Arterial Supply Upper Limb

Subclavian Artery

 

Origin

- on right arises from brachiocephalic trunk behind right sternoclavicular joint

- on left arises from the arch of the aorta

 

Ends

- outer border first rib as axillary artery

 

First part

- origin of artery to medial aspect scalenus anterior

- on right arches above the clavicle / lies on the pleura / RLN wraps about it

- vertebral artery / thyrocervical trunk branches

 

Second part

- behind scalenus anterior

 

Third part

- from lateral scalenus anterior to outer border first rib

- behind subclavius and the subclavian vein

- trunks of brachial plexus around it

 

Access / Proximal control

- must remove central portion clavicle

 

Axillary Artery

 

Origin

- Outer border first rib

 

Ends

- lower border teres major to become brachial artery

 

Relations

- axillary vein medial and anterior

- covered by P major and minor

 

Second part

- behind P major

- cords of the brachial plexus suround the second part

 

Third part

- below P major

- medial to conjoint tendon

- median nerve is lateral, median branch median crosses artery

- ulna nerve is medial

 

Branches

- thoracoacromial

- subscapular

- anterior and posterior circumflex humeral

 

Access / Proximal control

- divide P major from humerus

- divide P minor from medial coracoid

- take conjoint tendon from coracoid / coracoid osteotomy

 

Brachial Artery

 

Origin

- lower border tendon T major

 

Ends

- division radial and ulna at elbow / neck of the radius

 

Relations

- initially medial to humerus

- at elbow is midpoint between 2 epicondyles

- 2 venae commitantes

- basilic vein runs with it in upper part of arm / is superfical to fascia distally

- medial nerve is medial to nerve in lower part of arm

- crossed by lacertus fibrosis

- biceps tendon medial

 

Branches

- profunda brachii to run with radial nerve

- superior and inferior ulna collateral

 

Radial artery

 

Origin

- cubital fossa between BR and PT

- continuation of the brachial artery

- smaller than ulna artery

 

Relation forearm

- runs under brachioradialis

- runs over biceps / PT / FDS / FPL and PQ

- emerges between BR and FCR at the wrist

- accompanied by venae commitantes

- radial recurrent branch / leash of Henry to BR

 

Relations wrist

- runs under APL and EPB to dorum of wrist

- over volar aspect of scaphoid

- passes between 2 heads first dorsal interossei and Adductor Pollicis

- branches princeps pollicis and radialis indicis

 

Relations hand

- anastomoses with deep branch ulna artery

- forms deep carpal arch on the base of the metacarpals

- branches are the volar metacarpal arteries

 

Ulna artery

 

Larger branch

 

Relations elbow

- passes deep to two heads pronator teres

- median nerve passes superficial to it and the ulna head PT

 

Relations forearm

- lies on FDP between FDS and FCU

- runs with 2 venae comitantes

- emerges on radial side of the FCU with the ulna nerve medial to the artery

- posterior interosseous artery: passes dorsally between oblique ligament and interosseous membrane

- anterior interosseous artery: runs on interosseous membrance before passing dorsally proximally to PQ

 

Relations wrist

- passes into Guyon's canal on transverse carpal ligament

- roof is volar carpal ligament / pisiform medial

- becomes the superficial volar arch

 

Superficial volar arch

- runs at distal end transverse carpal ligament

- deep to palmar aponeurosis / superficial to FDS tendons

- 3 common volar arteries which each divide into two common digital arteries