L18 - Vascular supply to the limbs Flashcards
List the arteries in sequence for upper limb supply?
(From Brachiocephaic trunk)
Subclavian artery > Axillary artery > (Branch into) > Brachial artery and Deep brachial artery
Brachial artery > Radial artery/ Ulnar artery/ common interosseous artery > Anterior and posterior interosseous arteries
> Superficial and deep palmar arches > digital aa.
Location and root of Axillary artery?
- Located in the axilla
- Begins at lateral border of 1st rib; ends at lower border of teres major muscle
- Direct continuation of subclavian artery.
What are the 3 parts + branches of the axillary artery?
Subdivided into 3 parts by the pectoralis minor muscle
1) Superior thoracic artery
2) Thoracoacromial artery + Lateral thoracic artery
3) Subscapular artery + Anterior circumflex humeral artery + Posterior circumflex humeral artery
What are the branches from the 1st part of the axillary artery?
none
Just superior thoracic artery without branches
What are the branches from the 2nd part of the axillary artery?
- Thoracoacromial artery gives off:
Pectoral, Deltoid, Acromial and Clavicular branches - Lateral thoracic artery has no branches
What are the branches from the 3rd part of the axillary artery?
1) Subscapular artery gives off:
a) Circumflex scapula artery
b) Thoracodorsal artery
2) Anterior and 3) posterior circumflex humeral arteries encircle the surgical neck of the humerus
What axillary artery branch passes through the Triangular space and the Quadrangular space?
Triangular = circumflex scapular artery from 3rd part Subscapular artery
Quadrangular = Posterior circumflex humeral artery from 3rd part
Both circumflex scapular a. and Posterior circumflex humeral a. anastomose
Give the origin and supply of the superior thoracic artery?
From 1st part of axillary artery
Supply 1st and 2nd ICS
Give the origin and supply of the thoracoacromial artery?
From 2nd part of axillary artery
4 branches to supply
- Subcalvius muscle
- Sternoclavicular joint
- pectoralis major and minor muscles
- anterior deltoid muscle
- dermal sensation overlying the clavipectoral fascia
Give the origin and supply of the lateral thoracic artery?
From 2nd part of axillary artery
Supply pectoral muscles, Serratus anterior, Lateral side of breasts
Which of anterior and posterior circumflex humeral arteries are larger?
Posterior circumflex humeral a.
Give the origin and supply of the Subscapular artery?
From 3rd part of axillary artery
Branch:
- circumflex scapular artery»_space; collateral circulation of the scapula
- Thoracodorsal artery»_space; Latissimus dorsi
Function of arterial anastomoses?
Anastomosing branches allow blood to bypass the blockage in the main artery
Describe the collateral blood supply of the scapula?
Link between beginning and end of axillary artery
Subclavian artery > Thyrocervical trunk branches to give: Supra-scapular artery (for supraspinous fossa) + Transverse cervical artery
Transverse cervical artery > Dorsal scapula artery to supply infraspoinous fossa > anastomoses with circumflex scapular artery > Subscapular artery at 3rd part of Axillary artery
Anastomoses bypasses axillary artyer
Location and root of Brachial artery?
Root = directly continue from axillary artery
Runs between biceps brachii and brachialis, ends just distal to elbow
Location at cubital fossa = Medial to Biceps brachii tendon, Deep to bicipital aponeurosis, Lateral to median nerve
What are the branches of the Brachial artery?
Deep brachial a.
Ulnar a. (Medial branch)
Radial a. (Lateral branch)
What does Deep brachial artery supply?
supplies muscles in the posterior compartment of the arm
Takes part in anastomosis around the elbow joint
What does Ulnar artery supply?
Medial** forearm muscles
Gives off common interosseous artery»_space; Anterior and posterior interosseous arteries»_space; Superficial Palmar Arch (completed by superficial branch of radial artery)
Where to feel pulse of ulnar artery?
Pulse can be palpated in front of wrist, lateral to the flexor carpi ulnaris tendon and the pisiform bone
Where to feel pulse of radial artery?
in front of the wrist lateral to the tendon of flexor carpi radialis, in the anatomical snuffbox.
What does Radial artery supply?
Lateral** forearm muscles
Branches into superficial palmar branch of radial artery + Deep palmar arch (completed by deep branch of ulnar artery)
What forms the superficial and deep palmar arches?
anastomosis of the radial and ulnar arteries
Superficial = Ulnar artery + completed by superficial branch of radial artery
Deep = Radial artery + completed by deep branch of ulnar artery
List the sequence of main arteries of the lower limb?
(From abdominal aorta > Common iliac > External iliac)
Femoral artery gives branches:
Circumflex femoral arteries + Deep femoral artery
Femoral artery > Popliteal artery gives branches:
Peroneal (fibular) artery + Anterior tibial artery + Posterior tibial artery
Posterior tibial a.»_space; Lateral and medial plantar arteries
Anterior tibial a.»_space; Dorsalis pedis artery»_space; Arcuate artery
Root and course of the Femoral artery?
Root = direct continuation of external iliac artery
Start at midway between ASIS and Pubic symphysis
> > travels superficially in femoral triangle
> > pass through Adductor /subsartorial canal in medial aspect of middle thigh
> > pass through Adductor hiatus (a gap in the adductor magnus muscle)
> > Popliteal fossa
> > Popliteal artery
Root and supply of Circumflex femoral arteries?
Root = DEEP femoral artery
Supply: head of femur + 4 branches perforate adductor muscle to supply posterior muscles
Root and supply of Deep femoral artery?
Root = Femoral artery
Supply = thigh muscles
Branches and supply of Deep femoral artery?
medial and lateral circumflex femoral arteries»_space; retinacular arteries for head of femur + 4 perforating arteries for posterior leg muscles
Root, branches and supply of the Genicular artery?
Root = Femoral artery
Branch: saphenous branch and the articular branches of the descending genicular artery
Supply knee joint via Genicular anastomosis linking femoral, popliteal and tibial arteries around knee
Boundaries of the femoral triangle?
- Lateral border = Sartorius
- Medial border = Adductor longus
- Anterior/ Base border = Inguinal ligament
Skin and fascia for cover
Location of Adductor canal?
Medial aspect of middle 1/3 of thigh
Intramuscular space deep to Sartorius that leads to Adductor Hiatus for passage of Femoral A/V
Describe what passes through the femoral triangle?
Femoral V.A.N. from medial to lateral
Describe what passes through the Popliteal fossa?
From Deep to superficial, medial to lateral:
Popliteal artery > Popliteal vein > Tibial nerve
What are the branches of the popliteal artery?
3 branches
Anterior tibial a.
Posterior tibial a.
Peroneal (fibular) artery
Course and supply of the Anterior tibial artery?
Enter anterior compartment of leg via interosseous membrane
Supply anterior muscles of leg
Continue into foot as Dorsalis pedis a.
Where to feel anterior tibial artery pulse?
palpable just above the ankle joint, between tibialis anterior and extensor hallucis longus tendons, midway between the two malleoli
Branches of posterior tibial artery?
Posterior tibial a.
Lateral and medial plantar arteries (at medial of distal leg)
Root and supply of posterior tibial artery?
Root = Popliteal artery
Supply = (with peroneal artery) Posterior leg muscles + (with medial and lateral plantar arteries) Foot
Where to feel pulse of posterior tibial artery?
felt midway between the tip of the medial malleolus and the medial margin of the heel.
Where to feel pulse of Dorsalis pedis?
dorsum of the foot (pressing against the cuneiform bones) just lateral to the tendon of extensor hallucis longus muscle (a muscle that extends the big toe).
Function of Genicular anastomosis?
collateral circulation for the distal part of the limb if the popliteal artery is blocked
List two differences between Deep and superficial veins?
1) Deep veins parallel the arteries of the same name, Superficial veins are found in superficial fascia and externally visible
2) Deep veins drain muscles, bones and joints. Superficial veins drain subcutaneous tissue
Which type of veins is Commonly used for venipuncture and transfusion?
Superficial veins
Explain the connection between deep and superficial veins?
1) superficial and deep veins communicate by perforating (pierce the deep fascia) or communicating veins
2) Valves help direct blood from superficial to deep veins. Valves are present in deep, superficial and communicating veins to direct blood flow back to the heart
3 mechanisms of venous return?
- Valves > unidirectional flow
- Muscular pump > force movement of blood
- Pulsation of Venae comitantes that are adjacent to Medium sized arteries
List the DEEP veins that drain from axillary vein of upper limb to heart?
Deep veins»_space; Axillary vein»_space; Subclavian vein»_space; Brachiocephalic vein > SVC»_space; Right atrium
Describe the SUPERFICIAL venous drainage on the back of hand?
1) Dorsal venous arch > Basilic vein (medial side) > Axillary vein
2) Dorsal venous arch > Cephalic vein (lateral side)> Axillary vein
Cephalic vein and Basilic vein are linked by Median cubital vein @ cubital fossa
Root and End of Basilic Vein?
arises from medial side of dorsal venous network;
joins brachial veins to form the axillary vein.
Root and End of Cephalic Vein?
Cephalic vein: visible at anatomical snuffbox; runs up the lateral side of forearm and arm, joins axillary vein superiorly
List the DEEP veins that drain the lower limbs to heart?
Superficial veins > Deep veins > Femoral vein > External iliac vein > Common iliac vein > IVC > RA
Describe the SUPERFICIAL venous drainage OF THE LOWER LIMB?
1) Dorsal venous arch > Great saphenous vein (MEDIAL, Anterior) > Saphenous opening @ fascia lata lateral and inferior to pubic tubercule > Femoral Vein
2) Dorsal venous arch > Small saphenous vein (LATERAL, Posterior) > Popliteal vein > Femoral vein
2 types of lymphatic systems for draining limbs?
Superficial and Deep
Difference between superficial and deep lymph vessels?
Superficial lymphatic collecting vessels in the subcutaneous tissue travel along superficial veins
Deep lymphatic vessels accompany the deep blood vessels
Give the lymph nodes that drain the upper limbs?
Axillary nodes along axillary vein drains most of arm
Cubital nodes (small group of LN in front of elbow) drains small area @ medial cubital fossa
Give the lymph nodes that drain the Lower limbs?
1) Superficial inguinal lymph nodes:
Horizontal group = along inguinal ligament
Vertical group = along Great saphenous vein
2) Deep inguinal LN: drain most lower limb + lower abdomen below umbilicus + Posterior gluteal region below iliac crest; Around middle inguinal ligament
3) Popliteal LN: in popliteal fossa, along small saphenous vein; drain heel and posterior calf
