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Transcript
Gross Anatomy:
Upper Extremity
Arteries
By: Trevor Lohman DPT
Illustrated by: Dennis Breese
1
Subclavian and
Axillary arteries
“Hardening of the heart ages people more quickly than hardening
of the arteries”
-Anonymous
Subclavian and Axillary Artery Structure List:
1. Subclavian artery
a. thyrocervical trunk
i. inferior thyroid artery
1. ascending cervical artery
c. lateral thoracic artery
d. subscapular artery
i. scapular circumflex artery
ii. thoracodorsal artery
ii. dorsal scapular artery
e. posterior humeral circumflex artery
iii. suprascapular artery
f. anterior humeral circumflex artery
b. internal thoracic artery
c. costocervical trunk
i. deep cervical artery
ii. supreme intercostal artery
2. Axillary artery
a. highest thoracic artery
b. thoracoacromial trunk artery
i. acromial branch
ii. deltoid branch
iii. clavicular branch
iv. pectoral branch
2
Subclavian and Axillary Arteries
The left and right subclavian arteries supply the left and right upper extremities with
oxygenated blood, respectively. While
b. internal thoracic artery
c. costocervical trunk artery
there are several arterial structures that
branch from this pair of large arteries, we
will only be focusing on the location of the
2. Axillary artery
subclavian artery and its main branches in
these notes. We will however be covering
the axillary artery in depth.
1. Subclavian artery
b. highest thoracic artery
c. thoracoacromial trunk artery
ii. acromial br.
a. thyrocervical trunk
3
iii. deltoid br.
S= subscapular artery
iv. clavicular br.
P= posterior humeral circumflex artery
v. pectoral br.
A= anterior humeral circumflex artery
d. lateral thoracic artery
e. subscapular artery
ii. scapular circumflex artery
iii. thoracodorsal artery
f. posterior humeral circumflex artery
Not only does this mnemonic device help
you to memorize the axillary artery
branches, it helps you to memorize the order in which these branches depart from
the axillary artery.
An additional mnemonic device exists for
the branches of the thoracoacromial trunk
artery.
g. anterior humeral circumflex artery
All Dogs Can Pee
A= acromial br.
The structures of the axillary artery may
seem numerous, but there are some very
helpful mnemonic devices to aide in your
retention of the material.
The main branches of the axillary artery
can be committed to memory using the following phrase
HoTeL SPA
H= highest thoracic artery
T= thoracoacromial trunk
D= deltoid br.
C= clavicular br.
P= pectoral br.
Using these two study aides, you can
memorize nearly all of the axillary artery
branches.
On the next page, we will examine the
structure and location of the brachial artery
and its branches. The brachial artery is a
continuation of the axillary artery, and be-
L= lateral thoracic artery
gins as the axillary artery crosses the teres
major muscle.
4
2
Brachial Artery
“Faith is the vital artery of the
soul. When we begin to believe, we begin to love.”
– Richard Watson
Brachial Artery Structure List:
1. Brachial artery
a. profunda brachii artery (deep brachial
a.)
i. ascending br.
ii. radial collateral a.
iii. middle collateral a.
b. Superior ulnar collateral artery
c. Inferior ulnar collateral artery
6
The Brachial Artery and Associated Branches
The brachial artery is simply a continuation
of the axillary artery. This change in name
occurs as the axillary artery crosses the
teres major muscle. You can rest assured
that the transition has occurred once you
locate the brachial artery’s first branch, the
i. ascending br.
ii. radial collateral br.
iii. middle collateral br.
b. superior ulnar collateral artery
profunda brachii artery. Please find the brachial artery structure list below:
c. inferior ulnar collateral artery
1. Brachial artery
a. profunda brachiii artery (deep brachial
a.)
The branches of the brachial artery are
less in number than those of the axillary ar-
7
tery. There is however an acronym to help
you memorize the branches of the profunda brachii a.
A.R.M.
A= ascending branch
R= radial collateral branch
M= middle collateral branch
Each of these branches serves as one half
of an anastomosis with another arterial
structure. The ascending branch connects
to the loop formed around the humeral
head by the anterior and posterior humeral
circumflex arteries. The remaining anastomoses will be discussed on the following
pages.
8
3
Radial and Ulnar
Arteries
“A man is as old as his arteries and his interests.”
– Josephus Daniels
Radial and Ulnar Artery Structure List
1. Radial artery
a. radial recurrent a.
f. dorsal carpal branch
g. deep palmar arch
b. palmar carpal branch a.
c. superficial palmar arch a.
d. princeps pollicis a.
i. radialis indicis
e. deep palmar arch a.
3. Superficial palmar arch a. (continuation
of ulnar a.)
a. common palmar digital arteries
b. palmar digital arteries
i. palmar metacarpal arteries
2. Ulnar artery
b. anterior ulnar recurrent a.
c. posterior ulnar recurrent a.
d. common interosseous a.
ii. interosseous recurrent a.
iii. posterior interosseous a.
iv. anterior interosseous a.
e. palmar carpal branch
10
Arteries of the Forearm
The brachial artery bifurcates once it
in the forearm. We will cover the branches
reaches the antebrachial region forming
found in the wrist and hand in the following
two arteries that travel distally towards the
section. The forearm branches of these
hand. This bifurcation results in the divi-
two arteries are found below.
sion of the brachial artery into the radial
and ulnar arteries.
The radial artery travels down the forearm
1. Radial artery
a. radial recurrent artery
anterior to the radius, while the ulnar artery
travels down the forearm anterior to the
ulna. Keep in mind that we will only be cov-
2. Ulnar artery
ering the branches of these arteries found
a. anterior ulnar recurrent artery
11
b. posterior ulnar recurrent artery
c. common interosseous artery
i. interosseous recurrent anterior
ii. anterior interosseous artery
iii. posterior interosseous artery
2. The middle collateral artery anastomoses with the interosseous recurrent artery.
3. The superior ulnar collateral artery anastomoses with the posterior ulnar recurrent artery.
4. The inferior ulnar collateral artery anastomoses with the anterior ulnar collateral
artery.
Upon examination of the picture on the previous page, you may notice that many of
This arrangement can be more easily re-
these structure share similar descriptors in
tained by employing the following device
their names. Two such examples are the
pronounced Rimsy Rippa:
words “collateral” and “recurrent”. These
terms refer to the nature and direction of
the blood carried by these vessels. In this
manual we will examine eight of such ves-
RMSI
RIPA
sels and their relationships with one an-
Where RMSI is an acronym denoting the
other. It is these eight vessels that supply
the collateral branches of the brachial ar-
blood around the distal humerus and proxi-
tery, and RIPA is an acronym denoting the
mal radius and ulna bones. These struc-
recurrent branches of the radial and ulnar
tures and associated musculature form the
arteries. The letters of this device are ar-
elbow complex which is capable of a con-
ranged in vertical pairs based on the pairs
siderable amount of motion, and therefore
of structures comprising each anastomo-
requires a specialized vascular structure to
sis. In other words, R pairs with R, M with
allow for uninterrupted blood blow. The re-
I, S with P, and I with A.
lationship between these eight vascular
structures is as follows.
1. The radial collateral artery anastomoses
with the radial recurrent artery.
12
Arteries of the Hand
1. Radial artery
a. palmar carpal branch
a. palmar carpal branch
b. dorsal carpal branch
b. superficial palmar arch
c. deep palmar arch
c. princeps pollicis artery
i. radialis indicis artery
d. deep palmar arch
i. palmar metacarpal arteries
2. Ulnar artery
3. Superficial palmar arch (continuation of
ulnar a.)
a. common palmar digital arteries
b. palmar digital arteries
13
The list of structures on the previous page
may be confusing due to the repetition of
certain terms. You will find that certain
structures, the deep palmar arch for example, appear as both radial and ulnar artery
structures. This is due to the fact that
some arterial branches connect to both
the ulnar and radial artery, and therefore
are listed in duplicate based on their origin.
That’s it! You have now mastered the arteries of the upper extremity. The structures
may be numerous, but by using mnemonic
devices and lots and lots of repetition, you
can become an expert!
Be sure to assess your knowledge by
studying on cadavers in lab. You will find
that the form and location of these structures vary, and sometimes dramatic differences may be found. That said, these
notes present the arteries of the upper extremity in their most common arrangement, and although slight variations may
be found, these notes should prepare you
quite well for lab.
14