12.5 Blood Supply and Drainage of the Upper Limb

Question 1

Using an acronym, recall the branches of the subclavian artery, from medial to lateral

Answer 1

VITC (Vitamin C)

V: Vertebral
I: Internal thoracic (inferiorly)
T: Thyrocervical trunk
C: Costocervical trunk

Question 2

Describe how/where the subclavian artery changes name (all the way down)

Answer 2

1. Subclavian
2. Axillary (after the lateral border of the first rib)
3. Brachial (after inferior border of teres major)
4. Radial and ulnar (in cubital fossa)

Question 3

Which muscles does the subclavian artery travel between?

Answer 3

Anterior and middle scalenes

Question 4

List two important branches of the thyrocervical trunk, and what they supply

Answer 4

1. Suprascapular artery (supplies supra and infraspinatus muscles)
2. Transverse cervical, whose deep branch is the dorsal scapular (traps, levator scap, rhomboids)

Question 5

What are the boundaries of three parts of the axillary artery? From which part does the subscapular artery arise?

Answer 5

Pat 1: Proximal to pec minor
Part 2: Within pec minor
Part 3: Distal to pec minor

Subscapular artery arises from third part

Question 6

Describe the arterial anastomoses that occur on the posterior scapula. Why is this useful?

Answer 6

• Dorsal scapular artery anastomoses with suprascapular (from thyrocervical trunk) and subscapular (from axillary Pt 3)
• Suprascapular passes past lateral spine of scapula, and anastomoses on subscapular a. as well

This is useful, because — if a proximal part of the axillary artery is still supplied by other vessels.

Question 7

Why is the ulnar artery and nerve rarely damaged in carpal tunnel?

Answer 7

Because it travels over the retinaculum, unlike the median nerve, which is deep to it (and can therefore get squished).

Question 8

Which arteries combine to form the superficial and deep palmar arches? What structure is this similar to?

Answer 8

• Radial and ulnar arteries join
• This is similar to arcuate artery that arises from dorsalis pedis in the foot

Question 9

Describe the passage of the radial artery through the hand

Answer 9

Passes through the anatomical snuffbox, between the thumb and first digit to enter the depeer layers of the hand.

Question 10

What is the name of the group of veins found on the posterior hand?

Answer 10

Dorsal venous network

Question 11

What is the name of the two superficial veins that run on the medial and lateral arm? Which vein runs between them?

Answer 11

Medial: Basilic (BASe of embryonic limb bud)

Lateral: Cephalic (HEAD of embyronic limb bud)

Between them: median vein

Question 12

How does the deep venous circulation of the upper limb differ from the arterial circulation?

Answer 12

The veins are paired, known as vena comitans (e.g. there are two brachial veins)

Question 13

Which artery supplies the anterior and posterior compartments of the upper arm?

Answer 13

Anterior: Brachial artery
Posterior: Profunda brachii

Question 14

Describe the pathway of lymph drainage from the upper limb

Answer 14

• Pectoral (breast) and humeral drain into central and apical lymph nodes
• These drain into subclavian lymph nodes, and then their respective venous angles (RLD on right side, and TD on left side)

Question 15

What space does the profunda brachii artery travel through at the proximal humerus? What makes up the boundaries of that space? What nerve travels with it?

Answer 15

• Profunda brachii travels in triangular space
• Between the long, medial, and lateral heads of triceps
• Radial nerve travels with

Question 16

Which artery gives off the common interosseus artery in the forearm? What does the CIO artery then divide into?

Answer 16

• Ulnar gives common interosseus
• Becomes anterior and posterior interosseus