Blood vessels of upper limb

Blood vessels of upper limb

At the end of lecture the student should be able to: Describe the course and main branches of the axillary artery. Describe briefly the course and distribution of the: Brachial artey. Profunda brachii artery. Describe briefly the course and distribution of the radial and ulnar arteries in the forearm. Describe briefly the arterial supply of the hand. Describe briefly the beginning, course and termination of the cephalic and basilic veins. Describe the course and tributaries of the axillary vein.

Axillary artery
Origin
A continuation of the subclavian artery at the

outer border of the first rib Course

The artery traverses the axilla from apex to base Its course is divided by the pectoralis minor into 3 parts: -First part, above the pectoralis minor -Second part, behind the pectoralis minor -Third part, below the pectoralis minor
Subclavian artery Axillary artery

Termination
At the lower border of teres major, where it continues into the arm as the brachial artery

Brachial artery Latissimus dorsi

BRANCHES OF AXILLARY ARTERY

First part of axillary artery

Branches of the axillary artery

From the first part
Superior thoracic artery, a small artery which ramifies on the first digitation of serratus anterior

From the second part

1. Thoracoacromial artery A short trunk which arises behind the upper border of pectoralis minor Breaks into 4 branches: -Pectoral -Deltoid -Acromial -Clavicular 2. Lateral thoracic artery Supplies the pectoral muscles and gives mammary branches to the female breast Acromial branch
Clavicular branch

Thoracoacromial a.

Subclavian a.

Deltoid branch

Superior thoracic a. Pectoral branch

Lateral thoracic a.

From the third part

1. Anterior circumflex humeral artery
Runs to surgical neck of humerus anastomosing with the posterior circumflex humeral artery

Posterior circumflex humeral a.

Anterior circumflex humeral a. Circumflex scapular a.

Lateral thoracic a.

Subscapular a.

2. Posterior circumflex humeral artery

Runs posteriorly round the surgical neck of humerus (with the axillary nerve), anastomosing with the anterior circumflex humeral artery.

3. Subscapular artery Gives the circumflex scapular which shares in the anastomosis around the scapula

Posterior circumflex humeral a.

Descending br. of posterior circumflex humeral a.

NB. Pulsations of the axillary artery can be felt by compressing the artery against the lateral wall of the axilla.

Circumflex scapular a. Anterior circumflex humeral a.

Subscapular a.

Lateral thoracic a.

BRACHIAL ARTERY

COURSE POST. RELATION

BRANCHES OF BRACHIAL ARTERY

Lat. Med.

These are: 1. Profunda brachii. 2. Nutrient artery. 5. Radial artery, and 6. Ulnar artery
2 Teres major

1
Brachial a.

1 3

Profunda brachii artery: -It enters the spiral groove together with the radial nerve where it gives off the following branches: a. Ascending branch b.Two descending branches

which shares in the anastomosis around the elbow

BRANCHES OF BRACHIAL ARTERY

VESSELS AND NERVES OF THE ANTERIOR COMPARTMENT

Brachialis a.

II.Nerves: 1. Median nerve: supply all the muscles of the front of the forearm except flexor carpi ulnaris and medial 1/2 of flexor digitorum profundus. Ulnar nerve: supplies flexor carpi ulnaris and medial 1/2 of flexor digitorum profundus. Superficial branch of radial nerve: supplies a skin on the dorsum of the hand and fingers.

Median n. Ulnar n. Ulnar a.

Radial n.

Radial n. Radial a.

2.

3.

Lat.

Med.

III.Vessels: 1. 2. Ulnar artery ,and Radial artery

The nerves and vessels of the ant. compartment

RADIAL ARTERY
Radial a. Brachial a. 1 Radial a. at neck of radius 2 Brachioradialis tendon lateral Felx. carpiradialis longus tendon medial Brachial a. Ulnar a. Radial n. 2 venae comitantes

Branches: 1. 2. 3. 4. Radial recurrent artery Anterior (palmar) carpal branch Superficial palmar branch Muscular branches.

Structures posterior to radial a.

3 4 5

Lat. epicondyle1

6 Brachial a. at distal end of the radius Lat.

Brachial a.
Ulnar a.

Medial & lateral relations of radial a.

Radial a. Palmar carpal branch of ulnar a. Ulnar a. Med. Superficial palmar arch

Med. 2

Branches of radial artery

Lat

ULNAR ARTERY

BRANCHES OF ULNAR ARTERY

1.Ulnar recurrent arteries (anterior and posterior). 2.Common interosseous artery: which divides into anterior(iii) and posterior(iv) branches. 3.Muscular branches. 4,5. Anterior and posterior carpal branches
iv iii

Lat. epicondyle Interosseous recurrent branch

Brachial a. i & ii Ulnar a.

2

Median a.
Ulnar a.

iii

Deep terminal branch Lat.

Med. Superficial terminal branch

RADIAL AND ULNAR ARTERIES

ARTERIES IN THE HAND

Palmar metacarpal arteries Common palmar digital arteries

Radialis indicis a.

Deep branch of ulnar a. Deep palmar arch

Princeps pollicis a.

Palmar digital a. for med. side of little finger

Deep branch of ulnar a., piercing the hypothenar muscles to the depth of the palm
Ulnar a.

Superficial palmar branch of radial a.

Radial a.

Radial artery in the hand

Radial a.

Radial artery

Ulnar artery in the hand

Ulnar artery Gives deep branch joins the deep palmar arch.

- Reaches the palm from the back of the hand by passing between the 2 heads of 1st dorsal interosseous m. and 2 heads of adductor pollicis m.
-

Then continue as superficial palmar arch.

Then continue as deep palmar arch.

SUPERFICIAL PALMAR ARCH

Continuation of ulnar artery.

DEEP PALMER ARCH

Continuation of radial artery. It gives: 3 palmar metacarpal arteries + 3 perforating arteries.

Superficial veins of the upper limb

Dorsal venous network (arch) A venous plexus in the superficial fascia of the dorsum of the hand It receives three dorsal metacarpal veins (formed by the union of dorsal digital veins from the fingers)

The lateral end of the network is form the cephalic vein

The medial end form the basilic vein
Basilic vein Cephalic vein Dorsal venous arch

Dorsal metacarpal veins Dorsal digital veins

Cephalic vein
Formed from the lateral side of the dorsal venous network Curves round the radial side of the forearm to ascend on the lateral part of the front of forearm, to reach the

front of the elbow

One inch below the elbow, it gives off the median cubital vein

Continues up into the arm, on the lateral side of biceps brachii muscle
At the lower border of pectoralis major,, to end in the upper part of axillary vein.

It receives veins from the anterior and posterior surfaces of the forearm
Cephalic vein

Cephalic vein Basilic vein

Median cubital vein

Basilic vein
Begins from the medial end of the dorsal venous arch Ascends along the medial side of the back of the forearm Below the elbow, it curves forwards to reach the front of the elbow One inch above the elbow, it receives the median cubital vein Continues up on the medial side of biceps brachii In the middle of the arm, it pierces the deep fascia and ascends on the medial side of the brachial artery At the lower border of teres major, it continues in the axilla as the axillary vein

Axillary vein Basilic vein Cephalic vein Basilic vein Median cubital vein

Axillary vein
Origin Continuation of the basilic vein at the lower border of teres major Course Ascends on the medial side of the axillary artery Termination At the outer border of the first rib, it continues into the neck as the subclavian vein Tributaries Veins corresponding to branches of the axillary artery Cephalic vein
Cephalic vein

Subclavian vein

Axillary vein

Basilic vein

Venae comitantes of brachial artery

Median cubital vein

A short oblique vein, which lies across the front of the elbow Arises from the cephalic vein one inch below the elbow Runs upwards and medially to join the basilic vein, one inch above the elbow
Median cephalic vein Median vein of forearm Median basilic vein

Median cubital vein

Median vein of forearm