Upper Limb

Upper Limb Arterial Supply

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Overview


The right subclavian artery is a continuation of one of the two branches of the brachiocephalic trunk. However, the left subclavian artery is a branch of the arch of the aorta. The branches of the right and left subclavian arteries all originate from the proximal one third of the artery, with the sole exception of the costocervical trunk on the right.

 The axillary artery is a continuation of the subclavian artery. Anatomically, the axillary artery can be split into three parts by the pectoralis minor muscle. The first part is proximal to pectoralis minor, the second part is posterior to pectoralis minor, and the third part is distal to the pectoralis minor muscle

Gross Anatomy


Subclavian Artery


Origin:

right Subclavian artery – posterior to the sternoclavicular joint.

left Subclavian artery – slightly more inferior in the thorax than the right subclavian artery, posterior to the left common carotid artery at the level of T4.

Path: both the right and left subclavian arteries ascend and arch superior laterally, passing posterior to the anterior scalene muscle on each side. They continue their course laterally, across the first rib. They become the right and left axillary arteries when they pass the lateral border of the first rib.

Branch: vertebral artery, the thyrocervical trunk (inferior thyroid artery, the transverse cervical artery, and the suprascapular arteries), the costocervical trunk  (the deep cervical artery and the supreme intercostal artery) and the internal thoracic artery.

Surface Anatomy: the subclavian artery can be palpated deep and just lateral to the sternoclavicular joint.

Structures Supplied: the upper limbs. It also supplies branches to the neck and brain.


Axillary Artery


Origin: lateral border of the first rib.

Path: begins at the lateral border of the first rib. Passes posterior to the pectoralis minor muscle into the arm and becomes the brachial artery at the inferior border of the teres major muscle.

Branch: superior thoracic artery, thoraco-acromial artery, lateral thoracic artery, subscapular artery, anterior circumflex humeral artery, posterior circumflex humeral artery.

Surface Anatomy: the axillary artery is best palpated with the arm adducted. It can be palpated in the axilla just lateral to the apex of the floor of the axilla.

Structures supplied: the axilla, lateral thorax and continues as the major blood supply to the distal parts of the upper limb.


Brachial Artery


Origin: inferior border of the teres major muscle.

Path: the brachial artery runs from the medial aspect of the humerus, turning inferolateral until midway between the lateral epicondyle and medial epicondyle of the humerus. It terminates just distal to the elbow joint opposite the neck of the radius in the cubital fossa. Here it bifurcates into the radial and ulnar arteries.

Branch: muscular branches, profunda brachii artery, humeral nutrient artery, superior and inferior ulnar collateral arteries.

Surface Anatomy: most commonly palpated at the elbow, just medial to the biceps brachii aponeurosis.

Structures Supplied: muscles of the upper arm.


Radial Artery


Origin: originates in the cubital fossa, as the smaller terminal branch of the bifurcation of the brachial artery.

Path: lateral border of the forearm.

Branch: radial recurrent artery, palmar carpal branch, superficial palmar branch.

Surface Anatomy: the radial pulse can be felt at the wrist, lateral to the flexor carpi radialis tendon.

Structures Supplied: forearm muscles, carpal bones and joints.


Ulna Artery


Origin: originates in the cubital fossa, as the larger terminal branch of the bifurcation of the brachial artery.

Path: travels deep to the pronator teres muscle then along the forearm between the flexor carpi ulnaris and flexor digitorum profundus muscles. At the wrist, it passes superficially to the flexor retinaculum to enter the hand.

Branch: anterior and posterior branches of the ulnar recurrent artery, common interosseous artery, dorsal carpal branch artery and palmar carpal branch artery.

Surface Anatomy: the ulnar artery is palpable at the wrist, lateral to the flexor carpi ulnaris tendon

Structures Supplied: medial and central forearm muscles, medial three and a half digits and the wrist.


Clinical Anatomy


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Quick Anatomy


Key Facts

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Aide-Memoire

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Summary


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References


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