blanched/pallor
3) release pressure from each artery in turn and determine the filling pattern of the hand (observe for change in colour)
4) Coloration returns within few seconds if ulnar and radial arteries are patent
What is the disease if there is arterial insufficiency?
- hand remains white
What does the anatomical snuffbox contain?
Contains Radial artery
Where does the radial artery cross in the anatomical snuffbox?
Crosses the floor obliquely running deep to the extensor tendons
How is the radial pulse palpated by some individual at the anatomical snuffbox?
By placing two fingers on the proximal portion of the snuffbox
What is an aneurysm?
Dilation of a blood vessel to more than twice its original size
What happens during an axillary artery aneurysm?
The dilated portion of the axillary artery can compress the brachial plexus producing neurological symptoms such as paresthesia and muscle weakness
What is the treatment for an axillary artery aneurysm?
Surgery required to remove the aneurysm and reconstruct the vessel wall
What happens if the brachial artery is completely blocked or severed?
- medial emergency
- resulting ischaemia of the forearm can cause necrosis
What would happen following the brachial artery is completely blocked or severed?
- Paralysis of the muscles in the forearm - affected muscles are replaced by scar tissue and shorten considerably.
What does the occlusion or laceration of brachial artery cause?
- Cause a characteristic flexion deformity called Volkmann's ischaemic contracture
What does the ulnar artery define?
The carpel tunnel area
What are the special branches of the radial artery and where does it go?
1) Princeps Pollicis - goes into thumb
2) Radialis indicis - goes into half of index)