Arteries of the Upper Limb

The blood to the upper limb is supplied by 4 major arteries: axillary, brachial, radial, and ulnar.

The subclavian artery is followed by the axillary. Its name is changed to brachial artery at the lower border of the teres major muscle. The brachial artery continues down the arm and just distal to the elbow joint, it splits into radial and ulnar arteries, which follow the bones, following which they are named. Radial artery ends by forming the deep palmar arch in the hand, and ulnar artery terminates by creating the superficial palmar arch.

  • The axillary artery supplies the shoulder region.
  • The brachial artery supplies the anterior and posterior compartments of the arm.
  • The radial and ulnar arteries supply the lateral and medial parts of the forearm, respectively.

The axillary is the continuation of subclavian artery. At the lower border of the teres major muscle its name is changed to brachial artery. The brachial artery continues down the arm and just distal to the elbow joint, it divides into radial and ulnar arteries, which follow the bones, after which they’re named. In the hand, radial artery ends by creating the deep palmar arch and ulnar artery ends by creating the superficial palmar arch.

Axillary Artery

  • The axillary artery supplies the shoulder region.
  • The axillary artery supplies the walls of the axilla and related regions, and continues as the major blood supply to the more distal parts of the upper limb.
  • The subclavian artery in the neck becomes the axillary artery in the lateral margin of rib I and goes through the axilla, becoming the brachial artery in the inferior margin of the teres major muscle.

The axillary artery is divided into 3 parts by the pectoralis minor muscle, which crosses anteriorly to the vessel:

  • The first part is proximal to the pectoralis minor.
  • The second part is posterior to the pectoralis minor.
  • The third part is distal to the pectoralis minor.

Usually, 6 branches originate from the axillary artery:

  • 1 branch, the superior thoracic artery, starts from the first part.
  • 2 branches, the thoraco-acromial artery and the lateral thoracic artery, starts from the 2nd part.
  • 3 branches, the subscapular artery, the anterior circumflex humeral artery, and the posterior circumflex humeral artery, starts from the third part.

Brachial Artery

  • The brachial artery supplies the anterior and posterior compartments of the arm.
  • The major artery of the arm, the brachial artery, is seen in the anterior compartment. Beginning as a continuation of the axillary artery at the lower border of the teres major muscle, it ends just distal to the elbow joint where it divides into the radial and ulnar arteries.
  • In the proximal arm, the brachial artery is located on the medial side. In the distal arm, it moves laterally to assume a position midway between the lateral epicondyle and the medial epicondyle of the humerus. It crosses anteriorly to the elbow joint where it is located immediately medial to the tendon of the biceps brachii muscle. The brachial artery is palpable along its length. In proximal regions, the brachial artery can be compressed against the medial side of the humerus.
  • Branches of the brachial artery in the arm contain those to adjacent muscles and 2 ulnar collateral vessels, which contribute to a network of arteries around the elbow joint. Additional branches are the profunda brachii artery and nutrient arteries to the humerus, which go through a foramen in the anteromedial surface of the humeral shaft.

Profunda Brachii Artery

  • The profunda brachii artery, the largest branch of the brachial artery, enters into and supplies the posterior compartment of the arm. It enters the posterior compartment together with the radial nerve and together they go through the triangular interval, that is created by the shaft of the humerus, the inferior margin of the teres major muscle, and the lateral margin of the long head of the triceps muscle. They then pass along the radial groove on the posterior surface of the humerus deep to the lateral head of the triceps brachii muscle.
  • Branches of the profunda brachii artery supplies adjacent muscles and anastomose with the posterior circumflex humeral artery. The artery ends as 2 collateral vessels, which contribute to an anastomotic network of arteries around the elbow joint.

Radial And Ulnar Arteries

The radial and ulnar arteries supplies the medial and lateral parts of the forearm, respectively.

Radial Artery

The radial artery comes from the brachial artery at roughly the neck of the radius and enters along the lateral aspect of the forearm. It is:

  • just deep to the brachioradialis muscle in the proximal half of the forearm,
  • related on its lateral side to the superfcial branch of the radial nerve in the middle third of the forearm, and
  • medial to the tendon of the brachioradialis muscle and covered only by deep fascia, superfcial fascia, and skin in the distal forearm.

Ulnar Artery

The ulnar artery is larger in relation to the radial artery and enters down the medial side of the forearm. It leaves the cubital fossa by passing deep to the pronator teres muscle, and after that goes through the forearm in the fascial plane between the flexor carpi ulnaris and flexor digitorum profundus muscles.

The ulnar artery leaves the forearm, enters the hand by passing lateral to the pisiform bone and superfcial to the flexor retinaculum of the wrist, and arches over the palm. It is mostly the major blood supply to the medial 3 and half digits.

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