Arterial Supply of Upper Limb_MSB Flashcards Preview

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1

Name the components that are the part of the arterial system of upper limb

1) Subclavian
2) Axillary
3) Brachial
4) Ulnar
5) Radial
6) Palmar Arches
7) Dorsal and Palmar Digital Arteries

2

Where does the arterial supply to the upper limb begin with?

With the subclavian artery

3

Where does the right subclavian artery come from?

From the brachiocephalic trunk

4

Where does the left subclavian artery come from?

Directly from the arch of aorta

5

Where does the subclavian arteries cross? What does it become?

Cross the lateral border of the 1st rib to become axillary arteries

6

What does the arterial system connect to? What does it form?

Subclavian and axillary arteries
Forming circulatory anastomosis around scapula

7

Name the arteries found in the posterior scapular regions

1) Suprascapular Artery
2) Circumflex Scapular Artery
3) Thoracordorsal Artery
4) Dorsal Scapular Artery

8

What do the arteries in the posterior scapular region contribute to?

To an interconnected vascular network around the scapula

9

Where does the Suprascapular Artery originate in?

Originates in the base of the neck

10

Where can the the Suprascapular artery arise from?

1) Directly from subclavian artery
OR
2) Indirectly via Thyrocervical Trunk

11

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

12

Where does the Suprascapular nerve run through?

Runs through the Suprascapular notch

13

Where does the Suprascapular artery descend to?

Descends to reach infraspinous fossa

14

When the Suprascapular artery descend to reach infraspinous fossa, what does it supply?

Supplies 1) supraspinatus and 2) infraspinatus muscle

15

Where does the Suprascapular Artery send articular branches to?

Sends articular branches to AC and shoulder joints

16

What is the Circumflex Scapular Artery?

Branch of the subscapular artery

17

Where does the subscapular artery originate from?

From 3rd part of the axillary artery

18

Where does the Circumflex Scapular Artery enter?

Enters the posterior scapular region

19

When the Circumflex Scapular Artery enters the posterior scapular region, where does it pass through

Passing through the origin of the theres minor muscle

20

What does the Circumflex Scapular Artery form?

Forms anastomotic connections with other arteries in the region

21

What is anastomosis?

anastomosis is a surgical connection between two structures

22

What is the Thoracodorsal Artery?

Branch of the subscapular artery

23

What does the Thoracodorsal Artery do?

Continues the course of the Subscapular artery

24

Where does the Thoracodorsal artery descend to and with?

Descends with thoracordorsal nerve to the Latissimus Dorsi muscle

25

What is the Dorsal Scapular Artery?

Branch of the Subclavian artery

26

Where does the Dorsal Scapular Artery enter?

Enters the posterior scapular region

27

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

28

Where does the Dorsal Scapular Artery descend under?

Descends under rhomboids along medial border of scapular to inferior angle of scapula

29

What does the Dorsal Scapular Artery do?

Supplies:
1) Rhomboids
2) Latissimus Dorsi
3) Trapezius

30

What is the Axillary Artery?

Subclavian artery in the neck continues as Axillary Artery

31

What does the Axillary Artery do?

Supplies walls of the axilla and related regions

32

Where does the Axillary Artery start at?

At lateral border of first rib

33

Where does the Axillary Artery pass through?

Passes through Axilla

34

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

35

How many parts is the Axillary Artery divided into by Pectoralis Minor?

3 parts

36

Why is Axillary Artery divided into 3 parts?

Axillary artery passes posterior to pectoralis minor muscle therefore is divided by it

37

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

38

Where is the second part of the Axillary Artery?

1) Posterior to Pectoralis Minor

39

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]

40

How many branches arise from the axillary artery?

Generally, six branches.
1 from 1, 2 from 2, 3 from r3

41

How many branches arise from the first part of the Axillary Artery?

1 branch

42

What is the branch that arise from the first part of the Axillary Artery?

Superior Thoracic Artery

43

How many branches arise from the second part of the Axillary Artery?

2 branches

44

What are the branches that arise from the second part of the Axillary Artery?

1) Thoracoacromial Artery
2) Lateral Thoracic Artery

45

How many branches arise from the third part of the Axillary Artery?

3 branches

46

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

47

Name the Axillary artery branches from proximal to distal.

"Send The Lord To Say A Prayer"
1) Superior thoracic
2) Thoracacromial
3) Lateral Thoracic
4) Subscapular
5) Anterior circumflex humeral
6) Posterior circumflex humeral

48

Name the Thoracoacromial artery branches

"ABCD"
1) Acromial
2) Breast (pectoral)
3) Clavicular
4) Deltoid

49

What is the length of the Superior Thoracic Artery

Quite small

50

Where does the Superior Thoracic Artery originate from

From anterior surface of the 1st part of the axillary artery

51

What does the Superior Thoracic artery supply

1) Upper regions of the medial and axillary walls
2) Pectoral Muscles
3) Thoracic Walls
4) Breast

52

What is the length of the Thoracacromial artery

Quite short artery

53

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

54

Where does the Thoracacromial Artery curve around?

Around the muscle

55

Where does the Thoracacromial Artery penetrate?

The clavipectoral fascia

56

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

57

What does the Lateral Thoracic Artery follow?

the margin of the muscle to the thoracic wall

58

What does the Lateral Thoracic Artery supply

1) Medial and anterior walls of the axilla
2) Pectoral muscle
3) Serratus Anterior muscle

59

In women, what else does the Lateral Thoracic Artery contribute to?

To the vascular supply of the breast

60

What is the Subscapular Artery?

1) Largest branch of the axillary artery
2) Major blood supply to the posterior wall of the axilla

61

What does the Subscapular Artery contribute to?

To the blood supply of the posterior scapular region

62

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)

63

What does the Anterior Circumflex Humeral Artery supply branches to?

To:
1) glenohumeral joint
2) Head of humerus

64

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.

65

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

66

What is the quadrangular space?

Between teres major & minor, long head of the triceps brachii muscle & surgical neck of the humerus.

67

Where does the Posterior Circumflex Humeral Artery curve around?

Around the surgical neck of the humerus

68

Where does the Posterior Circumflex Humeral Artery supply?

Supplies surrounding muscles and glenohumeral joint

69

What does the Axillary artery become and at where?

Become the Brachial Artery
At the lateral border of Teres Major

70

What is the Brachial Artery?

Main source of blood for the arm

71

Where is the Brachial Artery found?

In the anterior compartment

72

Where does the Brachial artery begins as and where at?

Begins as continuation of Axillary artery at the lateral border of Teres Major

73

Where does the Brachial artery terminate

Terminates just distal to the elbow joint

74

What happens after Brachial artery terminates

Bifurcates into radial & ulnar arteries

75

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

76

What does the 2 ulnar collateral vessel contribute to?

To network of arteries around the elbow joint

77

Where does the brachial artery descend in?

In the arm posterior to the median nerve

78

In the proximal arm, where does the brachial artery lie?

lies on the medial side

79

In the distal arm, where does the brachial artery move?

moves laterally midway between lateral epicondyle & medial epicondyle of the humerus

80

Where does the brachial artery cross?

Crosses anterior to elbow joint

81

How does the brachial artery bifurcates into the radial and ulnar arteries?

As it crosses the cubital fossa underneath brachialis

82

What does the brachial artery give rise to?

To the profounda brachii

83

What is the profunda brachii?

- Deep artery of the arm
- largest branch of the brachial artery

84

What does the profunda brachii do?

Supplies structures in the posterior arm

85

Where is the profound brachii found?

Posterior surface of the humerus in the radial groove

86

Where does the Profunda Brachii terminate?

Terminates at elbow joint

87

What are the two arterial supply for the forearm

1) Radial artery
2) ulnar artery

88

What does the radial artery supply?

Supplies the posterior aspect of the forearm

89

What does the ulnar artery supply?

Supplies the anterior aspect of the forearm

90

Where does the radial artery originate from?

From brachial artery at the neck of the radius

91

Where does the radial artery pass along?

Passes along the lateral aspect of the forearm

92

In the distal forearm, how can the radial artery be located?

Using the flexor carpi radialis muscle as a landmark.

93

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.

94

Where does the radial artery leave?

The forearm

95

Where does the radial artery pass around?

Passes around the lateral side of the wrist

96

What does the radial artery penetrate?

Penetrates the posterolateral aspect of the hand between the bases of metacarpals I & II

97

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

98

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

99

What does the radial recurrent artery of the radial artery contribute to?

To an anastomotic network around the elbow

100

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

101

Where and how does the larger superficial palmar branch enter the hand?

By passing through the thenar muscle at the base of the thumb

102

Which is larger: Ulnar artery or Radial artery?

Ulnar artery larger than radial artery

103

Where does the ulnar artery pass down?

Passes down the medial side of the forearm

104

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

105

How does the ulnar artery enter the hand?

By passing lateral to the pisiform bone and superficial to the flexor retinaculum of wrist

106

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)

107

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

108

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

109

What does the muscular arteries supply to?

Supply surrounding muscles

110

What does the Common Interosseous artery divide into?

Into anterior and posterior interosseous arteries

111

What are the 2 small carpal arteries?

1) Dorsal carpal branch
2) Palmar carpal branch

112

What does the 2 small carpal arteries do?

Supply the wrist

113

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

114

What do the radial and ulnar arteries form?

Form two interconnected vascular arches

115

What are the two interconnected vascular arches the radial and ulnar arteries form?

1) Superficial Palmar Arch
2) Deep Palmar Arch

116

Vessels to the digits, muscle and joints originate from where?

From the two arches and the parent arteries

117

Where does the radial artery supply in the palmar hand?

Thumb and lateral side of the index finger

118

Where does the ulnar artery supply in the palmar hand?

Medial side of the index finger and remaining digits

119

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

120

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

121

What is the Allens test?

Tests adequate anastomoses between the radial and ulnar artery
- test if there is occlusion of arteries

122

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

123

What is the disease if there is arterial insufficiency?

Pallar Persists
- hand remains white

124

What does the anatomical snuffbox contain?

Contains Radial artery

125

Where does the radial artery cross in the anatomical snuffbox?

Crosses the floor obliquely running deep to the extensor tendons

126

How is the radial pulse palpated by some individual at the anatomical snuffbox?

By placing two fingers on the proximal portion of the snuffbox

127

What is an aneurysm?

Dilation of a blood vessel to more than twice its original size

128

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

129

What is the treatment for an axillary artery aneurysm?

Surgery required to remove the aneurysm and reconstruct the vessel wall

130

What happens if the brachial artery is completely blocked or severed?

- medial emergency
- resulting ischaemia of the forearm can cause necrosis

131

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.

132

What does the occlusion or laceration of brachial artery cause?

- Cause a characteristic flexion deformity called Volkmann's ischaemic contracture

133

What does the ulnar artery define?

The carpel tunnel area

134

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)

135

What does the superificial palmar and deep palmar arch show?

Show connection between arteries through arch