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Common carotid A
• R common carotid A arises from brachiocephalic A
• L common carotid A arises from arch of aorta
• It ascends in the neck under cover of anterior border of sternocleidomastoid
muscle to the upper border of the thyroid cartilage where it divides into external
and internal carotid arteries
External carotid A
• One of the terminal branches of the common carotid A
• It supplies structures in the neck, face, scalp, tongue and maxilla
• It begins at the level of the upper border of the thyroid cartilage
• It terminates in the parotid gland behind the neck of mandible by dividing into
superficial temporal and maxillary arteries
• Close to its origin the artery emerges from undercover of sternocleidomastoid
muscle where its pulsation can be felt
• It lies medial to the internal carotid A (ICA) at first, but as it ascends in the neck
it passes backward and then lateral to the ICA
Internal carotid A
• One of the terminal branches of the common carotid A
• It begins at the level of the upper border of the thyroid cartilage
• It supplies the brain, the eye, the forehead and part of the nose
• It ascends in the neck embedded in the carotid sheath with internal jugular V
and vagus N

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Subclavian A
• R Subclavian A arises from brachiocephalic A
• L Subclavian A arises from arch of aorta
• It ascends to the root of the neck and then arches laterally
• At outer border of the first rib it becomes the axillary A
• Scalenus anterior mm passes anterior to the artery and divides it into
three parts
• 1st part extends from origin to medial border of scalenus anterior and
gives off vertebral A, thyrocervical trunk, and internal thoracic A.
• 2nd t lies behind the scalenus anterior and gives off the costocervical
trunk
• 3rd part extends from lateral border of scalenus anterior to lateral
border of 1st rib where it becomes the axillary A. Its pulsation can be
easily felt where it lies on the upper surface of the first rib behind the
middle of clavicle

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Internal jugular V
• It is a large vein that receives blood from the brain, face and neck
• It leaves the skull through the jugular foramen
• It descends in the neck through the carotid sheath lateral to the vagus
N and the internal and common carotid arteries
• It ends by joining the subclavian V to form the brachiocephalic V

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Arteries of the upper limb
Axillary A
• It begins at the lateral border of the 1st rib as a continuation of subclavian A
• It ends at lower border of teres major mm to become the brachial A
• The pectoralis minor mm crosses in front of the artery and divides it into three
parts
• 1st part extends from lateral border of the 1st rib to upper border of pectoralis
minor
• 2nd part lies behind pectoralis minor
• 3rd part extends from lower border of pectoralis minor to lower border of teres
major
• 1st part gives off one branch (highest thoracic A)
• 2nd part gives off two branches (thoracoacromial and lateral thoracic arteries)
• 3rd part gives off three branches (subscapular, anterior and posterior
circumflex humeral arteries)
Brachial A
• It begins at the lower border of teres major as a continuation of axillary A
• It descends through the anterior compartment of the arm
• It ends in the cubital fossa at the level of the neck of the radius by dividing into
radial and ulnar arteries

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Radial A
• It is the smaller of the two terminal branches of the brachial A
• It begins in the cubital fossa at the level of the neck of the radius
• It descends through the anterior and lateral compartments of the forearm
• At the wrist, the artery winds backward and passes into the palm to form the
deep palmar arch
• In lower part of forearm, the artery lies on anterior surface of the radius
between two tendons (brachioradialis on its lateral side and flexor carpi radialis
on its medial side). This is the site for taking a radial pulse
Ulnar A
• It is the larger of the two terminal branches of the brachial A
• It begins in the cubital fossa at the level of the neck of the radius
• It descends through the anterior compartment of the forearm
• It enters the palm in front of the flexor retinaculum together with the ulnar nerve
• In front of the flexor retinaculum and just lateral to the Pisiform bone the artery
is covered only by skin and fascia. This is the site for taking an ulnar pulse

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Veins of the upper limb
Superficial veins of the upper limb
Dorsal venous network:
• It lies on the dorsum of the hand.
• It is drained on the lateral side by cephalic vein
• It is drained on the medial side by basilic vein
Cephalic V
• It arises from lateral side of the dorsal venous network
• It ascends around lateral border and then anterior aspect of the forearm
• It runs along lateral border of biceps in the arm
• It pierces the deep fascia in between deltoid and pectoralis major to join the
axillary vein
Basilic V
• It arises from medial side of the dorsal venous network
• It ascends on posterior surface of the forearm
• Just below the elbow it passes forward to reach the cubital fossa
• It ascends along medial border of biceps in the arm
• At the middle of the arm it passes deep to join the venae comitantes of brachial
A to form the axillary V

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Median cubital V
• It connects the cephalic and basilic veins
• It lies superficial in the cubital fossa and is separated from the underlying
brachial A by the bicipital aponeurosis
Median vein of the forearm
• It arises in the palm and ascends on the front of the forearm
• It drains into one of the following:
– Basilic V
– Median cubital V
– Divides into two branches: one joins basilic v (median basilic v) and the other
joins the cephalic v (median cephalic v)
Clinical notes
• The superficial veins of the upper limb are clinically important for
venipuncture, transfusion, and cardiac catheterization
Deep veins of the upper limb
• Venae comitantes
• Axillary V

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Arteries of the lower limb
Femoral A
• It is a continuation of the external iliac A
• It begins behind the middle of the inguinal ligament. This is the site
for taking a femoral pulse
• It descends through the thigh and enters the popliteal fossa as the
popliteal A
The popliteal A divides into anterior and posterior tibial arteries.
The anterior tibial A : at the ankle lies midway between the malleoli
between two tendons (extensor hallucis longus and extensor
digitorum longus). This is the site for taking an anterior tibial pulse.
The posterior tibial A : terminates behind the medial malleolus by
dividing into medial and lateral plantar arteries. Its pulse may be felt
midway between the medial malleolus and the heel

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Veins of the lower limb
Superficial veins of the lower limb
The dorsal venous network
• It lies on the dorsum of the foot
• It is drained on the medial side by great saphenous vein
• It is drained on the lateral side by small saphenous vein

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Great saphenous vein
• It ascends in front of the medial malleolus
• It passes up the leg then behind the knee, and then curves forward
around the medial side of the thigh
• It passes through the saphenous opening to join the femoral V
• The constant position of this vein in front of the medial malleolus
should be remembered for emergency blood transfusion
• A graft of this vein can be used in occlusive coronary artery disease
• A graft of this vein can be used to bypass obstructions of the femoral
or brachial arteries
Small saphenous vein
• It ascends behind the lateral malleolus and passes up the back of the
leg
• It drains into the popliteal V
Deep veins of the lower limb
• Venae comitantes
• Popliteal V
• Femoral V

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Arterial supply of the gut
• The celiac artery is the artery of the
foregut
• The superior mesenteric artery is the
artery of the midgut
• The inferior mesenteric artery is the artery
of the hindgut

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Dr. Mohamed Al-Motabagani

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