Upper Limbs Blood vessels | Anatomy2Medicine
Upper Limbs Blood vessel

Upper Limbs Blood vessels

´┐╝BLOOD VESSELS OF THE UPPER LIMB

    • Branches of the subclavian artery
    • Suprascapular Artery
      • Is a branch of the thyrocervical trunk
      • Passes over the superior transverse scapular ligament
        • suprascapular nerve passes under the ligament
      • Anastomoses with the deep branch of the transverse cervical artery (dorsal scapular artery) and the circumflex scapular artery around the scapula, providing a collateral circulation
    • Dorsal Scapular or Descending Scapular Artery
      • Arises from the subclavian artery
      • Accompanies the dorsal scapular nerve
    • Arterial Anastomoses Around Scapula
      • Occur between three groups of arteries

 

  • suprascapular, descending scapular, and circumflex scapular arteries

 

        • acromial and posterior humeral circumflex arteries
        • descending scapular and posterior intercostal arteries.
    • Axillary artery

 

  • Extends from the outer border of the first rib to the inferior border of the teres major muscle,

 

      • it becomes the brachial artery.

 

  • The axillary artery is bordered on its medial side by the axillary vein.

 

      • Is divided into three parts by the pectoralis minor muscle.
        • Superior or Supreme Thoracic Artery
        • Thoracoacromial Artery
          • Pierces the costocoracoid membrane (or clavipectoral fascia).
        • Lateral Thoracic Artery
          • gives rise to lateral mammary branches.
        • Subscapular Artery
          • Is the largest branch of the axillary artery
          • Divides into the thoracodorsal and circumflex scapular arteries
          • Thoracodorsal Artery
          • Circumflex Scapular Artery
            • Passes posteriorly into the triangular space
            • triangular space bounded by the

 

  • subscapularis muscle and the teres minor muscle above

 

              • teres major muscle below
              • long head of the triceps brachii laterally.

 

  • Ramifies in the infraspinous fossa and anastomoses with branches of the dorsal scapular and suprascapular arteries.

 

        • Anterior Humeral Circumflex Artery
          • Passes anteriorly around the surgical neck of the humerus.
          • Anastomoses with the posterior humeral circumflex artery.
        • Posterior Humeral Circumflex Artery
          • Runs posteriorly with the axillary nerve
          • Runs through the quadrangular space
          • quadrangular space bounded by the
            • teres minor muscle
            • teres major muscle
            • the long head of the triceps brachii

 

  • humerus.

 

          • Anastomoses with

 

  • anterior humeral circumflex artery
  • ascending branch of the profunda brachii artery

 

        • Brachial artery
          • Lies in the center of the cubital fossa
            • medial to the biceps tendon,
            • lateral to the median nerve
            • deep to the bicipital aponeurosis.
          • terminates by dividing into the radial and ulnar arteries
            • at the level of the radial neck
            • approximately 1 cm below the bend of the elbow, in the cubital fossa.
        • Profunda Brachii (Deep Brachial) Artery
          • Descends posteriorly with the radial nerve

 

  • gives off an ascending branch, which anastomoses with the descending branch of the posterior humeral circumflex artery.

 

          • Divides into the middle collateral artery, which anastomoses with the interosseous recurrent artery, and the radial collateral artery
        • Superior Ulnar Collateral Artery
          • Pierces the medial intermuscular septum
          • accompanies the ulnar nerve behind the septum and medial epicondyle.
          • Anastomoses with the posterior ulnar recurrent branch of the ulnar artery.
        • Inferior Ulnar Collateral Artery
          • Anastomoses with the anterior ulnar recurrent branch of the ulnar artery.
    • RADIAL ARTERY
      • Arises as the smaller lateral branch of the brachial artery in the cubital fossa
      • Runs through the anatomic snuffbox

 

  • divides into the princeps pollicis artery and the deep palmar arch.

 

      • Accounts for the radial pulse
      • felt proximal to the wrist between the tendons of the brachioradialis and flexor carpi radialis muscles.

 

  • also be palpated in the anatomic snuffbox between the tendons of the extensor pollicis longus and brevis muscles.

 

      • Gives rise to the following branches:
        • Radial Recurrent Artery
          • Anastomoses with the radial collateral branch of the profunda brachii artery
        • Palmar Carpal Branch
          • Joins the palmar carpal branch of the ulnar artery
          • forms the palmar carpal arch.
        • Superficial Palmar Branch
          • anastomoses with the superficial branch of the ulnar artery
          • complete the superficial palmar arterial arch.
        • Princeps Pollicis Artery
          • Divides into two proper digital arteries for each side of the thumb.
        • Radialis Indicis Artery

 

  • Also may arise from the deep palmar arch or the princeps pollicis artery.

 

        • Deep Palmar Arch
          • Is formed by the main termination of the radial artery
          • usually is completed by the deep palmar branch of the ulnar artery.
          • Passes between the transverse and oblique heads of the adductor pollicis muscle.
          • Gives rise to three palmar metacarpal arteries, which join the common palmar digital arteries from the superficial palmar arch.
        • Dorsal Carpal Branch

 

  • Ulnar artery

 

      • Is the larger medial branch of the brachial artery in the cubital fossa.
      • Enters the hand
        • anterior to the flexor retinaculum
        • lateral to the pisiform bone
        • medial to the hook of the hamate bone.
      • Divides into the superficial palmar arch and the deep palmar branch

 

  • They join the radial artery to complete the deep palmar arch.

 

      • If the ulnar artery arises high from the brachial artery and runs invariably superficial to the flexor muscles, the artery may be mistaken for a vein for certain drugs, resulting in disastrous gangrene with subsequent partial or total loss of the hand.
      • Branches

 

  • Anterior Ulnar Recurrent Artery

 

          • Anastomoses with the inferior ulnar collateral artery.

 

  • Posterior Ulnar Recurrent Artery

 

          • Anastomoses with the superior ulnar collateral artery.

 

  • Common Interosseous Artery

 

          • divides into the anterior and posterior interosseous arteries.

 

  • Anterior Interosseous Artery
  • Posterior Interosseous Artery
  • Palmar Carpal Branch
  • Dorsal Carpal Branch
  • Superficial Palmar Arterial Arch

 

          • Is the main termination of the ulnar artery

 

  • usually completed by anastomosis with the superficial palmar branch of the radial artery.

 

          • Lies immediately under the palmar aponeurosis.

 

  • Gives rise to three common palmar digital arteries, each of which bifurcates into proper palmar digital arteries, which run distally to supply the adjacent sides of the fingers.

 

        • Deep Palmar Branch
          • anastomoses with the radial artery, thereby completing the deep palmar arch.

 

  • Gives rise to the palmar metacarpal arteries, which join the common palmar digital arteries.
  • Veins of the upper limb

 

      • Axillary Vein
        • Is formed by the union of the brachial veins (venae comitantes of the brachial artery) and the basilic vein
        • ascends along the medial side of the axillary artery.
        • Continues as the subclavian vein at the inferior margin of the first rib.
        • Commonly receives the thoracoepigastric veins directly or indirectly and thus provides a collateral circulation if the inferior vena cava becomes obstructed.
        • tributaries

 

  • cephalic vein

 

          • brachial veins (venae comitantes of the brachial artery that join the basilic vein to form the axillary vein
          • veins that correspond to the branches of the axillary artery.
    • Surgical Anatomy
      • If the axillary artery is ligated between the thyrocervical trunk and the subscapular artery, then the blood from anastomoses in the scapular region arrives at the subscapular artery in which the blood flow is reversed to reach the axillary artery distal to the ligature.
      • The axillary artery may be compressed or felt for the pulse
        • in front of the teres major

 

  • against the humerus in the lateral wall of the axilla.

 

    • If the brachial artery is tied off distal to the inferior ulnar collateral artery, sufficient blood reaches the ulnar and radial arteries via the existing anastomoses around the elbow.
    • The brachial artery may be compressed or felt for the pulse on the brachialis against the humerus but medial to the biceps and its tendon and can be used for taking blood pressure.
    • The ulnar artery may be compressed or felt for the pulse on the anterior aspect of the flexor retinaculum on the lateral side of the pisiform bone.
    • Allen test
      • a test for occlusion of the radial or ulnar artery
      • either the radial or ulnar artery is digitally compressed by the examiner after blood has been forced out of the hand by making a tight fist
      • failure of the blood to return to the palm and fingers on opening indicates that the uncompressed artery is occluded.
    • Venipuncture may be performed on the
      • axillary vein to locate the central line
      • median cubital vein for drawing blood
      • dorsal venous network or the cephalic and basilic veins at their origin for long-term introduction of fluids or intravenous feeding.