Arteries - Upper Extremity

Question 1

Suprascapular Artery

Answer 1

Originates from the Thyrocervical trunk (which originates at the subclavian Artery)

Runs posteriorly OVER the suprascapular ligament (transverse scapular ligament) which transverses the notch

Continues into the supraspinous fossa

Winds around the spinoglenoid notch

Continues into infraspinous fossa

RUNS WITH SUPRASCAPULAR NERVE

Question 2

Transverse Cervical Artery

Answer 2

Branch of Thyrocervical Trunk (of Subclavian Artery)

2 branches:
Superficial Branch - Runs deep to Trapezius Muscle with CNXI
Deep branch - dorsal scapular artery

Question 3

Dorsal Scapular Artery

Answer 3

Deep Branch of Transverse Cervical Artery

Runs with Dorsal Scapular Nerve deep to the levator scapula and the rhomboids along the medial border of the scapula

**Irregular - often seen as its own branch off of the subclavian artery

Question 4

Axillary Artery

Answer 4

Continuation of the subclavian artery beginning at the level of the 1st rib (apex of the axilla)

Divided into 3 parts by Pec Minor
Part 1: Proximal to Pec Minor (1 branch)
Gives off 1 branch: Superior Thoracic Artery
Runs straight to the thoracic wall

Part 2: Deep to pec Minor (2 branches)
Gives off 2 branches:
Thoracoacromial Trunk Artery (branches off at the
upper medial border of Pec Minor)
Pectoral Branch
Deltoid Branch - found in deltopectoral triangle
Acromial Branch
Clavicular branch
Lateral Thoracic Artery
Runs along the lateral border of pec minor onto
the thoracic wall toward serratus anterior. Runs
with the long thoracic nerve along the thoracic
wall. This branch is very variable.

Part 3: distal to pec minor (3 branches)
Gives off 3 Branches
Subscapular Artery - largest branch; gives off 2
branches
1. Circumflex scapular artery branches off and
winds posteriorly to the posterior surface of the
scapula, it is seen in the TRIANGULAR SPACE
2. Thoracodorsal Artery - continuation of the
subscapular artery after hte circumflex scapular
branch; runs with the thoracodorsal nerve and
goes toward latissimus Dorsi
Anterior Circumflex Humeral Artery - Wraps around
the surgical neck of the humerus anteriorly
Posterior Circumflex Humeral Artery - Warps around
the surgical neck of the humerus posteriorly; seen
in the quadrangular space with the axillary nerve

Axillary Artery Becomes the Brachial Artery at the level of the inferior border of Teres Minor

Question 5

Brachial Artery

Answer 5

Origin: Continuation of the Axillary Artery beginning at the level of the inferior border of teres major

Runs medial and anterior to the humerus, anterior to brachialis.

Runs with the Median Nerve

Gives several branches on the lateral side that we will not name.

Gives of the following 3 branches off the medial side
1. Profunda brachii Artery: (deep artery of the arm)
Branches off medially then turns posteriorly
Seen in the triangular interval of the arm with the radial n
Runs with the radial nerve in the Triangualr interval and
Radial groove of the humerus
Spilts distally in the arm giving off the:
Radial collateral Artery (goes anterior) - anastomoses
with the radial recurrent artery off the radial artery
Middle Collateral Artery (stays posterior) -
anastomoses with reccurent interroseous artery of
ulnar artery
2. Superior Ulnar Collateral Artery:
P - goes posterior; runs posteriorly with the ulnar nerve
behind the medial epicondyle and anastomoses with
posterior ulnar recurrent artery
3. Inferior Ulnar Collateral Artery
Comes off just proximal to the elbow (distal to where the
superior ulnar collateral artery branches), runs anterior to
the medial epicondyle, anterior to the cubital fossa, and
anastomoses with the anterior ulnar recurrent artery

Ends in the Cubital Fossa where it splits into Ulnar and Radial Arteries

Question 6

Radial Artery

Answer 6

Origin: Lateral Branch of the Brachial Artery at the cubital fossa

Descends deep to Brachioradials, then sits on the posterior surface of the radius (its course is relatively superficial)

Gives of the Radial Recurrent Artery, which turns proximally to anastomose with the radial collateral artery anteriorly

Leaves the forearm by winding around the lateral aspect of the wrist behind/around the trapezium, scaphoid, and 1st metacarpal where it sits in the anatomic snuffbox

Enters the pal by passing through the heads of the first dorsal interosseous then goes between the heads of abductor pollicis.

Gives a posterior branch to the dosal carpal arch (which gives off dorsal metacarpal arteries which give off dorsal digital arteries)

Gives a branch to the superficial palmar arch (formed mostly by the ulnar artery.

It is the MAIN CONTRIBUTOR to the Deep Palmar Arch, which gives off palmar metacarpal arteries which feed into the common palmar digital arteries

Gives off a branch called RADIALIS INDICIS whicch supplies the second digit

Gives off a branch called PRINCEPS POLLICIS which supplies the thumb

Question 7

Ulnar Artery

Answer 7

Origin: Medial Branch of the Brachial Artery at the cubital fossa

Runs Deep to Pronator Teres, then runs deep to FCU with the ULNAR NERVE

Gives off the anterior ulnar recurrent artery which runs back up and anastomoses anteriorly with the inferior ulnar collateral artery

Gives off the posterior ulnar recurrent artery which runs back up and anastomoses posteriorly with the superior ulnar collateral artery

Gives off the Common Interosseous Artery, which spilts almost immediately into 3 branches:

1. Posterior Interosseous artery goes behind the interosseous membrane to run with the posterior interosseous nerve
2. Anterior interosseous artery lies deep and continues distally with the anterior interosseous nerve; pierces the interosseous membrane at the proximal border of pronator quadratus
3. Recurrent interosseous artery runs back up and posteriorly to anastomose with the middle collateral artery of the profunda brachii artery

The ulnar artery then continues into the hand by passing through Guyon’s Canal with the Ulnar Nerve (the pass superficial to the flexor retinaculum)

Its give off a dorsal carpal branch that crosses over the carpal bones on the dorsal side, anastamosing with the radial dorsal branch to form the dorsal carpal arch. Dorsal metacarpal arteries branch off the dorsal carpal arch and dorsal digital arteries are the continuation of the dorsal metacarpal arteries once they pass MCP

It gives off a branch to the superficial palmar arch which is formed with a branch from the radial artery. Ulnar artery is the MAIN CONTRIBUTOR to the superficial palmar arch. Common Palmar Digital Arteries branch off the superficial palmar arch. These branch into proper palmer digital arteries at the level of MCP joints

Also gives a branch to the deep palmar arch. Deep Palmar arch gives off palmar metacarpal that feed into the common palmar digital arteries.