Blood vessels: upper limb Flashcards
flow of arteries from subclavian:
axillary -> brachial -> ulnar and radial -> together: superficial and deep palmar arch -> digital arteries
where does subclavian artery become axillary?
lateral margin of rib 1
axillary artery: first part
proximal to insertion of pec major
axillary artery: second part
posterior to pec minor
axillary artery: third part
distal to pec minor
where does axillary artery become brachial artery:
inferior margin of teres major
axillary major branches: 1st part
superior thoracic-> medial/ anterior axilla walls
axillary major branches: 2nd part
thoroco-acromial: pectoral, deltoid, clavicular, acromial branches
lateral thoracic: medial/ anterior axilla walls, female breast
axillary major branches: 3rd part
subscapular:
posterior axilla wall and posterior scapular region -> divides into circumflex scapular aa, thoracodorsal aa
anterior circumflex humeral + posterior circumflex humeral = anastomose
brachial major branches: profunda brachii
supplies posterior com
brachial major branches: humeral nutrient artery
passes into foramen on anteromedial surface of humeral shaft
brachial major branches: radial and middle collateral arteries
branches of profunda brachii
brachial major branches: superior and inferior ulnar collateral
contribute to network around the elbow joint
to remember axillary artery branches:
Send The Lord To Say A Prayer:
- superior thoracic
- thoracoacromial
- lateral thoracic
- subscapular
- anterior circumflex humeral
- posterior circumflex humeral
cords of brachial plexus closely related to which part of axillary artery?
2nd part
list vessels in cubital fossa:
- brachial artery
- radial artery
- ulnar artery
(more info on slide)
major arterial branches in forearm: radial
- radial recurrent : anastomosis at elbow, supplies lateral forearm muscles
- palmar and dorsal carpal branches
- many ‘muscular arteries’
BEST muscles:
- brachioradialis
- extensors
- supinator
- triceps
major arterial branches in forearm: ulnar
- ulnar recurrent: with anterior and posterior branches, cont to anastomosis around elbow
- common interosseous: divides into ant/post branches
JOINS: posterior interosseous (for post com muscles) + anterior interosseous (deep ant and post com) - palmar and dorsal carpal branches (forms arches with radial branches of same name)
- many ‘muscular’ arteries
major branches in hand: radial
- superficial palmar branch
- dorsal carpal branch
- first dorsal metacarpal artery (supplies adjacent sides of index finger and thumb)
- princeps pollicis artery (major supply to thumb)
- radialis indicis artery (for lateral side of index finger from same point of PPA above)
- deep palmar arch: (3 palmar metacarpal arteries, 3 perforating branches that joint the dorsal metacarpal arteries from the dorsal carpal arch)
major branches in hand: ulnar
- superficial palmar arch: palmar digital artery (on medial side of pinky) 3 common palmar digital arteries (joined by palmar metacarpal arteries from deep palmar arch)-> bifurcate into proper palmar digital arteries to the fingers
- deep palmar branch
2 sets of veins:
superficial and deep
features: superficial veins
- lie in superficial fascia
- variable pattern
- do not accompany arteries
features: deep veins
- lie deep to deep fascia
- more valves than superficial veins
- accompany arteries, usually as PAIRS of veins (venae comitantes)
flow of venous drainage from: superficial posterior surface of hand to anterior forearm superficial
dorsal digital - dorsal metacarpal - dorsal venous network (dorsal venous arch) - accessory cephalic/ cephalic/ basilic - brachial/ axillary - subclavian
flow of venous drainage from: superficial anterior hand and forearm
palmar digital - palmar venous plexus - median antebrachial - basilic/ median cubital - brachial - axillary - subclavian
flow of venous drainage from: deep veins in anterior surface of forearm, each paired- palmar metacarpal
palmar metacarpal - palmar deep venous arch - radial - brachial - axillary - subclavian
flow of venous drainage from: deep veins in anterior surface of forearm, each paired- proper palmar digital
proper palmar digital - common palmar digital - superficial palmar venous arch - ulnar - brachial - axillary - subclavian
superficial lymphatics found:
skin and subcutaneous tissue
deep lymphatic vessels:
accompany deep arteries and veins
superficial and deep lymphatics drain into lymphatic trunks:
- lumbar,
- intestinal,
- bronchomediastinal
- subclavian
- jugular
lymphatic trunks drain into:
thoracic duct, right lymphatic duct
what drains into thoracic duct:
body inferior to diaphragm and LHS body superior to diaphragm.
- from L2 -> left subclavian vein
what drains into right lymphatic duct:
all right side superior to diaphragm.
- into right subclavian vein
main lymph nodes (7):
- cervical
- axillary
- popliteal
- inguinal
- thoracic
- abdominal
- GIT
list first 3 axillary groups of lymph nodes
- pectoral
- subscapular
- humeral
lymph node: pectoral
medial wall: drain anterior thoracic wall, breast
lymph node: subscapular
posterior: drain posterior thorax and scapula
lymph node: humeral
lateral wall: drains upper limb except vessels near cephalic vein
first 3 lymph nodes drain into:
- central: deep to pec major
then-
- apical: drains vessels around cephalic vein
apical lymph nodes drain to:
subclavian lymphatic trunks - right lymphatic duct and thoracic duct
right apical nodes to:
R subclavian trunk - right lymphatic duct. joins blood vessels at junction of R subclavian and R internal jugular veins at root of neck
left apical nodes to:
L subclavian trunk - thoracic duct at base of neck. joins blood vessels at junction of L subclavian and L internal jugular veins at root of neck
most imaging of upper limb blood vessels via: function
ultrasound:
- detects anatomical variants
- can measure blood flow
angiography:
also performed:
- x-ray of blood vessels seen through injection of dye to outline vessels on x-ray
