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mbbs ii mss > L18 - Vascular supply to the limbs > Flashcards

L18 - Vascular supply to the limbs Flashcards

1
Q

List the arteries in sequence for upper limb supply?

A

(From Brachiocephaic trunk)

Subclavian artery > Axillary artery > (Branch into) > Brachial artery and Deep brachial artery

Brachial artery > Radial artery/ Ulnar artery/ common interosseous artery > Anterior and posterior interosseous arteries

> Superficial and deep palmar arches > digital aa.

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2
Q

Location and root of Axillary artery?

A
  • Located in the axilla
  • Begins at lateral border of 1st rib; ends at lower border of teres major muscle
  • Direct continuation of subclavian artery.
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3
Q

What are the 3 parts + branches of the axillary artery?

A

Subdivided into 3 parts by the pectoralis minor muscle

1) Superior thoracic artery
2) Thoracoacromial artery + Lateral thoracic artery
3) Subscapular artery + Anterior circumflex humeral artery + Posterior circumflex humeral artery

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4
Q

What are the branches from the 1st part of the axillary artery?

A

none

Just superior thoracic artery without branches

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5
Q

What are the branches from the 2nd part of the axillary artery?

A
  • Thoracoacromial artery gives off:
    Pectoral, Deltoid, Acromial and Clavicular branches
  • Lateral thoracic artery has no branches
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6
Q

What are the branches from the 3rd part of the axillary artery?

A

1) Subscapular artery gives off:
a) Circumflex scapula artery
b) Thoracodorsal artery

2) Anterior and 3) posterior circumflex humeral arteries encircle the surgical neck of the humerus

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7
Q

What axillary artery branch passes through the Triangular space and the Quadrangular space?

A

Triangular = circumflex scapular artery from 3rd part Subscapular artery

Quadrangular = Posterior circumflex humeral artery from 3rd part

Both circumflex scapular a. and Posterior circumflex humeral a. anastomose

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8
Q

Give the origin and supply of the superior thoracic artery?

A

From 1st part of axillary artery

Supply 1st and 2nd ICS

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9
Q

Give the origin and supply of the thoracoacromial artery?

A

From 2nd part of axillary artery

4 branches to supply

  • Subcalvius muscle
  • Sternoclavicular joint
  • pectoralis major and minor muscles
  • anterior deltoid muscle
  • dermal sensation overlying the clavipectoral fascia
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10
Q

Give the origin and supply of the lateral thoracic artery?

A

From 2nd part of axillary artery

Supply pectoral muscles, Serratus anterior, Lateral side of breasts

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11
Q

Which of anterior and posterior circumflex humeral arteries are larger?

A

Posterior circumflex humeral a.

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12
Q

Give the origin and supply of the Subscapular artery?

A

From 3rd part of axillary artery

Branch:
- circumflex scapular artery&raquo_space; collateral circulation of the scapula

  • Thoracodorsal artery&raquo_space; Latissimus dorsi
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13
Q

Function of arterial anastomoses?

A

Anastomosing branches allow blood to bypass the blockage in the main artery

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14
Q

Describe the collateral blood supply of the scapula?

A

Link between beginning and end of axillary artery

Subclavian artery > Thyrocervical trunk branches to give: Supra-scapular artery (for supraspinous fossa) + Transverse cervical artery

Transverse cervical artery > Dorsal scapula artery to supply infraspoinous fossa > anastomoses with circumflex scapular artery > Subscapular artery at 3rd part of Axillary artery

Anastomoses bypasses axillary artyer

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15
Q

Location and root of Brachial artery?

A

Root = directly continue from axillary artery

Runs between biceps brachii and brachialis, ends just distal to elbow

Location at cubital fossa = Medial to Biceps brachii tendon, Deep to bicipital aponeurosis, Lateral to median nerve

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16
Q

What are the branches of the Brachial artery?

A

Deep brachial a.
Ulnar a. (Medial branch)
Radial a. (Lateral branch)

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17
Q

What does Deep brachial artery supply?

A

supplies muscles in the posterior compartment of the arm

Takes part in anastomosis around the elbow joint

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18
Q

What does Ulnar artery supply?

A

Medial** forearm muscles

Gives off common interosseous artery&raquo_space; Anterior and posterior interosseous arteries&raquo_space; Superficial Palmar Arch (completed by superficial branch of radial artery)

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19
Q

Where to feel pulse of ulnar artery?

A

Pulse can be palpated in front of wrist, lateral to the flexor carpi ulnaris tendon and the pisiform bone

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20
Q

Where to feel pulse of radial artery?

A

in front of the wrist lateral to the tendon of flexor carpi radialis, in the anatomical snuffbox.

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21
Q

What does Radial artery supply?

A

Lateral** forearm muscles

Branches into superficial palmar branch of radial artery + Deep palmar arch (completed by deep branch of ulnar artery)

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22
Q

What forms the superficial and deep palmar arches?

A

anastomosis of the radial and ulnar arteries

Superficial = Ulnar artery + completed by superficial branch of radial artery

Deep = Radial artery + completed by deep branch of ulnar artery

23
Q

List the sequence of main arteries of the lower limb?

A

(From abdominal aorta > Common iliac > External iliac)

Femoral artery gives branches:
Circumflex femoral arteries + Deep femoral artery

Femoral artery > Popliteal artery gives branches:
Peroneal (fibular) artery + Anterior tibial artery + Posterior tibial artery

Posterior tibial a.&raquo_space; Lateral and medial plantar arteries

Anterior tibial a.&raquo_space; Dorsalis pedis artery&raquo_space; Arcuate artery

24
Q

Root and course of the Femoral artery?

A

Root = direct continuation of external iliac artery

Start at midway between ASIS and Pubic symphysis

> > travels superficially in femoral triangle

> > pass through Adductor /subsartorial canal in medial aspect of middle thigh

> > pass through Adductor hiatus (a gap in the adductor magnus muscle)

> > Popliteal fossa

> > Popliteal artery

25
Q

Root and supply of Circumflex femoral arteries?

A

Root = DEEP femoral artery

Supply: head of femur + 4 branches perforate adductor muscle to supply posterior muscles

26
Q

Root and supply of Deep femoral artery?

A

Root = Femoral artery

Supply = thigh muscles

27
Q

Branches and supply of Deep femoral artery?

A

medial and lateral circumflex femoral arteries&raquo_space; retinacular arteries for head of femur + 4 perforating arteries for posterior leg muscles

28
Q

Root, branches and supply of the Genicular artery?

A

Root = Femoral artery

Branch: saphenous branch and the articular branches of the descending genicular artery

Supply knee joint via Genicular anastomosis linking femoral, popliteal and tibial arteries around knee

29
Q

Boundaries of the femoral triangle?

A
  • Lateral border = Sartorius
  • Medial border = Adductor longus
  • Anterior/ Base border = Inguinal ligament

Skin and fascia for cover

30
Q

Location of Adductor canal?

A

Medial aspect of middle 1/3 of thigh

Intramuscular space deep to Sartorius that leads to Adductor Hiatus for passage of Femoral A/V

31
Q

Describe what passes through the femoral triangle?

A

Femoral V.A.N. from medial to lateral

32
Q

Describe what passes through the Popliteal fossa?

A

From Deep to superficial, medial to lateral:

Popliteal artery > Popliteal vein > Tibial nerve

33
Q

What are the branches of the popliteal artery?

A

3 branches

Anterior tibial a.
Posterior tibial a.
Peroneal (fibular) artery

34
Q

Course and supply of the Anterior tibial artery?

A

Enter anterior compartment of leg via interosseous membrane

Supply anterior muscles of leg

Continue into foot as Dorsalis pedis a.

35
Q

Where to feel anterior tibial artery pulse?

A

palpable just above the ankle joint, between tibialis anterior and extensor hallucis longus tendons, midway between the two malleoli

36
Q

Branches of posterior tibial artery?

A

Posterior tibial a.

Lateral and medial plantar arteries (at medial of distal leg)

37
Q

Root and supply of posterior tibial artery?

A

Root = Popliteal artery

Supply = (with peroneal artery) Posterior leg muscles + (with medial and lateral plantar arteries) Foot

38
Q

Where to feel pulse of posterior tibial artery?

A

felt midway between the tip of the medial malleolus and the medial margin of the heel.

39
Q

Where to feel pulse of Dorsalis pedis?

A

dorsum of the foot (pressing against the cuneiform bones) just lateral to the tendon of extensor hallucis longus muscle (a muscle that extends the big toe).

40
Q

Function of Genicular anastomosis?

A

collateral circulation for the distal part of the limb if the popliteal artery is blocked

41
Q

List two differences between Deep and superficial veins?

A

1) Deep veins parallel the arteries of the same name, Superficial veins are found in superficial fascia and externally visible
2) Deep veins drain muscles, bones and joints. Superficial veins drain subcutaneous tissue

42
Q

Which type of veins is Commonly used for venipuncture and transfusion?

A

Superficial veins

43
Q

Explain the connection between deep and superficial veins?

A

1) superficial and deep veins communicate by perforating (pierce the deep fascia) or communicating veins
2) Valves help direct blood from superficial to deep veins. Valves are present in deep, superficial and communicating veins to direct blood flow back to the heart

44
Q

3 mechanisms of venous return?

A
  1. Valves > unidirectional flow
  2. Muscular pump > force movement of blood
  3. Pulsation of Venae comitantes that are adjacent to Medium sized arteries
45
Q

List the DEEP veins that drain from axillary vein of upper limb to heart?

A

Deep veins&raquo_space; Axillary vein&raquo_space; Subclavian vein&raquo_space; Brachiocephalic vein > SVC&raquo_space; Right atrium

46
Q

Describe the SUPERFICIAL venous drainage on the back of hand?

A

1) Dorsal venous arch > Basilic vein (medial side) > Axillary vein
2) Dorsal venous arch > Cephalic vein (lateral side)> Axillary vein

Cephalic vein and Basilic vein are linked by Median cubital vein @ cubital fossa

47
Q

Root and End of Basilic Vein?

A

arises from medial side of dorsal venous network;

joins brachial veins to form the axillary vein.

48
Q

Root and End of Cephalic Vein?

A

Cephalic vein: visible at anatomical snuffbox; runs up the lateral side of forearm and arm, joins axillary vein superiorly

49
Q

List the DEEP veins that drain the lower limbs to heart?

A

Superficial veins > Deep veins > Femoral vein > External iliac vein > Common iliac vein > IVC > RA

50
Q

Describe the SUPERFICIAL venous drainage OF THE LOWER LIMB?

A

1) Dorsal venous arch > Great saphenous vein (MEDIAL, Anterior) > Saphenous opening @ fascia lata lateral and inferior to pubic tubercule > Femoral Vein
2) Dorsal venous arch > Small saphenous vein (LATERAL, Posterior) > Popliteal vein > Femoral vein

51
Q

2 types of lymphatic systems for draining limbs?

A

Superficial and Deep

52
Q

Difference between superficial and deep lymph vessels?

A

Superficial lymphatic collecting vessels in the subcutaneous tissue travel along superficial veins

Deep lymphatic vessels accompany the deep blood vessels

53
Q

Give the lymph nodes that drain the upper limbs?

A

Axillary nodes along axillary vein drains most of arm

Cubital nodes (small group of LN in front of elbow) drains small area @ medial cubital fossa

54
Q

Give the lymph nodes that drain the Lower limbs?

A

1) Superficial inguinal lymph nodes:
Horizontal group = along inguinal ligament
Vertical group = along Great saphenous vein

2) Deep inguinal LN: drain most lower limb + lower abdomen below umbilicus + Posterior gluteal region below iliac crest; Around middle inguinal ligament
3) Popliteal LN: in popliteal fossa, along small saphenous vein; drain heel and posterior calf

mbbs ii mss (31 decks)

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