Blood Supply of the Upper Extremity Flashcards
What structures does the innominate artery supply?
innominate artery = brachiocephalic trunk
the right subclavian artery (SCA) and right common carotid artery
Based ib tge abteruir scalene muscle, what are the three segments of the subclavian artery?
1st part: medial to anterior scalene
2nd part: posterior to anterior scalene
3rd part: lateral to anterior scalene
Name the branches in the first part of the subclavian artery.
vertebral artery
internal thoracic artery
thyrocervical trunk
What does the thyrocervical trunk branch off into?
inferior thyroid artery and suprascapular artery (supplies blood to the posterior scapula)
What does the second part of the subclavian artery give rise to?
costocervical trunk - arises posteriorly and supplies the first two intercostals and deep cervical muscles
What does the third part of the subclavian artery give rise to?
dorsal scapular artery
may arise from transverse cervical artery
supplies levator scapulae and rhomboid muscles
What makes up the thoracic outlet?
subclavian artery - posterior to the anterior scalene muscle
subclavian vein - anterior to the anterior scalene muscle
Where does the axillary artery begin?
the lateral border of the first rib
Where does the axillary artery end?
inferior border of the teres major
How many parts are the axillary artery divided into? How many branches are tehre in each part?
1st part - one branch
2nd part - two branches
3rd part - three branches
Where are the divisions for each part of the axillary artery?
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
What arteries branch from the first part of the axillary artery?
superior thoracic artery
What arteries branch from the second part of the axillary artery?
thoracoacromal artery and lateral thoracic artery
What are the arteries that branch from the third part of the axillary artery?
anterior circumflex humeral artery
posterior circumflex humeral artery
subscapular artery
What does the superior thoracic artery supply?
the 1st and 2nd intercostal spaces and superior part of serratus anterior
What are the branches of the thoracoacromial artery?
pectoral
deltoid
acromial
clavicular
What does the lateral thoracic artery supple?
supplies lateral aspect of breast, serratus anterior, and pectoralis
What does the subscapular artery branch into?
circumflex scapular artery
thoracodorsal artery
What is the role of the subscapular artery?
provides a rich collateral network around scapula between the circumflex humerals and acromial branch of the thoracoacromial artery
Where does the brachial artery begin and end?
begins at the inferior border of teres major
ends in the cubital fossa
What are the branches of the brachial artery?
muscular branches
deep artery of the arm (aka profunda brachii)
superior ulnar collateral artery
inferior ulnar collateral artery
What forms the periarticular arterial anastomoses of the elbow?
ulnar collaterals
What are the boundaries of the cubital fossa?
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
What does the brachial artery divide into?
radial artery
ulnar artery
What does the ulnar artery turn into? What does that artery branch into?
common interosseus artery - branches into anterior and posterior interosseus arteries
What are the important features of the radial artery?
medial to brachioradialis throughout the arm
readily palpable throughout the forearm
travels partly with the superficial branch of the radial nerve
What are the important features of the ulnar artery?
deep to the pronator teres
palpable between flexor carpi ulnaris and flexor digitorum superficialis tendons
travels with ulnar nerve
What areteries and nerves are found in the flexor-pronator (anterior) compartment?
radial artery and superficial branch of radial nerve
ulnar artery and nerve
anterior interosseus artery and nerve
median nerve
What arteries and nerves are found in the extensor-supinator (posterior) compartment?
posterior interosseus artery and nerve
How does the ulnar artery enter the hand?
anterior to flexor retinaculum via the ulnar canal (Guyon canal)
How does the radial artery enter the hand?
curves around caphoid and trapezium in the floor of the anatomic snuff box
What arteries are found in the superficial palmar arch?
common palmar digital arteries
What areteries are found in the deep palmar arch?
palmar metacarpal arteries
How do the arteries supply the fingers?
each digit has two paired digital arteries, medial and lateral
Why is the internal thoracic artery important?
used for CABG
What is thoracic artery syndrome?
when the clavicle and the first rib compress the subclavian artery
can be due to congenital abnormalities or hypertrophy of the scalene muscles
Why is damage to the lateral part of the arm better than damage to the medial part of the arm?
there are less vessels in the lateral compartment
What artery that goes into the hand supplies the superficial arches? What about the deep palmar arches?
ulnar artery - superficial arch
radial artery - deep arch
Which palmar arch supplies the fingers?
superficial palmar arch
What are the deep veins of the upper extremities?
deep veins are thin walled
travel with arteries and include:
radial vein
ulnar vein
brachial vein
axillary vein
What are the superficial veins of the upper extremities?
thick walled and under skin
cephalic vein is lateral
basilic vein is medial
What happens in subclavian stenosis?
due to atherosclerosis
common and could be asymptomatic
symptoms could include claudication and subclavian steal syndrome
Reynauds Disease
episodic vasospastic attacks
pallor, cyanosis, rubor
ischemic digital ulceration and gangrene
work-related vibrational injuries
repetitive use of the palm of the hand
damage to the ulnar artery
spasm
corckscrew sign
aneurysm
occlusion
What are splinter hemorrhages pathopneumonic for?
a more proximal occlusion of the arm