MAJOR ARTERIES OF UPPER LIMB BY DR SHIVARAMA

MAJOR ARTERIES OF UPPER LIMB BY DR SHIVARAMA BHAT

LEARNING OBJECTIVES • TO KNOW ABOUT MAJOR ARTERIES. • TO LEARN ABOUT THEIR COURSE AND PARTS. • TO LEARN ABOUT THEIR BRANCHES AND DISTRIBUTION. • TO LEARN ABOUT ANASTOMOSIS AROUND MAJOR JOINTS OF UPPER LIMB.

MAJOR ARTERIES • • • AXILLARY ARTERY BRACHIAL ARTERY RADIAL ARTERY ULNAR ARTERY PALMAR ARCHES

Anastomosis • SCAPULAR ANASTOMOSIS • ANASTOMOSIS AROUND ELBOW • ANASTOMOSIS AROUND WRIST and CARPALS.

ARTERIES OF THE UPPER LIMB F AXILLARY ARTERY F BRACHIAL ARTERY F RADIAL ARTERY F ULNAR ARTERY

AXILLARY ARTERY ü Begins as the continuation of subclavian artery at the outer border of first rib. ü Ends by continuing as brachial artery at the lower border of teres major muscle. ü Along its course it is divided by pectoralis minor muscle into three parts.

PARTS: ü FIRST PART - medial to pectoralis minor muscle. ü SECOND PART - posterior to pectoralis minor. ü THIRD PART - lateral to pectoralis minor.

BRANCHES: I PART: 1. Superior thoracic artery. II PART: 1. Thoraco- acromial artery. thoracic artery. 2. lateral III PART: 1. subscapular artery. 2. ant. circumflex humeral artery. 3. post. circumflex humeral artery.

BRACHIAL ARTERY ü Begins as a continuation of axillary artery at the lower border of Teres major muscle. ü Ends at the level of neck of radius by dividing into radial & ulnar arteries. ü Accompanied by a pair of venae comitantes.

Branches: • Profunda brachii artery. • Superior Ulnar collateral artery. • Inferior Ulnar collateral artery. • Radial artery. • Ulnar artery. • Nutrient artery.

Applied anatomy Pulsation of the brachial artery is felt or auscultated in front of the elbow; this helps - recording the blood pressure.

RADIAL & ULNAR ARTERIES Brachial artery Radial artery Ulnar artery

Branches of ulnar artery µ Anterior ulnar recurrent artery. µ Posterior ulnar recurrent artery. µ Common interosseous artery. µ Palmar and dorsal carpal branches. µ Muscular branches.

Common interosseous artery • Anterior interosseous branch. • Posterior interosseous branch. • Median artery.

Radial artery

Branches of radial artery µ Radial recurrent artery µ Muscular branch µ Palmar carpal branch µ Dorsal carpal branch µ Superficial palmar branch µ First dorsal metacarpal artery µ Arteria princeps pollicis µ Arteria radialis indicis

Applied anatomy • Radial pulsations.

SUPERFICIAL PALMAR ARCH

FORMATION: ü formed as the direct continuation of ulnar artery ü laterally completed by one of the following branches of radial artery: i) superficial palmar branch ii) radialis indicis iii) princeps pollicis

Superficial Palmar Arch: Radial artery Ulnar artery Common palmar digital artery Proper palmar digital artery

branches of superficial palmar arch: FOUR PALMAR DIGITAL ARTERIES, arise from the convexity of the arch. 1. The PROPER DIGITAL BRANCH passes along the medial side of little finger. 2. Three COMMON PALMAR DIGITAL ARTERIES , each of which at the base of the interdigital region divide into two proper palmar digital arteries, which supply the adjacent fingers.

Deep palmar arch

DEEP PALMAR ARCH: FORMATION: Formed mainly by the terminal part of the radial artery, and is completed medially by the Deep palmar branch of the ulnar artery. BRANCHES: 1. Three palmar metacarpal arteries. 2. Perforating arteries. 3. Recurrent branches

Scapular anastomosis • Between the branches of 1 st part of subclavian artery and 3 rd part of axillary artery.

SCAPULAR ANASTOMOSIS • Between the branches of first part of subclavian artery and the third part of axillary artery. • In the subscapular, supraspinous fossa and infraspinous fossa between a) suprascapular artery b) deep cervical artery c) circumflex scapular artery.

Anastomosis around elbow • Between branches of brachial artery and ulnar artery. • Between branches of profunda brachial artery and radial artery.

Anastamoses around the elbow joint

Anastomosis near wrist and carpals • Dorsal and palmar carpal branches of ulnar and radial arteries. • Recurrent branch of deep palmar arch. • Anterior and posterior interosseous arteries. • Dorsal carpal arch. • Perforating branches of deep palmar arch.

Applied anatomy • • Axillary artery blockage. Injury to axillary artery. Volkmann’s ischaemic contracture. Myositis ossificans.

Questions • • Scapular anastomosis. Anastomosis around elbow. Axillary artery. Brachial artery. Radial artery. Ulnar artery. Superficial palmar arch. Deep palmar arch.