Lecture 13: Upper Extremity Angiology

Question 1

What muscle determines the regions for the Subclavian Artery?

Answer 1

The Anterior Scalene Muscle

Question 2

What are all the arteries and its branches of Part 1 of the Subclavin Artery and what do they supply?

Answer 2

Part 1: Before Anterior Scalene Muscle

Vertebral Artery: supplies Brain

Inferior Thoracic Artery: supplies Anterior Thoracic Region

Thyrocervical Trunk:

1. Inferior Thyroid A. and Ascending Cervical A.
2. Suprascapular Artery: Supplies supraspinatus and infraspinatus muscle
3. Transverse Cervical Artery: Trapezius M.
   - Deep Branch can replace dorsal scauplar and supply Rhomboids and Levator Scapulae

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Question 3

What are all the arteries and its branches of Part 2 of the Subclavin Artery and what do they supply?

Answer 3

Part 2: Behind Anterior Scalene Muscle

Costocervical Trunk:

1. Deep Cervical Artery: supplies Muscles of the Deep Neck
2. Supreme Intercostal Artery
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Question 4

What are all the arteries and its branches of Part 3 of the Subclavin Artery and what do they supply?

Answer 4

Part 3: After Anterior Scalene Muscle but before 1^st Rib

Dorsal Scapular Artery: Supplies Rhomboids and Levator Scapulae Muscles

VIT CD

Question 5

What defines the transition between the Subclavian and Axillary Arteries?

Answer 5

The First Rib

Question 6

What are all the arteries and its branches of Part 1 of the Axillary Artery and what do they supply?

Answer 6

Part 1: Before Teres Minor Muscle

The Superior Thoracic

Despite its name, it’s pretty tiny and often not present

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Question 7

What are all the arteries and its branches of Part 2 of the Axillary Artery and what do they supply?

Answer 7

Part 2: Behind Teres Minor Muscle

1. Thoracoacromial Trunk
   - Clavicular Branch
   - Acromial Branch
   - Deltoid Branch
   - Pectoral Branch
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2. Lateral Thoracic Artery: supplies Serratus Anterior Muscle
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Question 8

What are all the arteries and its branches of Part 3 of the Axillary Artery and what do they supply?

Answer 8

1. Subscapular Artery: supplies Subscapular
   - Circumflex Scapular Artery: supplies Infraspinatus, Teres Minor, and Teres Major
   - Thoracodorsal Artery: supplies Latissimus Dorsi Muscle
2. Anterior Circumflex Humeral Artery: supplies humerus
3. Posterior Circumflex Humeral Artery: supplies deltoids
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Question 9

What causes pain and loss of sensation in Axillary Artery Aneurysm?

Answer 9

Compression of the Brachial Plexus

Question 10

Where are the three scapular anastomoses?

Answer 10

1. B/t Suprascapular and Circumflex Scapular Arteries
2. B/t Circumflex Scapular and Dorsal Scapular Arteries
3. B/t Thoracodorsal and Dorsal Scapular Arteries

Question 11

If you want to cut off blood supply to the Upper Extremity, where can place ligatures?

Bare in mind the scapular anastomoses

Answer 11

Before Thyrocervical Trunk or After Subscapular Arteries

Question 12

The Deep Brachial Artery makes what 2 collateral arteries?

Answer 12

Radial Collateral Artery

Middle Collateral Artery

Question 13

The Brachial Artery makes what two collateral arteries?

Answer 13

Superior Ulnar Collateral Artery

Inferior Ulnar Collateral Artery

Question 14

What two major arteries give off the Recurrent Arteries of the Elbow Anastomosis?

Answer 14

Ulnar A. (Makes 3)

Radial A. (Makes 1)

Question 15

What are the branches of the Ulnar Artery that help form the Elbow Anastomosis?

Answer 15

1. Anterior Ulnar Recurrent Artery
2. Posterior Ulnar Recurrent Artery
3. Interosseous Recurrent Artery (via Common Interosseous Artery)

Question 16

What branch of the Radial Artery helps form the Elbow Anastomosis?

Answer 16

Radial Recurrent Artery

Question 17

What arteries anastamose with each other at the elbow?

Answer 17

1. Superior Ulnar Collateral A. w/ Posterior Ulnar Reccurrent A.
2. Inferior Ulnar Collateral A. w/ Anterior Ulnar Reccurent A.
3. Middle Collateral A. w/ Interosseous Recurrent A.
4. Radial Collateral A. w/ Radial Recurrent A.

Question 18

What two minor Arteries feed into the Dorsal Carpal Arches?

Answer 18

The Anterior and Posterior Interosseous Arteries

Question 19

What major Artery of the Hand is responsible for the Superficial Palmar Arterial Arch?

Answer 19

The Ulnar Artery

Question 20

What major Artery of the Hand is responsible for the Deep Palmar Arterial Arch

Answer 20

The Radial Artery

Question 21

When the Radial Artery ducks under the Thumb, what structure does it pass through?

Answer 21

The Anatomical Snuffbox

Question 22

On the Dorsal side, what two Arteries come off of the Radial artery when it ducks behind the Thumb?

Answer 22

Dorsalis Pollicis

1st Dorsal Metacarpal Artery

Question 23

The First Dorsal Metacarpal Artery comes off of the Radial Artery. What structure gives rise to the 2nd through 4th?

Answer 23

The Dorsal Carpal Arch

Question 24

What two oddly named Arteries of the Thumb does the Radial Artery make?

Which one is Dorsal, and which one is Palmar?

Answer 24

Dorsal: Dorsalis Pollicis

Palmar: Princeps Pollicis

Question 25

What Artery supplies the lateral side of the Second Digit?

Answer 25

Princeps Pollicis

Question 26

What four arteries supply the Third and Fourth digits?

Answer 26

Two Proper Palmar Digital Arteries Two Dorsal Digital Arteries

Question 27

What do Proper Palmar Digital Arteries split off from?

Answer 27

Common Palmar Digital Arteries

Question 28

What do Dorsal Digital Arteries split off from?

Answer 28

Dorsal Metacarpal Arteries

Question 29

What supplies the medial side of the 5th Digit?

Answer 29

The medial Proper Palmar Digital Artery of the 5th Digit ## Footnote *The pinky does not get a medial Dorsal Digital Arteries*

Question 30

If the Superficial Palmar Arterial Arch was blocked, how might the Palmar side of the Digits receive blood?

Answer 30

Blood can flow from the Deep Palmar Arterial Arch through the Palmar Metacarpal Arteries into the Common Palmar Digital Arteries

Question 31

Where might one find the Cephalic Vein?

Answer 31

On the lateral side of the Upper Extremity, crossing the head of the Humerus and joining in with the Scapula.

Question 32

Where might one find the Median Cubital Vein? What two Veins does it connect?

Answer 32

In the Antecubital Fossa The Cephalic and Basilic Vein

Question 33

What is the Axillary Vein emptied into by? When does it become the Subclavian Vein?

Answer 33

Brachial Veins (Veins of the Brachial Arteries), Cephalic Vein and Basilic Vein When it passes the First Rib

Question 34

What makes the Median Cubital Vein such a good site for Venipuncture?

Answer 34

Because of the protective nature of the Bicipital Aponeurosis.

Question 35

What is the clinical importance of Axillary Lymph Nodes?

Answer 35

They are frequently invaded by cancer cells.