ARTERIES OF THE UPPER LIMB-BRACHIAL//RADIAL/ULNAR Flashcards
(22 cards)
BRACHIAL ARTERY
Inferior border of teres major to Level of neck of radius
Median nerve Anterior to it at the distal third of the arm
Enters Cubital fossa under covering of bicipital aponeurosis where gives rise to its terminal branches Radial artery, Ulnar artery
In the cubital fossa
Brachial artery- Lateral to Median nerve
Medial to Radial nerve and its superficial and deep branches and Tendon of biceps brachii
Collateral branches
Deep brachial artery: Radial nerve, Radial collateral artery, Middle collateral artery
Superior ulnar collateral artery
Inferior ulnar collateral artery
Nutrient artery of humerus
Terminal branches-Radial artery, Ulnar artery
ULNAR ARTERY
Deep to Pronator teres and Flexor carpi ulnaris
Superficial to Flexor retinaculum
Enters palm of hand through Guyon’s canal
Ulnar artery branches
Anterior and posterior ulnar recurrent
Anterior interosseous-On interosseous membrane, Nutrient artery (ulna / radius), Flexor compartment, Deep extensor muscles,
Posterior interosseous-Deep to superficial extensors with deep radial nerve, Interosseous recurrent, Anastomosis with middle collateral artery
Muscular branches
Palmar carpal branch
Dorsal carpal branch
Deep palmar branch
Ulnar branches
Muscular branches-Flexor and Pronator muscles
Palmar carpal branch-Palmar carpal arch
Dorsal carpal branch-Dorsal carpal arch
Deep palmar branch-Deep palmar arch
RADIAL ARTERY
Deep to Brachiorradialis with superficial radial nerve
Lateral to Flexor carpi radialis tendon (at wrist)
Across Floor of anatomical snuff box
Enters hand between heads of 1st dorsal interosseous
Palm of hand Between heads of adductor pollicis
RADIAL ARTERY BRANCHES
Muscular-Flexor and extensor compartments of forearm
Radial recurrent-Anastomosis with radial collateral
Palmar carpal branch-Palmar carpal arch
Dorsal carpal branch-Dorsal carpal arch
Superficial palmar branch-Superficial palmar arch
1st dorsal metacarpal
Princeps pollicis artery-Nutrient for 1st metacarpal
Radialis indicis artery-Anastomosis with digital and princeps pollicis arteries
ELBOW ANASTOMOSIS
Brachial artery: Superior ulnar collateral artery, Inferior ulnar collateral artery, Deep brachial artery, Radial collateral artery, Middle collateral artery
Ulnar artery: Posterior ulnar recurrent artery, Anterior ulnar recurrent artery, Radial artery, Radial recurrent, Posterior interoseous (Ulnar artery), Interosseous recurrent
ARTERIES OF THE HAND/SUPERFICIAL PALMAR ARCH
Ulnar artery
Superficial palmar branch (Radial)
Beneath palmar aponeurosis
Level the base of the fully extended thumb
Branches-3 common palmar digital arteries 2 proper palmar digital arteries, Superficial to fibrous digital sheath, Main blood supply to digits
ARTERIES OF THE HAND/DEEP PALMAR ARCH
Radial artery
Deep palmar branch (Ulnar)
Just distal to the base of metacarpal bones
Deep to lumbricals and flexor digitorum profundus tendons
Branches: 3 palmar metacarpal arteries Join Common palmar digital arteries (superficial palmar arch)
3 perforating arteries Join Dorsal metacarpal arteries (dorsal carpal arch)
Recurrent branches Join Palmar carpal arch
Palmar metacarpal arteries and Common palmar digital arteries, Anastomoses between Deep palmar arch, Superficial palmar arch
THORACIC AORTA
T4-T5 IV disc level
Aortic hiatus (T12 vertebra)
THORACIC AORTA TOPOGRAPHICAL RELATIONSHIPS
Anterior-Left pulmonary hilum, Oblique pericardial sinus, Left atrium, Esophagus, Diaphragm
Posterior-Vertebral column, Hemiazygos vein
Lateral: Right, Azygos vein, Thoracic duct, Pleura Lung
Left: Pleura Lung
THORACIC AORTA BRANCHES
Visceral: Left bronchial (2), Pericardial, Mediastinal, Esophageal: Anastomoses Inferior thyroid, Left gastric, Left inferior phrenic,
Parietal: Posterior intercostal arteries (3rd - 11th), Superior phrenic, Subcostal
BLOOD SUPPLY OF THE THORACIC WALL
Thoracic aorta: Posterior intercostal arteries (3rd - 11th), Anastomosis with dorsal scapular artery, Collateral route in coarctation of aorta
Subclavian artery, Posterior intercostal arteries (1st – 2nd) (Superior intercostal / Costocervical trunk)
Anterior intercostal arteries, (Internal thoracic / Musculophrenic)
Axillary artery Lateral and superior thoracic arteries
ABDOMINAL AORTA
Retroperitoneal Aortic hiatus (T12 vertebral level) Aortic bifurcation (L4 vertebral level)-2 cm inferior and to the left of umbilicus, Common iliac arteries
ABDOMINAL AORTA TOPOGRAPHICAL RELATIONSHIPS
Anterior-Celiac ganglia and plexus.Body of pancreas, Splenic and left renal veins, Horizontal part of duodenum, Intestinal loops
Posterior-T12 through L4 vertebrae, Left lumbar veins
Lateral- Left and right crus of diaphragm, Left celiac ganglion, Azygos system of veins, Chyle cistern and thoracic duct
ABDOMINAL AORTA
Palpation of abdominal aortic aneurysm-Deep palpation, Above umbilicus, Left of midline
Presentation of rAAA- Classic triad: Hypotension, Abdominal pain, Pulsatile abdominal mass
Intraperitoneal rupture- Presentation is usually acute with hemodynamic inestability, Cardiovascular collapse often ensues
Presentation of rAAA
Retroperitoneal rupture
Can at least temporarily be contained via tamponade by the retroperitoneal periaortic and perivertebral tissues
Symptoms can include those resulting from hematoma on adjacent structures and result in atypical presentation
Atypical presentations of rAAA
Partial upper gastrointestinal obstruction (third part of duodenum)
Aortic enteric fistula
IVC fistulae
Ureteral obstruction, renal colic, pyelonephritis
Acute femoral neuropathy from femoral nerve compression
Paravertebral muscle spasm
VISCERAL BRANCHES
Unpaired-Celiac trunk, Superior mesenteric artery, Inferior mesenteric artery
Paired-Middle suprarenal arteries, Renal arteries, Gonadal arteries
ABDOMINAL AORTA PARIETAL BRANCHES
Unpaired-Median sacral artery
Paired-Inferior phrenic arteries, Lumbar arteries (4),Common iliac arteries
