Blood Supply of Limbs Flashcards
What are the branches of the aorta ? Which one is is the largest ?
- Brachiocephalic trunk (LARGEST, Wleading on to Right subclavian artery and Right common carotid)
- Left common carotid artery
- Left subclavian artery
Where does the brachiocephalic trunk bifurcate into R subclavian and R common carotid ?
Posterior to right Sternoclavicular joint
What do the R subclavian and R common carotid arteries supply respectively ?
R COMMON CAROTID:
• Supplies the right side of the head and neck, intracranial structures
R SUBCLAVIA:
• Supplies the right upper limb, intracranial structures
How many parts does the subclavian artery have ? Where is each part located ?
1st part: Between origin and medial border of anterior scalene muscle. Right recurrent laryngeal nerve wraps around it.
2nd part: Deep to anterior scalene muscle
3rd part: Between lateral border of anterior scalene muscle and the 1st rib. Anterior to brachial plexus and
posterior to subclavian vein
What are the branches of the subclavian artery ?
1) Vertebral artery
2) Thyrocervical trunk (Gives off suprascapular artery which crosses under clavicle to supraspinatus fossa then infraspinatus fossa)
3) Costocervical trunk
4) Internal thoracic artery
Where is the axillary artery found ?
In axillary fossa
How many parts does the axillary artery have ? Where is each part located ?
Three parts
1st part: proximal to Pectoralis minor
2nd part: behind Pectoralis minor
3rd part: distal to Pectoralis minor
What are the branches of the second part of the axillary artery ? What does each one supply ?
1) Lateral thoracic artery: Supplies breast, axillary lymph nodes and anterior wall of the thorax
2) Thoraco-acromial artery: Supplies the anterior wall of the axilla and thorax
What are the branches of the third part of the axillary artery ? Where does each pass ? What do all of these supply ?
1) Anterior circumflex humeral artery
2) Posterior circumflex humeral artery
• Passes through quadrangular space
• Forms an anastomosis around the surgical neck of the humerus
3) Subscapular artery:
• Anastomose with thyrocervical trunk
• 2 branches: Thoracodorsal artery, and Circumflex scapular artery whihch passes from superior triangular space to infraspinatus fossa
ALL SUPPLY POSTERIOR WALL OF AXILLA
Where does the brachial artery begin and where does it end ? What structures lie anterior, and on both sides of it ?
Begins at the lower border of teres major and ends in the cubital fossa
Lies anterior to triceps and between biceps and brachialis
What are the branches of the brachial artery ? Give the main features of these, especially where each one passes/possible anastomoses.
1) Profunda Brachii Artery: Passes through lower triangular space
• Travels with radial nerve in the radial (spiral) groove
• Terminates into medial & radial collaterals
2) Superior ulnar collateral artery: anastomoses with posterior ulnar recurrent artery
3) Inferior ulnar collateral artery: anastomoses with anterior ulnar recurrent artery
4) Radial artery
5) Ulnar artery
Identify peri-articular anastomoses of the arm and forearm.
1) Superior ulnar collateral artery anastomoses with posterior ulnar recurrent artery
2) Inferior ulnar collateral artery anastomoses with anterior ulnar recurrent artery
3) Radial collateral artery anastomoses with radial recurrent artery
Where does the radial artery begin and where do it end ?
Identify the structure which runs alongside the radial artery.
Runs laterally from the midpoint of the cubital fossa to just medial to the radial styloid process.
Radial nerve on lateral side.
How does the continuation of the radial artery enter the hand ?
Enters hand by curving dorsally around scaphoid and trapezium, crossing the anatomical snuff box
Which of radial or ulnar is larger ?
Ulnar
What are the branches of the ulnar artery ? What does each supply ?
1) Anterior and posterior ulnar recurrent arteries
2) Common interosseous artery, including:
• The Anterior interosseous artery
• The Posterior interosseous: Supplies all forearm extensors.
3) Unnamed branches: Supply medial forearm (deep forearm flexors and pronators).
Identify the structure which runs alongside the ulnar artery.
Ulnar nerve at medial side at distal forearm
How does the continuation of the ulnar artery enter the hand ?
Enters hand between two layers of flexor retinaculum, between the pisiform and hook of hamate
What is the arterial supply of the hand ?
2 Palmar arches
Where are the palmar arches located, relative to the palmar aponeurosis ?
Deep to the palmar aponeurosis
What are the names of the palmar arches ? What vessels are they a continuation of respectively ?
Superficial Palmar Arch (terminal branch of the ulnar artery)
Deep Palmar Arch (branch of radial artery)
What structure completes the superifical palmar arch ? What artery is this structure given off by ?
Radial artery gives off superficial palmar branch that completes the superficial palmar arch
What structure completes the deep palmar arch ? What artery is this structure given off by ?
Ulnar artery gives off deep palmar branch that completes the deep palmar arch
What are the continuations of the superifical palmar arch ?
COMMON PALMAR DIGITAL ARTERIES and then
PROPER PALMAR DIGITAL ARTERIES (2nd – 4th digits))
What are the continuations of the deep palmar arch ?
Palmar metacarpal arteries and then,
Proper palmar digital arteries (from superficial palmar arch)
What are the components of the dorsal carpal arch ?
Dorsal carpal branches (from radial and ulnar) + anterior and posterior interosseal branches
Identify peri-articular anastomoses of the hand.
Ulnar & radial arteries give off palmar & dorsal carpal branches forming peri-articular anastomoses around the wrist.
Name the vessels which emerge from the dorsal carpal arch.
Dorsal metacarpal and dorsal digital arteries
Name the superficial veins of the upper limbs. Identify their origin and any potential branches.
- Dorsal digital veins: join and form dorsal metacarpal veins
- Dorsal metacarpal veins: join and form dorsal venous network of the hand from which the superficial veins of the upper limb originate.
- Cephalic vein: originates from the lateral aspect of the venous network.
- Basilic vein: originates from the medial aspect of the venous network.
- Median cubital vein connects cephalic and basilic veins
- Median antebrachial vein
What are the different locations where a pulse can be left along the arm ?
- Mid shaft of humerus in medial bicipital groove (brachial)
- Cubital fossa (brachial)
- Wrist anterolateral surface (radial)
How, and where are the cephalic and basilic veins connected ?
At the elbow, the cephalic and basilic veins are connected by the median cubital vein
Describe where the brachial, and cephalic veins pass respectively, especially wrt surrounding structures.
Cephalic vein ascends along lateral border of the wrist and anterolateral surface of the forearm and arm. Then enters the clavipectoral triangle to join the axillary vein.
Basilic vein ascends along medial forearm and inferior arm, piercing brachial fascia to run parallel to brachial artery. Then opens into or merges with brachial vein to form axillary vein.
What areas does the median antebrachial vein drain, and where does it drain these ?
Drains the palm and anterior forearm into the basilica vein or median cubital vein