Arteries - Upper Extremity
Arteries of the Upper Extremity
The upper extremities are supplied with oxygenated blood by branches aortic arch.
- Review bones
Branches of the aortic arch:
- Brachiocephalic trunk
- Gives rise to the right common carotid and right subclavian arteries.
- Left common carotid artery
- Supplies head and neck
- Left subclavian artery
- Supplies left arm
Subclavian artery
The subclavian artery curves inferiorly and passes under the clavicle (hence its name, sub-clavian a.).
- Gives rise to the Axillary artery at lateral border of first rib.
Axillary artery
Arises from subclavian artery.
- Branches of the axillary artery can be organized by their relationship to pectoralis minor:
- Superior thoracic artery: Proximal to pectoralis minor; this small artery serves the upper areas of the medial and anterior axillary walls.
- Thoraco-acromial artery: Deep to pectoralis minor; has four branches (the pectoral, deltoid, clavicular, and acromial branches, which are named for their target regions).
- The lateral thoracic artery: travels inferiorly along the medial and anterior surface of the thoracic cage.
- Subscapular artery: Distal to pectoralis minor; gives rise to arteries that serve the posterior scapular region.
- The anterior and posterior circumflex arteries: Distal to pectoralis minor; wrap around the surgical neck of the humerus to form an anastomosis.
Brachial artery
Arises from axillary artery at the inferior border of teres major.
- Deep brachial artery:
- Travels posteriorly around the humerus in the radial groove (to serve the triceps brachii).
- Wraps anteriorly over the lateral epicondyle of the humerus, where it becomes the radial collateral artery.
Radial collateral artery
- Arises from the brachial artery and anastomoses with the recurrent radial artery, which ascends from the radial artery.
Ulnar collateral arteries
Arteries form anastomoses:
- From the medial side of the brachial artery:
- From the ulnar arteries:
- The ulnar artery also gives rise to the common interosseous artery, which splits to form the posterior and anterior interosseous arteries. These anterior and posterior branches will anastomose in the distal forearm.
Radial and ulnar arteries
- Arise from brachial artery bifurcation at the elbow.
Deep and superficial arteries of the palm
- In the palm, arise from the radial and ulnar arteries.
- Deep and superficial arteries anastomose (and give rise to several branches that serve the palmar and dorsal aspects of the hand).
Clinical correlation:
- The radial artery is often chosen for arterial puncture (aka, stick), in which blood is sampled for blood gas analysis.
- Prior to arterial puncture, an Allen test is performed to assess collateral blood flow in the palm.
- Sufficient ulnar arterial contribution is necessary to ensure that if the radial artery is accidentally severed during the puncture, palmar blood supply will be maintained.