Blood supply to the upper limb

Question 1

Which artery supplies the upper limb and where does it come from?

Answer 1

Subclavian
Right side from brachiocephalic trunk -> divides into right common carotid + right subclavian.
Left side from arch of aorta

Question 2

What does the right subclavian artery pass over and how is it divided?

Answer 2

Scalene triangle over 1st rib
Divided into 3 parts by scalenus anterior:
1st - medial to muscle
2nd - behind muscle 
3rd - lateral to muscle

Question 3

Which vessel arises from the 1st portion of the subclavian artery and what does it contribute to?

Answer 3

Thyrocervical trunk contributes to scapular anastomosis

Question 4

Which vessel arises from the 2nd or 3rd portion of the subclavian artery and what does it contribute to?

Answer 4

Dorsal scapular artery contributes to scapular anastomosis

Question 5

What does the subclavian artery become as it crosses outer border of first rib, how is it divided, where does it end and which vessel does it become?

Answer 5

Axillary artery -> divided into 3 parts by pectoralis minor:
1st - medial to muscle
2nd - behind muscle
3rd - lateral to muscle
First and second associated with brachial plexus.
Ends at lower border of teres major -> brachial artery

Question 6

What are the branches coming off of the 3rd part of the axillary artery?

Answer 6

Subcapsular artery (contributes to subcapsular anastomosis).
Ant/post circumflex humeral arteries -> forms circle around surgical neck of humerus -> risk of fracture.

Question 7

What does the brachial artery supply and how does it divide?

Answer 7

Flexors of arm
Profunda brachii artery is large branch -> accompanies radial nerve in spiral groove -> supplies extensors + contributes to anastomosis around elbow.
Divides in cubital fossa into radial + ulna arteries

Question 8

What can fracture to the humerus cause?

Answer 8

Trauma to profunda brachii artery -> affect blood supply to triceps

Question 9

What is the course and size of the radial artery, what is it covered by and what does it form?

Answer 9

Lateral side of forearm -> winds at wrist around dorsum of hand through anatomical snuff box -> pierces 1st dorsal interosseous muscle -> reaches palmar aspect of hand.
Smaller of two terminal branches
Covered by brachioradialis muscle
Forms deep palmar arch, anastomoses with ulna artery.

Question 10

What is the course of the ulna artery, what is it covered by, what is its branch and what does it form?

Answer 10

Medial side of forearm
Flexor carpi ulnaris muscle
Deep branch - common interosseus artery
Forms superficial palmar arch -> above flexor tendons at hands

Question 11

Outline the venous return of the upper limbs

Answer 11

Drains into axillary vein into subclavian vein.
Deep veins: paired veins + venae comitantes.
Superficial veins: cephalic runs up lateral forearm
basilic runs up medial forearm
both arise from back of hand, from dorsal venous arch.

Question 12

Outline the lymphatic drainage of the upper limbs

Answer 12

Lymph drains to axillary nodes -> beside axillary vein
Cubital nodes -> basilic vein
Deltopectoral node -> cephalic vein