Vessels of the Upper Limb


Summary:

  • Arteries
  • Veins
    • Superficial veins
    • Deep venous network
  • Lymphatic drainage

Arterial Supply of the Upper Limb

  • All supply of the upper limb originates from the subclavian artery (see neck anatomy)
    • The subclavian artery (SCA) becomes the axillary artery and then brachial artery, lastly branching into the radial and ulnar arteries
  1. Subclavian artery
    • To the lateral border of 1st rib
    • Becomes axillary artery beyond this
  1. Axillary artery
    • Lateral border of the 1st rib -> inferior border of teres major
    • Surrounded by brachial plexus at axilla
      • Posterolateral to axillary vein
      • There are three parts categorised by their relation to the Pec Minor 
        • First part medial to pec minor (1 branch) :
          • Superior thoracic artery – supplies upper ribs, pec major/minor and the medial axilla
        • Second part posterior to pec minor (2 branches) :
          • Thoraco-acromial artery – supplies via the clavicular, acromial, deltoid, pectoral branches
          • Lateral thoracic artery – supplies lateral breast, pec muscles, serratus anterior
        • Third part lateral to pec minor(3 branches):
          • Subscapular artery
          • Anterior circumflex humeral artery
          • Posterior circumflex humeral artery
      • Note the location of teres major anterior to the artery and first rib posterior to it. The axillary artery is highlighted in pink in the above picture

  2. Brachial artery
    • From teres major -> head of radius
    • Immediately below deep fascia
      • Relations with median, radial, and ulnar nerves
    • Bifurcates medial to the tendon of biceps at the head of the radius to form:
      1. Ulnar artery
        • Larger than radial – this is therefore the dominant artery
          • Lies between ulnar nerve and palmaris longus
        • Palmar arches contribution
        • Provides common interosseus artery => anterior and posterior branches
      2. Radial artery
        • Palpable
          • Close  to radial nerve
          • Palmar arches contribution

Veins of the upper limb

It is important to remember there are two venous networks

Deep veins of the upper limb
  • These are known as vena comitantes and correspond with the arterial supply described above
Superficial veins of the upper limb
  • These do not have arterial counterparts
  • There are 3 key veins to know
    • Cephalic vein (laterally)
      • Comes up lateral bicep
      • Joins axillary vein
    • Basilic vein (medially)
      • Medial forearm (posterior then anterior)
      • Forms axillary vein at posterior axillary fold
    • Medial cubital vein
      • Crosses cubital fossa to link the two veins


Lymphatic drainage

  • There are two parallel systems
    • Superficial system
      • Skin, and epithelial drainage
      • Drains parallel to superficial veins
    • Deep system
      • Muscle and organ drainage
      • Drains parallel to arteries/deep veins to pan-aortic nodes.

 

 

Leave a Reply

Your email address will not be published. Required fields are marked *