Upper Extremity Angiology Flashcards
Internal thoracic artery path
Travels inferiorly to supply the posterior aspect of the anterior thoracic wall
Suprascapular artery path
Travels through suprascapular notch over the transverse scapular ligament to the posterior aspect of scapula to supply supraspinatus and infraspinatus muscles
Transverse cervical artery path
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
When does the subclavian artery become the axillary artery
Once it is distal to the first rib
Superior thoracic path
Branches off axillary artery, travels to thoracic wall, supplies 1st and 2nd intercostal spaces and superior portion of serratus anterior
Axillary aneurism
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
Thoracoacromial trunk branches and what they supply
Pectoral, acromial, clavicular and deltoid branches
Supplies pectoralis major/minor, deltoid, acromion and clavicle
Lateral thoracic artery path
Branches off axillary, travels along lateral border of pectoralis minor, supplying pectoralis major/minor, serratus anterior and intercostal muscles
Subscapular artery branches/path
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
Anterior/posterior circumflex humeral
ACH- smaller, supplies glenohumeral joint and head of humerus
PCH- visible in quadrangular space, supplies surround musculature and glenohumeral joint
If you wanted to cut off all circulation to the arm, ligation of the axillary artery must occur where, and why
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
When does axillary artery become brachial artery
Distal to the teres major
Deep brachial artery path
Branches from brachial A. just distal to teres major, travels with radial nerve around the humerus, branches into middle collateral and radial collateral arteries
Middle collateral artery
Branches off of deep brachial artery, travels posterior to lateral humeral epicondyle, anastomosis w/recurrent interosseous A. from ulnar A.
Radial collateral artery
Branches off brachial artery, travels anterior to lateral humeral epicondyle, anastomosis with radial recurrent A.
Humeral nutrient artery
Branch of brachial artery, supplies humerus
Superior ulnar collateral artery
Branch of brachial artery
Travels with ulnar nerve behind medial epicondyle where it anastomosis with posterior ulnar recurrent A.
Inferior ulnar collateral artery
Branch of brachial artery
Travels anterior to medial epicondyle and anastomosis with anterior ulnar recurrent artery
Ulnar artery
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
Anterior/posterior ulnar recurrent
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
Common interosseous artery
Branches off ulnar artery, then branches into anterior and posterior interosseous arteries
Anterior interosseous artery
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
Posterior interosseous artery
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
Palmar carpal branch of ulnar artery
Travels along anterior wrist, anastomosis with palmar carpal branch of radial artery to produce palmar carpal arch
Dorsal carpal branch of ulnar artery
Travels laterally around wrist into dorsal aspect to anastomosis with dorsal carpal branch of radial artery to produce dorsal carpal arch
Dorsal carpal arch
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
Superficial palmar arch
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
Deep palmar branch of ulnar artery
Feeds into deep palmar arch (which is principally supplied by radial artery)
Radial artery
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
Radial recurrent artery
Travels superiorly anterior to lateral epicondyle where it anastomosis with radial collateral artery
Palmar carpal branch of radial artery
Anastomoses with palmar carpal branch of ulnar artery to form palmar carpal arch
Dorsal carpal branch
Travels laterally around wrist to anastomosis with dorsal carpal branch of ulnar artery to form dorsal carpal arch
Palmar branch of radial artery
Feeds into superficial palmar arch, which is principally supplied by ulnar artery
Dorsalis pollicis artery
Arises from radial artery at base of 1st metacarpal, travels along lateral aspect of thumb
1st dorsal metacarpal artery
Branch of radial artery, supplies adjacent sides of 1st and 2nd digits
Princeps pollicis artery
Branch of radial artery, travels along medial aspect of thumb
Radialis indicis artery
Arises from radial artery or princeps pollicis artery
Travels along lateral aspect of 2nd digit
Deep palmar arch
Continuation of radial artery, communicates with deep palmar branch of ulnar artery, produces palmar metacarpal and perforation branches
Subclavian vein
Continuation of axillary vein proximal to the 1st rib, forms brachiocephalic vein with the internal jugular vein
Axillary vein
Formed in the medial brachium when multiple brachial veins unite with superficial basilic vein
Cephalic vein
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
Median cubital vein
Connects basilic and cephalic veins
Overlies bicipital aponeurosis
Most common site of venipuncture because of its superficial location
Brachial veins
Multiple anastomosing vessels that accompany brachial artery
Drains ulnar, radial, posterior and anterior interosseous veins, unites with basilic vein to form axillary vein
Ulnar vein
Accompany ulnar artery, drains superficial and deep palmar venous arches and empty into brachial veins
Basilic vein
Drains dorsal venous network of hand and median antebrachial vein (drains anterior aspect of forearm), forms axillary vein after uniting with brachial veins
Thoracic duct
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
Left Subclavian lymphatic trunk
Receives drainage from lymphatic plexuses of upper extremity, empties into thoracic duct
Right lymphatic duct
Drains right subclavian lymphatic trunk and bronchomediastinal trunk
Empties into brachiocephalic vein
Cubital lymph nodes
Proximal to medial humeral epicondyle and medial to basilic vein, communicate with humeral axillary nodes
Axillary lymph nodes
Five groups of nodes in the axilla Pectoral Subscapular Humeral axillary Central axillary Apical axillary
Pectoral axillary lymph nodes
Receive lymph from breast and lateral thoracic wall
Subscapular axillary lymph nodes
Receive lymph from posterior thoracic wall and scapular region
Humeral axillary lymph nodes
Receive lymph from nearly the whole upper extremity, except the lymph vessels accompanying the cephalic vein, which empty into clavicular nodes
Central axillary lymph nodes
Receives lymph from pectoral, subscapular and humeral axillary nodes
Apical axillary nodes
Receives lymph from central axillary nodes
Deltopectoral lymph nodes
Lie near the cephalic vein at the clavipectoral triangle
Importance of axillary lymph nodes
They are frequently invaded by cancer cells from elsewhere in the body, usually breast cancer
