blood vessels of upper limb

8/4/2019 Blood Vessels of Upper Limb

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Blood vessels of upper limb


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Blood vessels of upper limb

At the end of lecture the student should be able to:

Describe the course and main branches of the axillaryartery.

Describe briefly the course and distribution of the:

Brachial artey.

Profunda brachii artery.

Describe briefly the course and distribution of the radialand 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.


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Subclavian artery

Axillary artery

Brachial artery

Latissimus dorsi

Axillary artery Origin

A continuation of the subclavian artery at the

outer border of the first rib

CourseThe artery traverses the axilla from apex tobase

Its course is divided by the pectoralisminor into 3 parts:-First part, above the pectoralis minor

-Second part, behind the pectoralis minor-Third part, below the pectoralis minor

TerminationAt the lower border of teres major,where it continues into the arm asthe brachial artery


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BRANCHES OF AXILLARY ARTERY

First part of axillary artery


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

From the second part1. Thoracoacromial artery

A short trunk which arises behind the

upper border of pectoralis minor

Breaks into 4 branches:

-Pectoral

-Deltoid

-Acromial

-Clavicular2. Lateral thoracic artery

Supplies the pectoral muscles and gives

mammary branches to the female breast

Subclavian a.Thoraco-

acromial a.

Clavicular

branch

Acromial

branch

Deltoid

branch

Lateral thoracic a.

Pectoral branch

Superior

thoracic a.


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

From the third part

Posterior circumflex

humeral a.

Anterior circumflexhumeral a.

Circumflex

scapular a.

Subscapular a.

Lateral thoracic a.


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Posterior circumflex

humeral a.

Descending br. of posterior

circumflex humeral a.

Anterior circumflex

humeral a.

Circumflex

scapular a.

Subscapular a.Lateral

thoracic 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 circumflexscapular which shares inthe anastomosis aroundthe scapula

NB.

Pulsations of the axillary artery can

be felt by compressing the artery

against the lateral wall of the axilla.


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BRACHIAL ARTERY

COURSE

POST. RELATION


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BRANCHES OF BRACHIAL ARTERY

Teres major

1

2

3

4

56

1

Lat. Med.

Brachial a.

These are:

1. Profunda brachii.

2. Nutrient artery.

5. Radial artery, and

6. Ulnar artery

Profunda brachii artery:

-It enters the spiral groove together with the radial nervewhere it gives off the following branches:

a. Ascending branch

b.Two descending branches which shares in theanastomosis around the elbow


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BRANCHES OFBRACHIAL ARTERY


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.

II.Nerves:

1. Median nerve: supply all the musclesof the front of the forearm exceptflexor carpi ulnaris and medial 1/2 offlexor digitorum profundus.

2. Ulnar nerve: supplies flexor carpi

ulnaris and medial 1/2 of flexordigitorum profundus.

3. Superficial branch of radial nerve:supplies a skin on the dorsum of thehand and fingers.

VESSELS AND NERVES OF THEANTERIOR COMPARTMENT

III.Vessels:

1. Ulnar artery ,and

2. Radial arteryThe nerves and vessels of

the ant. compartment

Lat. Med.

Brachialis a.

Median n.

Ulnar n.

Ulnar a.

Radial n.

Radial n.

Radial a.


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1

2

3

4

5

6

7

Brachial a.

Radial a. at

neck of radius

Brachial a. at

distal end of

the radius

Lat. Med.

Structures

posterior to

radial a.

1

3

2

Radial a.

Ulnar a.

Brachial a.

Ulnar a.

Palmar carpal

branch of ulnar

a.

Superficialpalmar arch

Lat.

epicondyle

Lat

Med.

Brachial a.

Ulnar a.

2 venae

comitantes

Brachioradialis

tendon

lateralFelx. carpi-

radialis longus

tendonmedial

Radial n.

Radial a.

Medial &

lateral relations

of radial a.

RADIAL ARTERY

Branches of radial artery

Branches:

1. Radial recurrent artery2. Anterior (palmar) carpal branch

3. Superficial palmar branch

4. Muscular branches.


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ULNAR ARTERY


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i & ii

2

iv

iii

Brachial a.

Ulnar a.

Lat.

epicondyle

45

Superficial

terminal

branch

Deepterminal

branch

Interosseous

recurrent

branch

Median a.

Lat.

Med.

iii

Ulnar a.

BRANCHES OF ULNAR ARTERY

1.Ulnar recurrent arteries (anterior and posterior).

2.Common interosseous artery: which divides intoanterior(iii) and posterior(iv) branches.

3.Muscular branches.

4,5. Anterior and posterior carpal branches


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RADIAL AND ULNARARTERIES


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Radial artery in the hand

Radialisindicis a.

Princepspollicis a.

Radial a.

Palmarmetacarpalarteries

Deep branchof ulnar a.

Deep palmararch

Common palmardigital arteries

Superficial

palmar branchof radial a.

Ulnar a. Radial a.

Palmar digital a. formed. side of littlefinger

Deep branch of ulnar a.,piercing the hypothenarmuscles to the depth ofthe palm

Ulnar artery in the hand

Radial artery

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

- Then continue as deep palmararch.

Ulnar artery

Gives deep branch joins the deeppalmar arch.

Then continue assuperficial palmar arch.

ARTERIES IN THE HAND


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SUPERFICIALPALMAR ARCH

Continuation of ulnarartery.


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DEEP PALMER ARCH

Continuation ofradial artery.

It gives: 3 palmarmetacarpal arteries +3 perforating arteries.


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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

Dorsal metacarpal

veins

Dorsal venous

arch

Cephalic veinBasilic

vein

Dorsal digitalveins

C h li i


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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 themedian 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 ofaxillary vein. It receives veins from the anterior and posterior surfaces of the forearm

Cephalic

vein

Basilic

vein

Median cubitalvein

Cephalic

vein

B ili i


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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 ofteres major, it continues in the axilla as the axillary vein

Basilic

vein

Basilic

vein

Cephalic

vein

Median cubital

vein

Axillary

vein

A ill i


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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

Subclavian vein

Axillary

vein

Basilic vein

Venae comitantes

of brachial artery

Cephalic vein

Median cubital vein


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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 cubital

vein

Median vein

of forearm

Median vein

of forearm

Median cephalic

vein

Median basilic

vein

blood vessels of upper limb

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