BMS Anatomy Asynchronous Lecture 9 Upper Limb Vasculature and Transitional Areas PDF

BMS Anatomy Asynchronous Lecture 9 Upper Limb Vasculature and Transitional Areas Presented By: Dr. M. Doroudi; [email protected] Boucher Campus) Moore's Clinically Oriented Anatomy, by Arthur F. Dalley II Ph.D. FAAA (Author), Anne M. R. Agur BSc (OT) MSc Ph.D. FAAA (Author), 9th ed. Upper Limb Chapt...

BMS Anatomy Asynchronous Lecture 9 Upper Limb Vasculature and Transitional Areas Presented By: Dr. M. Doroudi; [email protected] Boucher Campus) Moore's Clinically Oriented Anatomy, by Arthur F. Dalley II Ph.D. FAAA (Author), Anne M. R. Agur BSc (OT) MSc Ph.D. FAAA (Author), 9th ed. Upper Limb Chapter; Pages: 162 – 167, 189 – 194, 212 – 213, 233 – 237, 255 – 258 BLOOD SUPPLY OF THE UPPER EXTREMITY 2 BLOOD SUPPLY OF THE UPPER EXTREMITY 3 Axillary Artery 5 Axillary Artery 6 This artery is the continuation of subclavian artery, and lies between the first rib and the lower border of teres major muscle or pectoralis major muscle. Based on the position of the artery relative to the pectoralis minor muscle, axillary artery is divided into three different parts. The first part which lies before the muscle, has one branch which supplies the upper part of the thoracic cavity; hence the name Superior Thoracic artery. The second part of the artery that is covered by the muscle anteriorly, gives off two branches. The first branch is called thoracoacromial, and supplies some parts of pectoral and deltoid regions. The second branch is called lateral thoracic artery which mainly supplies the lateral thoracic wall including the serratus anterior muscle. The third part of the artery locating after the pectoralis minor gives off three branches. first branch is subscapular artery that supplies the muscles of the scapular region. The other two branches are anterior and posterior circumflex humeral arteries which turn around the surgical neck of the humerus anteriorly and posteriorly respectively. These arteries will supply those muscles attached to the proximal end of humerus. After passing the inferior border of teres major or pectoralis, the name of the artery will change to Brachial artery. 7 Brachial Artery This artery starts at the lower border of teres major or pectoralis major. Then it runs down in the arm. The main branches of the brachial artery are as follows: 1.Deep brachial (profonda brachii) artery, which moves posteriorly towards the radial groove to accompany the radial nerve. Here it supplies the posterior compartment of the arm. 2.Muscular branches (2-5) for the anterior compartment musculature. 8 Arteries of the Forearm ❑Brachial A. ends in the distal part of the cubital fossa by dividing into the ulnar and radial arteries.  Ulnar A. : The larger of the two terminal branches of the brachial artery. The ulnar artery lies under flexor carpi ulnaris and is accompanied by ulnar nerve on its way. Its branches in the forearm are more numerous than radial artery and supply the elbow, muscles of the anterior compartment on the medial side, the deep muscles of anterior compartment of forearm, the majority muscles of the posterior compartment and the wrist joint. It passes distally over the anterior aspect of the wrist to the palm and takes part in forming the palmar arterial arches.  Radial A.: Is smaller than the ulnar artery and supplies the lateral side of the forearm. The radial artery descends on the lateral side of the forearm under the cover of the brachioradialis muscle. The branches of this artery in forearm will supply elbow , muscles of the anterior compartment on the lateral side, the muscles on the lateral side of the posterior compartment, and the wrist joint. In the distal part of the forearm, it passes through the anatomical snuff box and, after passing through the first interosseous space in hand, enters the palm of the hand and takes part in forming the deep palmar arch. 9 Arteries of the Hand Radial artery is the major source of blood supply for the dorsal surface of the hand. The branches of this artery form a dorsal arterial arch at the level of carpal bones. The other branches of the radial artery will join with terminal branches of the ulnar artery to form a superficial and a deep palmar arterial arch. Arteries derived from these arches will supply the hand. 10 11 12 13 14 Surface Anatomy of Upper Limb 15 Surface Anatomy of Upper Limb 16 Surface Anatomy of Upper Limb 17 Locations of the Arterial Pulses of the Upper Limb Venous Return of the upper Extremity The venous system of the upper limb drains deoxygenated blood from the hand, forearm, and hand It can anatomically be divided into the superficial veins and the deep veins 19 20 21 22 Upper Limb Area of Transition 23 Cubital Fossa 24 Carpal Tunnel 25 Axilla ❑ Axilla or armpit is a four-sided pyramidal space situated between the upper part of the arm and the chest wall. This space is a transition region between the root of the neck and the upper limb and most of the structures that enter or leave the upper limb pass through this space. ❑ It has 4 walls: √ Anterior wall is formed by the pectoral region. √ Posterior wall is formed by the scapular region √ Medial wall is formed by the upper 4 ribs and the upper part of he serratus anterior muscle that attaches to these ribs. √ Lateral wall is narrow and is formed by the upper part of the humerus. Contents of Axilla Axillary artery and its branches Axillary vein and its tributaries Infraclavicular part of the brachial plexus Axillary Lymph nodes 27