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