Arteries & Veins of the Upper Limb

Question 1

Axillary artery

Answer 1

• Begins as the continuation of the Subclavian Artery at the first rib
• Passes deep to the pectoralis minor muscle
• Ends at the teres major, where it is renamed the Brachial Artery

Question 2

Brachial artery

Answer 2

• Begins as the continuation of Axillary artery at the teres major muscle
• Runs medial to the humerus between the anterior & posterior muscle compartments (PULSE POINT)
• Runs into the cubital fossa, located between median nerve and biceps tendon (blood pressure auscultation)
• Terminates within cubital fossa, bifurcating into Radial and Ulnar arteries

Question 3

Deep artery of the arm

Answer 3

• Large branch of the brachial artery in the arm
• Runs through the lateral triangular space with radial nerve
• Passes posterior to the humerus in the radial/spiral groove with the radial nerve
• Supplies posterior compartment of arm

Question 4

Radial artery

Answer 4

• The smaller, more lateral, terminal branch of the brachial artery in cubital fossa
• Enters the forearm descending deep to brachioradialis
• Lies on the anterior surface of the distal radius, lateral to the tendon of Flexor Carpi Radialis tendon at the wrist PULSE POINT
• Winds laterally around wrist, passes through floor of the anatomical snuffbox
• Pierces muscles between the 1st and 2nd metacarpals to enter the hand
• Connectswith the ulnar artery, forming the superficial and deep palmar arches

Question 5

Ulnar artery

Answer 5

-The larger, more medial, terminal branch of the brachial artery in the cubital fossa

• Enters forearm deep to pronator teres
• Found lateral to Flexor Carpi Ulnaris tendon at the wrist PULSE POINT
• Enters the palm superficial to carpal tunnel (flexor retinaculum)
• Passes through the ulnar canal (tunnel of Guyon) with the ulnar nerve
• Connects with the radial artery, forming the superficial and deep palmar arches

Question 6

Arteries of the hand

Answer 6

Palmar arches (anterior of hand)

• Superficial
• Deep

Dorsal carpal arch (posterior to the carpals)

-From these, a collection of digital arteries arise to supply the fingers and thumb

Question 7

Deep veins

Answer 7

• Superficial and deep palmar venous arches – form ulnar and radial veins
• Ulnar & radial veins- unite in cubital fossa to form brachial veins
• Brachial veins- from cubital fossa to teres major
• Axillary vein- from teres major to 1st rib (within axilla)
• Subclavian vein – proximal to 1st rib

Question 8

Superficial veins

Answer 8

Cephalic vein – ‘towards the head’, located on lateral aspect of forearm and arm, drains into axillary vein

Basilic vein – ‘towards the base’, on medial aspect of forearm and arm, drains into axillary vein

Median cubital vein – joins the cephalic and basilic vein’s anterior to the cubital fossa

Perforating veins – drain blood from superficial veins into deep veins (for more efficient return of blood to the heart)

Question 9

Artery Summary

Answer 9

Subclavian Artery- ends at the 1st rib

Axillary Artery- from 1st rib to the teres major muscle (within axilla)

Brachial Artery- from teres major to its bifurcation within cubital fossa

Ulnar & Radial Arteries- begin as brachial artery divides

Superficial and Deep Palmar Arches & Dorsal Carpal Arch - branches of ulnar & radial arteries that supply the hand

Question 10

Veins

Answer 10

Deep veins

• Located alongside deep structures eg muscle, bone
• Tend to follow the pattern of the arteries
• Multiple ‘accompanying veins’ run alongside the arteries. More efficient blood return, compared to superficial veins, due to musculovenous pump

Superficial veins

• Located in subcutaneous tissue (superficial fascia)
• Do not accompany arteries
• Not as efficient blood return, as deep veins, due to absence of musculovenous pump

Perforating Veins
-Drain blood from superficial veins into deep veins to enhance venous return

Question 11

Lymphatics of the Upper Limb

Answer 11

• The lymphatic system returns excess tissue fluid & leaked plasma proteins back into the blood stream, as well as removal of cell debris and infection
• Lymph nodes are found along the course of the vessels at junctional points such as joints and anatomical spaces eg cubital fossa and axilla

Question 12

Lymphatics of Upper Limb : Right Hand Side

Answer 12

• Lymph from right upper quadrant of the body is returned to the circulation by the right lymphatic duct.
• It drains into the right venous angle (the junction b/w right internal jugular vein and the subclavian vein)

Question 13

Lymphatics of Upper Limb : Left Hand Side

Answer 13

• Lymph from the remainder of the body (left upper quadrant and bottom half of the body) is returned to the circulation via the thoracic duct
• It drains into the left venous angle (junction b/w left internal jugular vein and the left subclavian vein)