Blood Supply to the Upper Limb Flashcards
State the major blood supply to the upper limbs
The subclavian arteries :
- Starts at the brachiocephalic trunk (right) and aortic arch (left)
- Finishes at the lateral border of the 1st rib
- Becomes the axillary artery
Describe the extent of the axillary artery
Extends from the lateral border of the 1st Rib to the inferior border of Teres major, where it becomes the brachial artery
Describe the parts of the axillary artery
Split into 3 parts
1st before pec. minor : 1 branch
2nd behind pec. minor : 2 branches
3rd after pec. minor : 3 branches
Mnemonic to remember branches of the axillary artery
Screw The Lawyer
Save A Patient
State the branches of the axillary artery
Superior Thoracic
Thoraco-acromial
Lateral thoracic
Subscapular
Anterior circumflex humeral
Posterior circumflex humeral
Name the scapular anastomosis
Suprascapular artery
Subscapular artery
Dorsal scapular artery
Describe the extent of the brachial artery
Starts at the lower border of the Teres Major
Ends at its bifurcation anterior to the elbow to give the ulnar and radial arteries.
State the branches of the brachial artery
Profunda Brachii
Superior Ulnar collateral
Inferior Ulnar collateral
Describe the ulnar and radial arteries
Variable bifurcation
Ulnar is larger and deeper than the radial
Both have recurrent branches –> Elbow anastomosis
Radial, anterior in the forearm
- dorsally in the wrist
Ulnar remains anterior into the hand
What are the interosseous arteries ?
Ulnar artery quickly gives a branch
Common interosseous
- Anterior interosseous
- Posterior interosseous
Describe arteries of the wrist
Radial artery on the lateral side
Ulnar nerve and artery on the medial side
Neither enters the carpal tunnel
Radial passes posteriorly to the carpal bones
Ulnar passes anterior (superficial) to the flexor retinaculum
Describe branches of wrist arteries
Radial and Ulnar have palmar and dorsal carpal branches
Dorsal and Palmar carpal arches
Describe scaphoid fractures
Blood supply from distal to proximal
Fracture can cause avascular necrosis
Describe the superficial arteries of the hand
Ulnar enters hand and gives off the deep branch, continuing as superficial branch, which creates the superficial palmar arch.
The superficial palmar arch meets the superficial palmar branch of radial
State the branches of the superficial palmar arch
The arch gives off 3 common palmar digital arteries, each of which divides into 2 proper palmar digital arteries.
Describe the deep arteries of the hand
The radial artery passes posteriorly on the scaphoid and trapezium.
It re-enters the palmar surface through the 1st dorsal interosseous muscles.
It forms the deep palmar arch, anastomosing with deep branch of ulnar.
State the branches of the deep palmar arch
The deep palmar arch gives palmar metacarpal arteries which anastomose with common palmar arteries.
Describe the relevance of hand anastomoses
Good collateral supply around highly moveable joints
Hand arterioles are very important for thermal regulation
Describe venous drainage of the upper limbs
Deeps veins follow arterial supply (mostly) - venae comitantes
The brachial veins ( joined by the basilic vein at the lower border of teres major.) coalesce into the axillary vein.
Describe the superficial veins of the upper limb
Dorsal venus network gives cephalic and basilica veins
Describe the central venus system in the axilla
Veins are more numerous and variable than arteries
Frequent anastomoses
Axillary vein also receives some body wall veins from the lower abdomen.
What is the cubital fossa ?
The area where the cephalic and basilic veins are joined/ linked anterior to the elbow, by the median cubital vein.
What vein is used in venupunture ?
The median cubital vein
State some general rules of lymphatics of the upper limbs
Superficial lymphatic drainage runs alongside the veins.
Superficial lymphatics from the lateral limb go alongside the cephalic, and the medial side go alongside the basilic.
Deep drainage :
Deep veins –> Lateral –> Apical
