Blood Supply of the Upper Extremity

Question 1

What structures does the innominate artery supply?

Answer 1

innominate artery = brachiocephalic trunk

the right subclavian artery (SCA) and right common carotid artery

Question 2

Based ib tge abteruir scalene muscle, what are the three segments of the subclavian artery?

Answer 2

1st part: medial to anterior scalene

2nd part: posterior to anterior scalene

3rd part: lateral to anterior scalene

Question 3

Name the branches in the first part of the subclavian artery.

Answer 3

vertebral artery

internal thoracic artery

thyrocervical trunk

Question 4

What does the thyrocervical trunk branch off into?

Answer 4

inferior thyroid artery and suprascapular artery (supplies blood to the posterior scapula)

Question 5

What does the second part of the subclavian artery give rise to?

Answer 5

costocervical trunk - arises posteriorly and supplies the first two intercostals and deep cervical muscles

Question 6

What does the third part of the subclavian artery give rise to?

Answer 6

dorsal scapular artery

may arise from transverse cervical artery

supplies levator scapulae and rhomboid muscles

Question 7

What makes up the thoracic outlet?

Answer 7

subclavian artery - posterior to the anterior scalene muscle

subclavian vein - anterior to the anterior scalene muscle

Question 8

Where does the axillary artery begin?

Answer 8

the lateral border of the first rib

Question 9

Where does the axillary artery end?

Answer 9

inferior border of the teres major

Question 10

How many parts are the axillary artery divided into? How many branches are tehre in each part?

Answer 10

1st part - one branch

2nd part - two branches

3rd part - three branches

Question 11

Where are the divisions for each part of the axillary artery?

Answer 11

1st part - form lateral border of 1st rib and medial border of pec minor

2nd part - posterior to the pec minor

3rd part - from lateral border of pec minor to inferior border of teres major

Question 12

What arteries branch from the first part of the axillary artery?

Answer 12

superior thoracic artery

Question 13

What arteries branch from the second part of the axillary artery?

Answer 13

thoracoacromal artery and lateral thoracic artery

Question 14

What are the arteries that branch from the third part of the axillary artery?

Answer 14

anterior circumflex humeral artery

posterior circumflex humeral artery

subscapular artery

Question 15

What does the superior thoracic artery supply?

Answer 15

the 1st and 2nd intercostal spaces and superior part of serratus anterior

Question 16

What are the branches of the thoracoacromial artery?

Answer 16

pectoral

deltoid

acromial

clavicular

Question 17

What does the lateral thoracic artery supple?

Answer 17

supplies lateral aspect of breast, serratus anterior, and pectoralis

Question 18

What does the subscapular artery branch into?

Answer 18

circumflex scapular artery

thoracodorsal artery

Question 19

What is the role of the subscapular artery?

Answer 19

provides a rich collateral network around scapula between the circumflex humerals and acromial branch of the thoracoacromial artery

Question 20

Where does the brachial artery begin and end?

Answer 20

begins at the inferior border of teres major

ends in the cubital fossa

Question 21

What are the branches of the brachial artery?

Answer 21

muscular branches

deep artery of the arm (aka profunda brachii)

superior ulnar collateral artery

inferior ulnar collateral artery

Question 22

What forms the periarticular arterial anastomoses of the elbow?

Answer 22

ulnar collaterals

Question 23

What are the boundaries of the cubital fossa?

Answer 23

Superiorly by a line from the medial and lateral epicondyles

Medially, pronator teres

Laterally, brachiradialis

Floor, brachialis and supinator muscles

Roof, brachial and antebrachial fascia, and bicipital aponeurosis

Question 24

What does the brachial artery divide into?

Answer 24

radial artery

ulnar artery

Question 25

What does the ulnar artery turn into? What does that artery branch into?

Answer 25

**common interosseus artery** - branches into anterior and posterior interosseus arteries

Question 26

What are the important features of the radial artery?

Answer 26

medial to brachioradialis throughout the arm readily palpable throughout the forearm travels partly with the superficial branch of the radial nerve

Question 27

What are the important features of the ulnar artery?

Answer 27

deep to the pronator teres palpable between flexor carpi ulnaris and flexor digitorum superficialis tendons travels with ulnar nerve

Question 28

What areteries and nerves are found in the flexor-pronator (anterior) compartment?

Answer 28

radial artery and superficial branch of radial nerve ulnar artery and nerve anterior interosseus artery and nerve median nerve

Question 29

What arteries and nerves are found in the extensor-supinator (posterior) compartment?

Answer 29

posterior interosseus artery and nerve

Question 30

How does the ulnar artery enter the hand?

Answer 30

anterior to flexor retinaculum via the ulnar canal (Guyon canal)

Question 31

How does the radial artery enter the hand?

Answer 31

curves around caphoid and trapezium in the floor of the anatomic snuff box

Question 32

What arteries are found in the superficial palmar arch?

Answer 32

common palmar digital arteries

Question 33

What areteries are found in the deep palmar arch?

Answer 33

palmar metacarpal arteries

Question 34

How do the arteries supply the fingers?

Answer 34

each digit has two paired digital arteries, medial and lateral

Question 35

Why is the internal thoracic artery important?

Answer 35

used for CABG

Question 36

What is thoracic artery syndrome?

Answer 36

when the clavicle and the first rib compress the subclavian artery can be due to congenital abnormalities or hypertrophy of the scalene muscles

Question 37

Why is damage to the lateral part of the arm better than damage to the medial part of the arm?

Answer 37

there are less vessels in the lateral compartment

Question 38

What artery that goes into the hand supplies the superficial arches? What about the deep palmar arches?

Answer 38

ulnar artery - superficial arch radial artery - deep arch

Question 39

Which palmar arch supplies the fingers?

Answer 39

superficial palmar arch

Question 40

What are the deep veins of the upper extremities?

Answer 40

deep veins are thin walled travel with arteries and include: radial vein ulnar vein brachial vein axillary vein

Question 41

What are the superficial veins of the upper extremities?

Answer 41

thick walled and under skin cephalic vein is lateral basilic vein is medial

Question 42

What happens in subclavian stenosis?

Answer 42

due to atherosclerosis common and could be asymptomatic symptoms could include claudication and subclavian steal syndrome

Question 43

Reynauds Disease

Answer 43

episodic vasospastic attacks pallor, cyanosis, rubor ischemic digital ulceration and gangrene

Question 44

work-related vibrational injuries

Answer 44

repetitive use of the palm of the hand damage to the ulnar artery spasm corckscrew sign aneurysm occlusion

Question 45

What are splinter hemorrhages pathopneumonic for?

Answer 45

a more proximal occlusion of the arm