UE Angiology Flashcards
Where does the subclavian A originate?
On the right side from the brachiocephalic trunk
On the left side it branches directly off the aortic arch
What are the three regions of the subclavian A?
- Proximal to the anterior scalene M
- Deep to anterior scalene
- Distal to the anterior scalene M and proximal to 1st rib
Which branches are in the first region of the subclavian A?
Vertebral and internal thoracic
Thyrocervical trunk*
What are the branches of the thyrocervical trunk?
Inferior thyroid, suprascapular, transverse cervical artery (branches into superficial and deep branches)
What does the suprascapular A supply?
Travels through the suprascapular notch over the transverse scapular L to the posterior aspect of the scapula to supply the supraspinatus and infraspinatus M
What are the branches of region two of the subclavian A?
Costocervical trunk giving a supreme intercostal and deep cervical A
What branches are in the third region of the subclavian A?
Dorsal scapular A
What is the axillary A a continuation of?
The subclavian A distal to the first rib
Divided into three regions by the pectoralis minor
What are the three regions of the axillary A?
- Distal to the 1st rib and proximal to pec minor
- Deep to pec minor
- Distal to pec minor and proximal to teres major
What branches are in the first region of the axillary A?
Superior thoracic A
Supplies the superior most serratus anterior M
Which branches are in the second region of the axillary A?
Thoracoacromial trunk and lateral thoracic A
What does the thoracoacromial trunk of the axillary A supply?
Pectoralis major and minor + deltoid
What does the lateral thoracic A of the axillary A supply?
Pectoralis major and minor, serratus anterior and intercostal muscles
Which arteries are in region 3 of the axillary A?
Subscapular A + anterior and posterior circumflex humeral,
What are the two terminal branches of the subscapular A of the axillary A?
Circumflex scapular A and thoracodorsal A
Which region of the axillary A is susceptible to anuerysm?
Region one especially in individuals experiencing repeated rapid arm movements (like baseball pitchers) and can compress the brachial plexus resulting in pain and loss of sensation
What supplies the deltoid muscle?
Posterior circumflex humeral A from region 3 of the axillary A
Due to the extensive anastomoses around the scapula, where must ligation occur to cut off all blood supply to the arm?
Distal to the subscapular A of the axillary A
Ligation of the axillary A between the thyrocervical trunk and subscapular A results in what?
A reversal of blood flow in the subscapular A due to collateral circulation arriving via suprascapular, transverse cervical and intercostal A to the scapular region and continued feed of arterial blood to the brachial A
The anterior circumflex humeral is always what compared to the posterior circumflex humeral A?
Smaller
What is the brachial A a continuation of?
The axillary A distal to the teres major muscle beginning medial to the humerus
What are the branches of the brachial A?
Deep brachial, muscular branches, humeral nutrient A, superior and inferior ulnar collateral, ulnar A and radial A
Which arteries contribute to the scapular anastomosis?
Suprascapular A, circumflex scapular A and dorsal scapular A
What are the two terminal branches of the brachial A?
Radial and ulnar A
What does the deep brachial A run with?
Radial N
What does the deep brachial A supply?
Posterior brachial muscles
The deep brachial A terminates as two arteries that feed into what?
The elbow anastomosis including middle and radial collateral arteries
What does the muscular branch of the brachial A supply?
Muscles of the anterior brachial compartment
What does the ulnar branch of the brachial A supply?
Most of the flexor muscles of the forearm
What are the branches of the thoracoacromial trunk?
Pectoral, deltoid, acromion and clavicular branches
What does the anterior interosseous A (of common interosseous of brachial A) supply?
Sends perforating branches through the interosseous membrane to supply deep muscles of the posterior forearm
Which arteries form the elbow anastomosis?
Superior and inferior ulnar collateral, middle collateral and radial collateral A
The superior ulnar collateral A runs with which structure?
Ulnar N
What does the radial collateral A anastomosis with?
Radial recurrent A of the radial A
What does the middle collateral A anastomosis with?
Interosseous recurrent A of the ulnar A
What does superior ulnar collateral A anastamosis with?
Posterior ulnar recurrent A of the ulnar A
What does inferior ulnar collateral A anastomosis with?
Anterior ulnar recurrent A of the ulnar A
What structure is the most common site for venipuncture?
Median cubital vein because of its superficial location and the protection of underlying deep structures by the bicipital aponeurosis
Why are the axillary LNs important?
Due to their frequent invasion by cancer cells from elsewhere in the body (usually breast)
What are the branches of the ulnar A?
Anterior and posterior ulnar recurrent A, common interosseous A (branches into posterior and anterior interosseous), palmar and dorsal carpal branch
What forms the palmar carpal arch?
Palmar carpal branch of ulnar A travels anteriorly to the wrist and anastomoses with the palmar carpal branch of the radial A to form the palmar carpal arch
What forms the dorsal carpal arch?
Dorsal carpal branch of ulnar and radial A + anterior interosseous A
Gives rise to four dorsal metacarpal arteries —> dorsal digital As
What forms the deep palmar arch?
Mostly radial A with some contribution from ulnar A
What forms the superficial palmar arterial arch?
Mostly the ulnar A with a small contribution from radial A
What do the superficial and deep arches form?
Palmar Metacarpal As —> common palmar digital A —> proper palmar digital As
What is the princeps pollicis A?
Branch from the deep palmar arterial arch that travels to the thumb on the palmar side of the hand
Can branch into radialis indicis which travels along the index finger on the radial side
What branches does the radial A form when it goes posteriorly around the thumb on the dorsal side of the hand?
Dorsal pollicis and 1st dorsal metacarpal A
What does the radial artery supply?
1/2 of index finger to thumb
Remainder is ulnar A
What is the subclavian vein?
Continuation of the axillary V proximal to 1st rib
Forms the brachiocephalic vein with the internal jugular
What is the axillary vein?
Formed in the medial brachium when the brachial veins unite with the superficial basilic vein
Branches into cephalic, brachial and basilic veins
What is the dorsal venous network?
Superficial venous plexus on the dorsum of the hand
Feeds medially into the basilic vein and laterally into the cephalic vein
What is the communication for basilic and cephalic veins?
Median cubital vein which is superficial to the bicipital aponeurosis
Basilic vein forms what?
Forms the axillary vein by uniting with brachial veins
What forms the brachial veins?
Deep veins of the UE including ulnar, radial, posterior interosseous and anterior interosseous veins
Describe the cephalic vein
Drains into the dorsal venous network and traverses the clavipectoral triangle to empty into the axillary V
