Vasculature of the Upper Limb

Question 1

As it emerges from the left ventricle, the aortic arch gives rise to three major vessels, from right to left:

Answer 1

the brachiocephalic artery (trunk), the left common carotid artery, and the left subclavian artery

Question 2

On the right, the brachiocephalic artery (trunk) gives rise to the (2)

Answer 2

right common carotid artery and the right subclavian

artery

Question 3

The subclavian arteries are the origin of blood supply to the

Answer 3

upper limb (but also head, neck, and brain)

Question 4

The subclavian artery passes posterior to the anterior scalene muscle and courses posterior to the clavicle
into the axilla, where it becomes the

Answer 4

axillary artery

Question 5

Blood supply originates with

Answer 5

subclavian artery

Question 6

Subclavian a. branches supply (5)

Answer 6

brain, neck, pectoral
region, back and posterior shoulder (scapular
region)

Question 7

Subclavian a. becomes

Answer 7

axillary artery

Question 8

Axillary a. branches supply (3)

Answer 8

posterior shoulder

(scapular region), axilla, lateral thorax

Question 9

Axillary a. becomes

Answer 9

brachial artery

Question 10

Brachial a. branches supply (2)`

Answer 10

arm and cubital region

elbow

Question 11

Brachial a. splits into (2)

Answer 11

radial artery and ulnar artery

Question 12

Radial a. branches supply (3)

Answer 12

cubital region (elbow), 
posterior forearm, hand

Question 13

Ulnar a. branches supply (3)

Answer 13

cubital region (elbow), 
anterior forearm, hand

Question 14

Subclavian artery

Origin on the right:

Answer 14

brachiocephalic trunk

Question 15

Subclavian artery

Origin on the left:

Answer 15

aortic arch

Question 16

Subclavian artery

Arises posterior to

Answer 16

sternoclavicular joint

Question 17

Subclavian artery

usually has - divisions in relation to

Answer 17

3

anterior scalene muscle

Question 18

Subclavian artery

Part 1 is — to the anterior scalene muscle

Answer 18

medial

Question 19

Subclavian artery

Part 1 is medial to the anterior scalene muscle (3)

Answer 19

• Vertebral a.
• Internal thoracic a.
• Thyrocervical arterial trunk

Question 20

Subclavian artery

Thyrocervical arterial trunk (4)

Answer 20

• Transverse cervical a. (cervicodorsal trunk)
  * Deep branch (dorsal scapular a.)
  * Superficial branch
• Suprascapular a.
• Ascending cervical a.
• Inferior thyroid a.

Question 21

Subclavian artery

Part 2 is posterior to the

Answer 21

anterior scalene muscle

Question 22

Subclavian artery

Part 2 is posterior to the anterior scalene muscle (1)

Answer 22

• Costocervical trunk

Question 23

Subclavian artery

Costocervical trunk is divided into (2)

Answer 23

• Supreme intercostal a.

* Deep cervical a.

Question 24

Subclavian artery

Part 3 is lateral to the

Answer 24

anterior scalene muscle

Question 25

Subclavian artery Part 3 is lateral to the anterior scalene muscle (1)

Answer 25

• Usually no arterial branches but sometimes dorsal | scapular a. will arise here

Question 26

The superficial and deep branches of The t.c.a. may arise independently. When they do form an arterial trunk, this structure is referred to as the

Answer 26

cervicodorsal trunk

Question 27

Continuation of subclavian a.

Answer 27

axillary artery

Question 28

axillary artery is posterior to ---, supplies (3)

Answer 28

clavicle | axilla, pectoral and shoulder regions

Question 29

Axillary artery has 3 divisions relative to

Answer 29

pectoralis | minor muscle

Question 30

Axillary Artery Part 1 is (2) to the pectoralis minor m

Answer 30

proximal and medial

Question 31

superior thoracic artery:

Answer 31

passes between pectoralis major and pectoralis minor to supply the first and second intercostal spaces and the superior part of serratus anterior.

Question 32

Axillary Artery | Part 2 is --- to pectoralis minor m.

Answer 32

posterior

Question 33

Thoracoacromial trunk:

Answer 33

a short arterial trunk with 4 named | branches; pierces costocoracoid membrane

Question 34

Thoracoacromial trunk: a short arterial trunk with 4 named | branches; pierces costocoracoid membrane (4)

Answer 34

* pectoral branch * deltoid branch * acromial branch * clavicular branch

Question 35

Lateral thoracic artery:

Answer 35

descends along lateral border of pectoralis minor m. to lateral thoracic wall; supplies pectoral, serratus anterior, and intercostal muscles, and lateral aspect of

Question 36

Axillary Artery | Part 3 is (2) to pectoralis minor m.

Answer 36

distal and lateral

Question 37

argest branch of axillary a

Answer 37

subscapular artery

Question 38

subscapular artery descends along

Answer 38

lateral border of subscapularis m.

Question 39

subscapular artery divides into (2)

Answer 39

circumflex scapular a. | thoracodorsal a.

Question 40

circumflex scapular a.

Answer 40

curves around lateral border of scapula to enter infraspinous fossa and anastomose with suprascapular a.

Question 41

circumflex scapular a. is of primary importance in

Answer 41

scapular anastomoses

Question 42

thoracodorsal a.

Answer 42

lesser contribution to scapular anastomoses | but principally supplies latissimus dorsi m.

Question 43

anterior circumflex humeral artery:

Answer 43

smaller; anterior around | surgical neck of humerus

Question 44

posterior circumflex humeral artery:

Answer 44

larger; posterior around surgical neck of humerus and emerges in quadrangular space at back of shoulder/scapular region with axillary n.; supplies deltoid, teres major, teres minor, and long head of triceps muscles

Question 45

Scapular Anastomoses: | Arterial branches arising from the (2) from an anastomosis around the scapula, allowing --- --- to the upper limb

Answer 45

subclavian and axillary arteries (with some contributions from branches arising directly from thoracic aorta) collateral circulation

Question 46

Anastomosing Arterial Branches: (5)

Answer 46

1. Suprascapular artery (from subclavian artery) 2. Dorsal Scapular artery (deep branch of transverse cervical a. from subclavian a.) 3. Posterior Intercostal arteries (from thoracic aorta) (less important) 4. Circumflex Scapular artery (division of subscapular artery from axillary artery) 5. Thoracodorsal artery (division of subscapular artery from axillary artery)

Question 47

In certain cases of injury to, or ligation or occlusion of the axillary artery superior to the subscapular artery, direction of blood flow in the subscapular artery is

Answer 47

reversed, allowing blood to flow to the distal portion of the axillary artery and the rest of the arm, forearm and hand.

Question 48

Brachial artery is a continuation of the

Answer 48

axillary artery

Question 49

Brachial artery begins at the

Answer 49

inferior border of tires major m.

Question 50

Brachial artery is relatively superficial/palpable in the --- aspect of arm

Answer 50

medial

Question 51

main blood supply to the arm

Answer 51

brachial artery

Question 52

Radial and Ulnar arteries | Continuing Path of Blood Supply From

Answer 52

Arm (brachium) into Forearm (antebrachium)

Question 53

Anastomoses between: | Brachial Artery – Ulnar Artery (2)

Answer 53

* Superior ulnar collateral – Posterior ulnar recurrent | * Inferior ulnar collateral – Anterior ulnar recurrent

Question 54

Anastomoses between: Deep Brachial Artery – Radial & Interosseous Arteries (2)

Answer 54

* Radial collateral artery – Radial recurrent artery | * Middle collateral artery – Interosseous recurrent artery

Question 55

Anterior Forearm: (3)

Answer 55

- ulnar artery (proper) - radial artery (proper) - anterior interosseous a.

Question 56

Posterior Forearm: (4)

Answer 56

- radial artery (proper) - recurrent interosseous a.* - posterior interosseous a. - Dorsal carpal branch (ulnar a.)

Question 57

Superficial Palmar Arch (3)

Answer 57

• ulnar artery - common palmar digital aa. - proper palmar digital aa.

Question 58

Deep Palmar Arch (1)

Answer 58

• radial artery

Question 59

Radial artery (primarily) (3)

Answer 59

* Princeps pollicis a. (medial thumb) * Dorsal carpal arch• Anatomical snuff box* * Dorsal digital arteries

Question 60

For deep drainage of the upper limb, most named arteries have companion veins with same name. However, these veins may be

Answer 60

comprised of groupings and anastomoses of veins, making it | sometimes difficult to distinguish them as individual veins

Question 61

The two main superficial veins of the upper | limb are the

Answer 61

cephalic (lateral) and basilic | (medial) veins

Question 62

The cephalic and basilica veins are united in | the cubital fossa by the

Answer 62

median cubital vein

Question 63

The cephalic vein enters the deltopectoral | triangle (groove) and drains into the

Answer 63

axillary vein

Question 64

The basilic vein enters the basilic hiatus to | join with brachial veins and become

Answer 64

axillary | vein

Question 65

Veins from hand and wrist drain into

Answer 65

radial | and ulnar veins in forearm

Question 66

These then drain to

Answer 66

brachial veins in arm

Question 67

Brachial veins join with basilic vein as it | become

Answer 67

axillary vein

Question 68

Axillary vein picks up cephalic vein and | then drains in

Answer 68

subclavian vein