Upper Limb Vasculature and Lymphatics to the Elbow

Question 1

The brachiocephalic trunk starts at the beginning of the arch of the aorta (on the right side), passes superolaterally, and then divides into what?

Answer 1

rt. common carotid and rt. subclavian arteries

Question 2

The left subclavian artery arises from what?

Answer 2

the arch of the aorta

Question 3

Once the subclavian arteries cross the outer margin of the ___ ___, they change their names to the axillary arteries

Answer 3

1st rib

Question 4

The branches of the subclavian arteries - give all 3 parts

Answer 4

1st part: vertebral arteries, internal thoracic arteries, and thyrocervical trunk
2nd part: the costocervical trunk
3rd part: the dorsal scapular artery (variable)

Question 5

The thyrocervical trunk has 4 branches. What are they?

Answer 5

the inferior thyroid, ascending cervical, suprascapular, and transverse cervical

Question 6

The ____ artery passes over the transverse scapular ligament

Answer 6

suprascapular

Question 7

The ____ ____ arteries pass laterally and slightly posterior across the base of the posterior triangle of the neck

Answer 7

transverse cervical

Question 8

Where do the superficial and deep branches of the transverse cervical artery go?

Answer 8

superficial: deep surface of trapezius
deep: deep surface of rhomboids

Question 9

The major vessels and nerves pass from the neck to the axilla though the ___ enclosed in the axillary sheath

Answer 9

inlet

note: this is where subclavian becomes axillary

Question 10

What are the contents of the axilla?

Answer 10

axillary artery, axillary vein, lymphatic vessels, axillary lymph nodes, brachial plexus

Question 11

The axillary artery is a continuation of the subclavian artery from the lateral border of ___ ___ to the lower border of ___ ___ muscle

Answer 11

1st rib; teres major

Question 12

The overlying pec minor subdivides the axillary into 3 parts. Describe each part and its branches

Answer 12

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

Question 13

where does the superior thoracic artery run?

Answer 13

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

Question 14

The thoracoacromial artery penetrates ____ fascia and then divides into 4 branches. What are they?

Answer 14

clavipectoral; branches: pectoral, deltoid, acromial, clavicular

Question 15

The pectoral branch of the thoracoacromial artery runs with which nerve?

Answer 15

lateral pectoral nerve

Question 16

The deltoid branch of the thoracoacromial artery runs with which vein?

Answer 16

cephalic vein

Question 17

____ artery is the largest branch of the axillary artery, and is the major blood supply to the posterior wall of the axilla.

Answer 17

subscapular

Question 18

The subscapular artery divides into two branches. What are they?

Answer 18

circumflex scapular artery (through triangular space) and thoracodorsal artery

Question 19

The numerous arteries that supply the scapular region form an anastomotic network. The major vessels that participate in this are?

Answer 19

deep branch of transverse cervical (from thyrocervical trunk), suprascapular (from thyrocervical trunk), and circumflex scapular branch of subscapular artery

Question 20

The axillary vein begins at the inferior border of the teres major by the union of the ___ veins (2) and the ___ vein

Answer 20

brachial; basilic

Question 21

The basilic vein is a superficial vein that drains the ___ surface of the hand

Answer 21

posteromedial

Question 22

The axillary vein becomes the subclavian vein at the lateral border of rib 1 after receiving the ___ vein

Answer 22

cephalic

Question 23

In regards to axillary lymph nodes, what region does the humeral group drain?

Answer 23

receives most of lymph from the upper limb, drains to central group

Question 24

In regards to axillary lymph nodes, what region does the subscapular group drain?

Answer 24

drains the scapular and posterior thoracic regions, drains to central group

Question 25

In regards to axillary lymph nodes, what region does the pectoral group drain?

Answer 25

drains the anterior thoracic wall, including the breast, drains to central and apical groups

Question 26

In regards to axillary lymph nodes, what region does the central group drain?

Answer 26

receives drainage from the humeral, subscapular, and pectoral groups, drains into the apical group

Question 27

In regards to axillary lymph nodes, what region does the apical group drain?

Answer 27

receives drainage from the central group, as well as from other groups, and forms the subclavian lymphatic trunk.

Question 28

The subclavian lymphatic trunk drains into two ducts. What are they?

Answer 28

on the left side, it drains into the thoracic duct

on the right side, it forms the right lymphatic duct

Question 29

Give the boundaries of the quadrangular space, as well as its contents.

Answer 29

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

Question 30

Give the boundaries of the triangular space and its contents.

Answer 30

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

Question 31

Give the boundaries of the triangular interval and its contents.

Answer 31

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

Question 32

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

Answer 32

teres major; radial; ulnar

Question 33

In regards to the proximal arm, the brachial artery lies on the ___ side

Answer 33

medial

Question 34

In regards to the distal arm, the brachial artery passes anterior to the ___ ____ ___ and trochlea of the humerus

Answer 34

medial supracondylar ridge

Question 35

The brachial artery accompanies the ___ nerve

Answer 35

median

Question 36

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?

Answer 36

radial; radial collateral and middle collateral arteries

Question 37

The radial collateral artery forms an anastomosis with the ___ ____ artery

Answer 37

radial recurrent

Question 38

The middle collateral artery forms an anastomosis with the ___ ___ artery

Answer 38

recurrent interosseus

Question 39

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 –> ?

Answer 39

posterior ulnar recurrent artery

Question 40

The inferior ulnar collateral arises from the brachial artery, and then passes inferomedially anterior to the medial epicondyle of the humerus –> ?

Answer 40

anterior ulnar recurrent artery

Question 41

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.

Answer 41

median cubital; clavipectoral; axillary

Question 42

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.

Answer 42

medial; brachial; medial cutaneous

Question 43

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.

Answer 43

brachial; radial; ulnar