Upper Limb Vasculature and Lymphatics to the Elbow Flashcards
The brachiocephalic trunk starts at the beginning of the arch of the aorta (on the right side), passes superolaterally, and then divides into what?
rt. common carotid and rt. subclavian arteries
The left subclavian artery arises from what?
the arch of the aorta
Once the subclavian arteries cross the outer margin of the ___ ___, they change their names to the axillary arteries
1st rib
The branches of the subclavian arteries - give all 3 parts
1st part: vertebral arteries, internal thoracic arteries, and thyrocervical trunk
2nd part: the costocervical trunk
3rd part: the dorsal scapular artery (variable)
The thyrocervical trunk has 4 branches. What are they?
the inferior thyroid, ascending cervical, suprascapular, and transverse cervical
The ____ artery passes over the transverse scapular ligament
suprascapular
The ____ ____ arteries pass laterally and slightly posterior across the base of the posterior triangle of the neck
transverse cervical
Where do the superficial and deep branches of the transverse cervical artery go?
superficial: deep surface of trapezius
deep: deep surface of rhomboids
The major vessels and nerves pass from the neck to the axilla though the ___ enclosed in the axillary sheath
inlet
note: this is where subclavian becomes axillary
What are the contents of the axilla?
axillary artery, axillary vein, lymphatic vessels, axillary lymph nodes, brachial plexus
The axillary artery is a continuation of the subclavian artery from the lateral border of ___ ___ to the lower border of ___ ___ muscle
1st rib; teres major
The overlying pec minor subdivides the axillary into 3 parts. Describe each part and its branches
1st part: between rib 1 and medial border of pec minor; has one branch - the superior thoracic artery
2nd part: deep to pec minor; has 2 branches - thoracoacromial and lateral thoracic
3rd part: from the lateral border of pec minor to inferior border of teres major; has 3 branches - sub scapular, anterior circumflex humeral and posterior circumflex humeral
where does the superior thoracic artery run?
along the superior border of the pec major to the thoracic wall to help supply the 1st and 2nd intercostal space and superior part of serratus anterior
The thoracoacromial artery penetrates ____ fascia and then divides into 4 branches. What are they?
clavipectoral; branches: pectoral, deltoid, acromial, clavicular
The pectoral branch of the thoracoacromial artery runs with which nerve?
lateral pectoral nerve
The deltoid branch of the thoracoacromial artery runs with which vein?
cephalic vein
____ artery is the largest branch of the axillary artery, and is the major blood supply to the posterior wall of the axilla.
subscapular
The subscapular artery divides into two branches. What are they?
circumflex scapular artery (through triangular space) and thoracodorsal artery
The numerous arteries that supply the scapular region form an anastomotic network. The major vessels that participate in this are?
deep branch of transverse cervical (from thyrocervical trunk), suprascapular (from thyrocervical trunk), and circumflex scapular branch of subscapular artery
The axillary vein begins at the inferior border of the teres major by the union of the ___ veins (2) and the ___ vein
brachial; basilic
The basilic vein is a superficial vein that drains the ___ surface of the hand
posteromedial
The axillary vein becomes the subclavian vein at the lateral border of rib 1 after receiving the ___ vein
cephalic
In regards to axillary lymph nodes, what region does the humeral group drain?
receives most of lymph from the upper limb, drains to central group
In regards to axillary lymph nodes, what region does the subscapular group drain?
drains the scapular and posterior thoracic regions, drains to central group
In regards to axillary lymph nodes, what region does the pectoral group drain?
drains the anterior thoracic wall, including the breast, drains to central and apical groups
In regards to axillary lymph nodes, what region does the central group drain?
receives drainage from the humeral, subscapular, and pectoral groups, drains into the apical group
In regards to axillary lymph nodes, what region does the apical group drain?
receives drainage from the central group, as well as from other groups, and forms the subclavian lymphatic trunk.
The subclavian lymphatic trunk drains into two ducts. What are they?
on the left side, it drains into the thoracic duct
on the right side, it forms the right lymphatic duct
Give the boundaries of the quadrangular space, as well as its contents.
inferior border of the subscaplaris (superior border)
surgical neck of humerus (lateral border)
superior margin of the teres major (inferior border)
lateral margin of the long head of the triceps brachia (medial border)
contents: posterior humeral circumflex artery and axillary nerve
Give the boundaries of the triangular space and its contents.
inferior border of subscapularis (superior border)
superior margin of the teres major (inferior border)
medial margin of the long head of the triceps brachia (lateral border)
contents: circumflex scapular artery
Give the boundaries of the triangular interval and its contents.
inferior border of teres major (superior border)
lateral surface of the shaft of the humerus (medial border)
lateral margin of the long head of triceps brachia (lateral border)
contents: radial nerve and deep brachial artery
The brachial artery is the continuation of the axillary artery starting at the lower border of the ___ ____ muscle and ending just distal to the elbow joint where it divides into the ___ and ___ arteries
teres major; radial; ulnar
In regards to the proximal arm, the brachial artery lies on the ___ side
medial
In regards to the distal arm, the brachial artery passes anterior to the ___ ____ ___ and trochlea of the humerus
medial supracondylar ridge
The brachial artery accompanies the ___ nerve
median
The deep brachial artery arises from the medial aspect of the brachial artery, and then accompanies the ___ nerve around the shaft of the humerus. It then divides into what?
radial; radial collateral and middle collateral arteries
The radial collateral artery forms an anastomosis with the ___ ____ artery
radial recurrent
The middle collateral artery forms an anastomosis with the ___ ___ artery
recurrent interosseus
The superior ulnar collateral arises from the medial aspect of the brachial artery, and then accompanies the ulnar nerve posterior to the medial epicondyle of the humerus –> ?
posterior ulnar recurrent artery
The inferior ulnar collateral arises from the brachial artery, and then passes inferomedially anterior to the medial epicondyle of the humerus –> ?
anterior ulnar recurrent artery
The cephalic vein communicates with the ___ ___ vein anterior to the elbow and then courses superiorly between the deltoid and pec major to enter the ___ triangle. It then pierces the costocoracoid membrane and the clavipectoral fascia to join the ___ vein.
median cubital; clavipectoral; axillary
The basilica vein after passing up the ___ side of the forearm, and inferior part of the arm continues deeply piercing the brachial fascia and running parallel to the ___ artery and ___ ___ nerve of the forearm to the axilla where it joins with brachial veins to form the axillary vein.
medial; brachial; medial cutaneous
Paired deep veins, the brachial veins form an anastomotic network around the ___ artery. The brachial veins form at the elbow from the ___ and ___ veins and then end when it merges with the basilic vein to form the axillary vein.
brachial; radial; ulnar
