Main peripheral arteries and veins (neck, upper and lower limb) Flashcards
Common carotid arteries (origin, course)
- Right common carotid arises from the brachiocephalic trunk behind the right sternoclavicular joint
- Left common carotid arises directly from the arch of the aorta in the superior mediastinum
- Runs upwards through the neck to the upper border of the thyroid cartillage -> divides into external and internal carotid arteries
- Embedded in the carotid sheath throughout its course. Internal jugular vein lies laterally, vagur nerve lies posterolaterally
What are the contents of the carotid sheath
I see 10 CCs in the IV
* Internal carotid artery
* Vagus nerve (CN 10)
* Common carotid artery
* Internal jugular vein
Internal and external carotid artery (course, supplies)
Internal carotid:
* Arises at bifurcation of common carotid into internal and external at the level of the upper border of the thyroid cartillage
* No branches in the neck
* Enters skull through carotid canal in petrous part of the temporal bone
* Major blood supply to the intracranial contents
External carotid:
* Main blood supply to head and neck (structures external to skull)
Internal jugular vein (origin, course, surface anatomy, bulbs, valves)
- Origin: continuation of sigmoid sinus at the jugular foramen in the skull
- Continues in the carotid sheath (internal carotid lies medially, vagus nerve lies posteriolaterally)
- Joins the subclavian vein to form the brachiocephalic vein
- Surface anatomy: extends from earlobe to sternoclavicular joint
- Dilatations at the beginning and end are known as the superior and inferior bulbs, respectively. There is a bicuspid valve immediately above the inferior bulb
Axillary artery (origin, termination, branches)
- Origin: subclavian artery becomes axillary artery at the lateral border of the first rib
- Terminates at inferior border of teres major -> brachial artery
- Three parts (see diagram), second part lies under pectoralis minor
- Supplies thoracic wall and shoulder region
Branches (Some Times Life Seems A Pain)
* Superior thoracic
* Thoracoacromial
* Lateral thoracic
* Subscapular
* Anterior circumflex humeral
* Posterior circumflex humeral
Brachial artery
- Origin: continuation of axillary artery at the lower border of teres major
- Terminates opposite the neck of the radius (-> radial and ulna arteries. The ulnar is larger)
- Closely related to the median and ulna nerves and the basilic vein
Branches:
1. Profunda artery
2. Superior and inferior ulnar collateral arteries
3. Nutrient artery to the humerus
Radial artery
Smaller terminal branch of the brachial artery
Course:
* Lies on the radius along the medial border of brachioradialis
* Then lies superficially on anterior aspect of radius between tendons of brachioradialis laterally and flexor carpi radialis medially. Covered only with skin and superficial fascia: radial pulse can easily be felt
* Winds around the lateral aspect of the radius in the anatomical snuffbox
* Terminates in deep palmar arch
Main branches
1. Radial recurrent
2. Muscular
3. Superficial palmar branch
Ulnar artery
- Larger terminal branch of the brachial artery
- Enters the wrist superficial to the flexor retinaculum, ending in the superficial palmar arch
- Acccompanies the ulna nerve, which lies medially
Branches:
1. Common interosseous (-> anterior and posterior branches)
2. Anterior and posterior ulnar recurrent arteries
3. Branches taking part in arterial anastomosis around elbow and wrist joints
Describe the contents and borders of the anatomical snuffbox
A skin depression distal to the styloid process of radius
Boundaries
* Medial: tendon of extensor pollicis longus
* Lateral: tendons of abductor pollicis longus and extensor pollicis brevis
* Floor: scaphoid and trapezium bones
Radial artery lies on the floor
Describe the venous drainage of the upper limb (general)
Superficial veins: Used for venepuncture, catheterisation
* Cephalic vein
* Basilic vein
Deep veins i.e. vena comitantes, accompany the larger arteries and axillary vein
Cephalic vein (origin, course)
- Originates from dorsal network of hand veins
- Runs on radial aspect of forearm in superficial fascia
- Near the elbow, receives the median cubital vein (which communicates with the basilic)
- Ascends lateral to biceps brachii in the arm
- Terminates in the axillary vein
Basilic vein (origin, course)
- Origin: dorsal network of hand veins
- Runs on ulnar aspect of the of forearm in the superficial fascia
- Near elbow, receives the median cubital vein (which communicates with the cephalic vein
- Ascends medial to biceps brachii in the arm, pierces the deep fascia
- At **lower border of teres major **joins the two brachial veins (accompanying the brachial artery) to continue as the axillary vein
NB used for introduction of cardiac catheters for angiography as is directly in line with the acillary artery
Axillary vein (origin, course)
- Formed at lower border of teres major by the union of the basilic vein and venae comitantes of brachial artery
- Runs upwards, medial to the axillary artery
- Ends at lateral border of first rib -> subclavian vein
Common, internal and external iliac arteries
Common iliac artery
* terminal branch of abdominal aorta at level of L4
* -> divides into internal and external iliac arteries in front of sacroiliac joint at the pelvic inlet
Internal iliac artery
* major vessel supplying the pelvic organs
* also supplies genitalia, body wall, gluteal muscles, small part of lower limb
External iliac
* Ends as the femoral artery in the thigh after passing under the inguinal ligament
* Branches: inferior epigastric and deep circumflex iliac branches
Femoral artery (origin, course, branches)
- Origin: continuation of external iliac artery, beginning as it emerges under the inguinal ligament
- Lies in femoral triangle (femoral nerve lies laterally, femoral vein lies medially)
- Ends at the opening in the adductor magnus muscle to enter the popliteal fossa as the popliteal artery
Branches:
* Superior epigastric
* Superior circumflex iliac artery
* Superficial and deep external pudendal arteries
* Profunda femoris artery
* Descending genicular artery
Describe the veins of the lower limb (general)
Can be divided into:
* Deep veins: venae comitantes, which accompany the arteries - anterior and posterior tibial veins, popliteal vein, femoral vein
* Superficial veins: great saphenous and small saphenous, located in the superficial fascia
* Perforating veins: communicating vessels between superficial and deep veins, mostly around ankle and medial side of lower part of leg. Contain valves to prevent blood flow from deep to superficial
Great and small saphenous veins
Great saphenous vein
* Longest vein in body
* Originates from dorsal venous arch on medial side of dorsum of foot
* Ascends medially in the leg and thigh
* Terminates in the femoral vein in the femoral triangle, below and lateral to pubic tubercle
Small saphenous vein
* Originates from the venous arch on the lateral side of the dorsum of the foot
* Passes posterior to lateral malleolus, ascends up posteiror surface of the leg and thigh
* Terminates in **popliteal vein **behind knee
Femoral vein (origin, course,
- Tibial vein -> popliteal vein -> femoral vein
- Enters the thigh through an opening in the adductor magnus muscle
- Initially lies lateral to the femoral artery, then posteriorly, then medial
- Lies medial to femoral artery in the femoral sheath, and receives the great saphenous vein and other veins which accompany the fmeoral artery
- Passes below the inguinal ligament -> continues as the external iliac vein
