Arterial Blood Supply of the Upper Limb

Arterial Blood Supply of the Upper Limb

• Subclavian artery: Primary blood supply to the upper limb
  • Becomes the axillary artery after passing the first rib.
• Axillary artery: Passes through the axilla and becomes the brachial artery at the lower border of the teres minor muscle.
  • Divided into three parts using the pectoralis minor muscle as a landmark:
    • Part 1 (medial to pectoralis minor): Supplies deep muscles of the first and second intercostal spaces via the superior thoracic artery.
    • Part 2 (behind pectoralis minor): Supplies structures with branches of the thoracoacromial artery (ACPD: acromial, pectoral, clavicular, deltoid). Also supplies the anterior serratus muscle and mammary glands via the lateral thoracic artery.
    • Part 3 (lateral to pectoralis minor): Supplies subscapularis muscle via the subscapular artery, branching into the thoracodorsal artery and scapular circumflex artery. Supplies the shoulder joint and deltoid muscle with the anterior and posterior humeral circumflex arteries. The scapular circumflex artery forms a loop in the infraspinous fossa, connecting with the suprascapular artery.
• Brachial artery:
  • Lies on the medial bicipital groove between the biceps and triceps.
  • Commonly utilized for blood pressure measurements.
  • Supplies muscles of the anterior compartment (coracobrachialis, biceps, brachialis) and posterior compartment (triceps) via the deep brachial artery, which runs behind.
  • Branches related to the elbow:
    • Superior ulnar collateral artery: Lies in the groove of the ulnar nerve
    • Inferior ulnar collateral artery: Passes in front of the medial epicondyle
    • Radial collateral artery: Runs posteriorly
    • Medial collateral artery: Posteriorly, connects with the anterior and posterior interosseous arteries.
    • Recurrent radial artery: Communicates with radial collateral artery
    • Recurrent ulnar artery: Divides into anterior and posterior branches, connecting with inferior ulnar and superior ulnar collateral arteries, respectively.
• Radial artery:
  • Lies between the brachioradialis and flexor carpi radialis muscles.
  • Pulse palpable above the styloid process of the radius.
  • Supplies the anterior forearm compartment and the radial side of the posterior compartment.
  • Passes behind the thumb muscles (abductor pollicis longus and extensor pollicis longus) and through the anatomical snuffbox before piercing the muscles to the first intercostal space, forming the deep palmar arch with the ulnar artery.
  • Provides the superficial palmar branch, connecting with the ulnar artery to form the superficial palmar arch.
  • Forms the palmar carpal network, supplying the wrist.
• Ulnar artery:
  • Enters the hand as the superficial palmar arch.
  • Forms the dorsal carpal network with the radial artery, posterior interosseous artery, and anterior interosseous artery.
• Blood supply of the hand:
  • Palmar side:
    • Supplied by the superficial and deep palmar arches.
    • Superficial palmar arch: Three common palmar digital arteries divide into two proper palmar digital arteries, supplying the radial side of the little finger, ring finger, middle finger and ulnar side of the index finger.
    • Deep palmar arch: Supplies the thumb and ulnar side of the index finger via the princeps pollicis artery (main artery of the thumb).
    • Palmar metacarpal arteries: Connect the deep and superficial palmar arches.
  • Dorsal side:
    • Supplied by the dorsal carpal network (dorsal carpal arch), branching into dorsal metacarpal arteries and then dorsal digital arteries.