Upper Extremity Angiology Flashcards

1
Q

Internal thoracic artery path

A

Travels inferiorly to supply the posterior aspect of the anterior thoracic wall

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2
Q

Suprascapular artery path

A

Travels through suprascapular notch over the transverse scapular ligament to the posterior aspect of scapula to supply supraspinatus and infraspinatus muscles

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3
Q

Transverse cervical artery path

A

Travels posteriorly across neck, branches into deep and superficial branches (if no branching, it travels to deep surface of trapezius)
Superficial branch- travels with spinal accessory nerve along deep surface of trapezius
Deep branch- if present, replaces dorsal scapular artery traveling along medial border of scapula supplying levator scapulae and rhomboid muscles

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4
Q

When does the subclavian artery become the axillary artery

A

Once it is distal to the first rib

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5
Q

Superior thoracic path

A

Branches off axillary artery, travels to thoracic wall, supplies 1st and 2nd intercostal spaces and superior portion of serratus anterior

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6
Q

Axillary aneurism

A

Region one of the axillary artery is susceptible to aneurysm in individuals experience repeated rapid arm movements (pitchers) and can compress the brachial plexus, resulting in pain and loss of sensation

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7
Q

Thoracoacromial trunk branches and what they supply

A

Pectoral, acromial, clavicular and deltoid branches

Supplies pectoralis major/minor, deltoid, acromion and clavicle

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8
Q

Lateral thoracic artery path

A

Branches off axillary, travels along lateral border of pectoralis minor, supplying pectoralis major/minor, serratus anterior and intercostal muscles

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9
Q

Subscapular artery branches/path

A

Distal to pectoralis minor, proximal to teres major
Branches into circumflex scapular and thoracodorsal
CS travels around lateral border of scapula, visible in triangular space, into infraspinous fossa to contribute to scapular anastomosis.
Thoracodorsal supplies latissimus dorsi

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10
Q

Anterior/posterior circumflex humeral

A

ACH- smaller, supplies glenohumeral joint and head of humerus
PCH- visible in quadrangular space, supplies surround musculature and glenohumeral joint

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11
Q

If you wanted to cut off all circulation to the arm, ligation of the axillary artery must occur where, and why

A

Ligation must be distal to the subscapular artery of the axillary artery. Due to extensive anastomosis in the scapula, ligation of axillary artery b/w thoracoacromial trunk and subscapular artery results in reversal of blood flow in the subscapular artery and continued feed of arterial blood to the brachial artery

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12
Q

When does axillary artery become brachial artery

A

Distal to the teres major

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13
Q

Deep brachial artery path

A

Branches from brachial A. just distal to teres major, travels with radial nerve around the humerus, branches into middle collateral and radial collateral arteries

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14
Q

Middle collateral artery

A

Branches off of deep brachial artery, travels posterior to lateral humeral epicondyle, anastomosis w/recurrent interosseous A. from ulnar A.

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15
Q

Radial collateral artery

A

Branches off brachial artery, travels anterior to lateral humeral epicondyle, anastomosis with radial recurrent A.

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16
Q

Humeral nutrient artery

A

Branch of brachial artery, supplies humerus

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17
Q

Superior ulnar collateral artery

A

Branch of brachial artery

Travels with ulnar nerve behind medial epicondyle where it anastomosis with posterior ulnar recurrent A.

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18
Q

Inferior ulnar collateral artery

A

Branch of brachial artery

Travels anterior to medial epicondyle and anastomosis with anterior ulnar recurrent artery

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19
Q

Ulnar artery

A

Terminal branch of brachial A., forms in cubital fossa
Descends through antebrachium supplying mostly flexors, enters hand over flexor retinaculum, terminates as superficial palmar arch and deep palmar branch

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20
Q

Anterior/posterior ulnar recurrent

A

Branch off ulnar, travel superiorly through arm, anterior branch goes anterior to medial epicondyle and anastomosis with inferior ulnar collateral, posterior branch goes posterior to medial epicondyle and anastomosis with superior ulnar recurrent

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21
Q

Common interosseous artery

A

Branches off ulnar artery, then branches into anterior and posterior interosseous arteries

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22
Q

Anterior interosseous artery

A

Branches off common interosseous, travels anterior to interosseous membrane, perforates membrane and supplies deep posterior forearm muscles, replaces posterior interosseous artery just proximal to wrist and then feeds into dorsal carpal arch

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23
Q

Posterior interosseous artery

A

Branches off common interosseous, produces interosseous recurrent artery and then receives anterior interosseous artery and terminates into dorsal carpal arch
Interosseous recurrent- travels superiorly, behind medial epicondyle, anastomosis with middle collateral artery

24
Q

Palmar carpal branch of ulnar artery

A

Travels along anterior wrist, anastomosis with palmar carpal branch of radial artery to produce palmar carpal arch

25
Q

Dorsal carpal branch of ulnar artery

A

Travels laterally around wrist into dorsal aspect to anastomosis with dorsal carpal branch of radial artery to produce dorsal carpal arch

26
Q

Dorsal carpal arch

A

Formed from the two dorsal carpal branches and the anterior interosseous artery
Forms dorsal metacarpal arteries which join with perforating branches of deep palmar arch to form digital arteries supplying medial side of digit 2 and both sides of 3,4,5

27
Q

Superficial palmar arch

A

Continuation of ulnar artery
Supplies medial side of digit 2 and all of 3,4,5
Communicates with palmar branch of radial artery
Gives rise to palmar metacarpal and digital arteries

28
Q

Deep palmar branch of ulnar artery

A

Feeds into deep palmar arch (which is principally supplied by radial artery)

29
Q

Radial artery

A

Smaller of the terminal branches of brachial artery
Branches in cubital fossa
Descends through antebrachium supplying flexors and extensors of forearm, travels through anatomical snuff box and then posteriorly around thumb, then anteriorly to enter palm and terminate as deep palmar arch

30
Q

Radial recurrent artery

A

Travels superiorly anterior to lateral epicondyle where it anastomosis with radial collateral artery

31
Q

Palmar carpal branch of radial artery

A

Anastomoses with palmar carpal branch of ulnar artery to form palmar carpal arch

32
Q

Dorsal carpal branch

A

Travels laterally around wrist to anastomosis with dorsal carpal branch of ulnar artery to form dorsal carpal arch

33
Q

Palmar branch of radial artery

A

Feeds into superficial palmar arch, which is principally supplied by ulnar artery

34
Q

Dorsalis pollicis artery

A

Arises from radial artery at base of 1st metacarpal, travels along lateral aspect of thumb

35
Q

1st dorsal metacarpal artery

A

Branch of radial artery, supplies adjacent sides of 1st and 2nd digits

36
Q

Princeps pollicis artery

A

Branch of radial artery, travels along medial aspect of thumb

37
Q

Radialis indicis artery

A

Arises from radial artery or princeps pollicis artery

Travels along lateral aspect of 2nd digit

38
Q

Deep palmar arch

A

Continuation of radial artery, communicates with deep palmar branch of ulnar artery, produces palmar metacarpal and perforation branches

39
Q

Subclavian vein

A

Continuation of axillary vein proximal to the 1st rib, forms brachiocephalic vein with the internal jugular vein

40
Q

Axillary vein

A

Formed in the medial brachium when multiple brachial veins unite with superficial basilic vein

41
Q

Cephalic vein

A

Drains dorsal venous network (from dorsum of hand), communicates with basilic vein via median cubital vein
Travels in deltopectoral groove, traverses clavipectoral triangle, empties into axillary vein

42
Q

Median cubital vein

A

Connects basilic and cephalic veins
Overlies bicipital aponeurosis
Most common site of venipuncture because of its superficial location

43
Q

Brachial veins

A

Multiple anastomosing vessels that accompany brachial artery

Drains ulnar, radial, posterior and anterior interosseous veins, unites with basilic vein to form axillary vein

44
Q

Ulnar vein

A

Accompany ulnar artery, drains superficial and deep palmar venous arches and empty into brachial veins

45
Q

Basilic vein

A

Drains dorsal venous network of hand and median antebrachial vein (drains anterior aspect of forearm), forms axillary vein after uniting with brachial veins

46
Q

Thoracic duct

A

Originates as chyle cistern in the abdomen
Drains lymph from lower extremeties, abdomen, pelvis, left half of thorax, left upper extremity and left side of head and neck superiorly
In thorax it drains subclavian lymphatic trunk and bronchomediastinal trunk

47
Q

Left Subclavian lymphatic trunk

A

Receives drainage from lymphatic plexuses of upper extremity, empties into thoracic duct

48
Q

Right lymphatic duct

A

Drains right subclavian lymphatic trunk and bronchomediastinal trunk
Empties into brachiocephalic vein

49
Q

Cubital lymph nodes

A

Proximal to medial humeral epicondyle and medial to basilic vein, communicate with humeral axillary nodes

50
Q

Axillary lymph nodes

A
Five groups of nodes in the axilla
Pectoral
Subscapular
Humeral axillary
Central axillary
Apical axillary
51
Q

Pectoral axillary lymph nodes

A

Receive lymph from breast and lateral thoracic wall

52
Q

Subscapular axillary lymph nodes

A

Receive lymph from posterior thoracic wall and scapular region

53
Q

Humeral axillary lymph nodes

A

Receive lymph from nearly the whole upper extremity, except the lymph vessels accompanying the cephalic vein, which empty into clavicular nodes

54
Q

Central axillary lymph nodes

A

Receives lymph from pectoral, subscapular and humeral axillary nodes

55
Q

Apical axillary nodes

A

Receives lymph from central axillary nodes

56
Q

Deltopectoral lymph nodes

A

Lie near the cephalic vein at the clavipectoral triangle

57
Q

Importance of axillary lymph nodes

A

They are frequently invaded by cancer cells from elsewhere in the body, usually breast cancer