Slides_08_UpperLimbAnatomy_Pickering.pdf

Overview of blood supply
to the upper limb
With Dr. James Pickering
Maria Rodríguez, ilenbravodiaz@gmail.com
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Introduction
1. Overview of blood supply to upper limb
• Axilla | Arm | Forearm | Arm
2. Axillary artery
• Three divisions | Branches
3. Brachial artery
• Branches
4. Ulnar and radial arteries
• Branches | Anastomoses around the elbow
5. Superficial and deep palmar arches
• Formation of palmar arches | Blood supply to digits

Overview of blood supply to upper limb

Each upper limb is supplied with arterial blood
via the left or right subclavian artery.
For the left upper limb the subclavian artery
originates from the arch of the aorta; for the
right it originates from the brachiocephalic
trunk.
The principle artery/arteries of the:
• Axilla – axillary
• Arm – brachial
• Forearm – radial and ulna
• Hand – superficial and deep palmar arches
Overview of blood supply to upper limb

Blood supply: Axillary artery

Divided into three parts:
1. Between lateral border of rib 1 and medial
border of pectoralis minor
• Superior thoracic artery = Supplies 1st
and 2nd intercostal space and serratus
anterior
2. Posterior to pectoralis minor
• Lateral thoracic artery = Supplies
lateral thoracic wall
• Thoraco-acromial artery

Divided into three parts:
3. Lateral border of pectoralis minor to
inferior border of teres major
• Subscapular artery = Supplies
thoracic wall
• Anterior and posterior circumflex
humeral artery = Anastomose around
surgical neck of humerus

Coming from the second part of axillary, deep
to pectoralis minor = thoraco-acromial artery
Short wide artery, pierces the clavipectoral
fascia and divides into four branches:
1. Clavicular
2. Pectoral
3. Deltoid
4. Acromial
Blood supply: Thoraco-acromial artery

Blood supply: Antero-medial arm

Brachial artery begins at the inferior border
of the teres major as the direct continuation of
the axillary artery and passes through the arm
anterior to triceps and brachialis.
Branches (from lateral aspect):
• Numerous unnamed branches
• Nutrient artery to humerus
Blood supply: Brachial artery

Branches (from medial aspect):
• Profunda brachii
• Supplies posterior compartment
of arm
• Superior and inferior ulnar collateral
branches
• Forms anastomosis around
the elbow joint
Blood supply: Brachial artery

Blood supply: Posterior axilla and arm

From third part of axillary:
• Posterior circumflex artery passes through
quadrangular space with axillary nerve
• Circumflex scapular artery, from the
subscapular artery, runs over the posterior
surface of the scapula and forms an
anastomosis around the scapula with the
suprascapular artery

From brachial artery:
• Profunda brachii (deep artery of arm) runs
alongside radial nerve and passes through
the triangular interval to posterior
compartment
• Gives off anterior and posterior radial
collateral arteries around the elbow

Forearm: Radial and ulnar arteries
Anterior view; right

Brachial artery passes through cubital fossa
and bifurcates into: Ulnar and Radial
Ulnar artery: Passes through anterior
compartment deep to pronator teres and runs
alongside flexor carpi ulnaris with the ulnar
nerve running medial
Radial artery: Passes through the anterior
compartment deep to brachioradialis. It exits
the forearm by passing around lateral wrist to
enter anatomical snuff box in the hand
Anterior view; right

Numerous anastomoses around the elbow
joint:
• Radial > Radial recurrent = Radial
collateral < Profunda brachii
• Ulnar > Anterior and posterior recurrent
= Inferior and superior ulnar collateral
< Brachial artery
Anterior view;
right

Other branches
• Ulnar > Common interosseous
> Anterior and posterior interosseous
(run either side of interosseous
membrane)
• Radial > dorsal and palmar carpal
branches = dorsal and palmar carpal
branches < Ulnar (run over wrist)
Anterior view;
right

Blood Supply: Hand

All arterial blood to the hand is supplied
by the radial and ulnar arteries
Form two palmar arches that run across the
central compartment of the hand: Superficial
and Deep
Ulnar
Enters anterior to flexor retinaculum (Guyon’s
canal) between pisiform and hook of hamate.
Gives rise to deep palmar branch and then
passes superficial to the long flexor tendons,
forming the superficial palmar arch by turning
laterally.
Blood Supply: Hand

This arch gives off three common palmar
digital arteries. These anastomose with
palmar metacarpal arteries from the deep
palmar arch and supply the digits via proper
palmar digital arteries.
The superficial palmar arch unites with the
radial artery to complete the arch
Blood Supply: Hand

Radial
Wraps around lateral wrist to run along floor
of anatomical snuff box.
Enters palm by passing between the heads
of the 1st dorsal interosseous muscle
Continues medially across base of
metacarpals and unites with the deep palmar
branch of the ulnar to complete the deep
palmar arch.
Blood Supply: Hand

The deep palmar arch gives rise to three
palmar metacarpal arteries that anastomose
with the common palmar digital arteries.
Also gives off princeps pollicis and radialis
indices arteries to supply the thumb and
index finger, respectively.
Blood Supply: Hand

Summary
1. Overview of blood supply to upper limb
• Axilla | Arm | Forearm | Arm
2. Axillary artery
• Three divisions | Branches
• Anastomoses around the scapula
3. Brachial artery
• Profunda brachii
• Collateral branches to elbow

Summary
4. Ulnar and radial arteries
• Recurrent and collateral branches form anastomoses around
elbow
• Interosseous branches to supply deep musculature
• Palmar and dorsal carpal arches
5. Superficial and deep palmar arches
• Superficial palmar arch via Ulnar artery
• Deep palmar arch via Radial artery

This document is a property of: Maria Rodríguez
Note: This document is copyright protected. It may not be copied, reproduced, used, or
distributed in any way without the written authorization of Lecturio GmbH.

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