Proper Planning and Preparation Prevents Poor Performance.

2. ARTERIAL SUPPLY OF THE
UPPER LIMB
Presented
To:
SIR MALIK SHERAZ

3. GROUP MEMBERS
1) Ismail Khan (Physiotherapist-JPMC)
2) Wasey Ali
3) Muhammad Irfan
4) Nisar Ali
5) Ishtiaque Ahmed
6) Syed Osama

4. OBJECTIVES
 Axillary artery
 Parts, Relations and Branches of Axillary artery
 The arterial anastomosis around the shoulder joint
 Brachial artery
 Relations and Branches of brachial artery
 The arterial anastomosis around the elbow joint.
 Radial and Ulnar arteries with their relations and branches.
 The formation of superficial and deep palmar arches.
 Pulsation areas of upper limb

5. ARTERIAL SUPPLY OF
THE UPPER LIMB
Axillary arteryAxillary artery
RightRight
subclaviansubclavian
arteryartery
BrachialBrachial
arteryartery
Radial
artery
UlnarUlnar
arteryartery
PalmarPalmar
archesarches

7. AXILLARY ARTERY
Origination:
Begins at the lateral border of 1st
rib as a continuation of
subclavian artery.
Termination:
Ends at the lower border of teres major muscle by
continuing as brachial artery.

8. Axillary Artery

9. PARTS OF AXILLARY
ARTERY
 Pectoralis minor muscle crosses in front of the artery and
divides it into 3 parts.
1) First part: Proximal to pectoralis minor (from lateral
border of 1st
rib to upper border of pectoralis minor).
2) Second part: Deep (behind) to pectoralis minor.
3) Third part: Distal to pectoralis minor (from lower
border of pectoralis minor to lower border of teres
major)

10. PARTS OF AXILLARY ARTERY

12.  RELATIONS
 Relations of 1st
part of Axillary Artery:
Anteriorly:
1.Skin
2.superficial fascia
3.Platysma
4.Supraclavicular nerves
5.Deep fascia
6.Pectoralis Major (clavicular part)
7.Clavipectoral fascia + cephalic vein, lateral pectoral nerve and
thoracoacromial artery

14.  Relations of 1st
part of Axillary Artery:
Posteriorly:
1) 1st
intercostal space
2) 1st
and 2nd
digitations of the serratus anterior + nerve
3) Long thoracic nerve

16.  Relations of 1st
part of Axillary Artery:
Laterally:
1) Lateral and posterior cords of brachial plexus
Medially:
1) Axillary vein
2) Medial pectoral nerve

18.  Relation of 2nd
part of Axillary Artery:
Anteriorly:
1)Skin
2)Superficial fascia
3)Deep fascia
4)Pectoralis Major
5)Pectoralis Minor

20.  Relation of 2nd
part of Axillary Artery:
Posteriorly:
1) Posterior cord of Brachial Plexus
2) subscapularis muscles

22.  Relation of 2nd
part of Axillary Artery:
Laterally:
1) Lateral cord of Brachial Plexus
2) coracobrachialis
Medially:
1) Medial Lateral cord of Brachial Plexus
2) Medial pectoral nerve
3) axillary vein

24.  Relation of 3rd
part of Axillary Artery:
Anteriorly:
1) Skin
2) Superficial fascia
3) Deep fascia
4) Pectoralis Major for a short distance
5) medial root of median nerve

26.  Relation of 3rd
part of Axillary Artery:
Posteriorly:
1) Subscapularis
2) Latissimus dorsi
3) Teres Major
4) Axillary and radial nerve

28.  Relation of 3rd part of Axillary Artery:
Laterally:
1) lateral root of median nerve
2) Musculocutaneous nerve
3) Corachobrachialis
4) Biceps
5) Humerus

30.  Relation of 3rd part of Axillary Artery:
Medially:
1) Axillary vein
2) Medial cutaneous nerve of arm
3) Medial cutaneous nerve of forearm
4) Ulnar nerve (between axillary artery & vein)

32. BRANCHES OF AXILLARY
ARTERY
Branches from 1st
part:
1) Superior (highest) thoracic artery
Branches from 2nd
part :
 Thoraco-acromial artery
 Lateral Thoracic artery
Branches from 3rd
part :
1)Subscapular artery
2)Anterior circumflex humeral artery
3)Posterior circumflex humeral artery

33. BRANCHES OF AXILLARY ARTERY

34. (1) SUPERIOR THORACIC ARTERY
 It is a very small branch arising from 1st
part.
 Near the subclavius.
 It runs downwards, forwards and medially passes
between the two pectoral muscles.
 Ends by supplying the pectoral muscles and thoracic wall.

36. (2) THORACO-ACROMIAL ARTERY
 Branch of 2nd
part.
 Emerges at the upper border of pectoralis minor.
 Pierces clavipectoral fascia.
 Divides into following 4 branches;
(a) Pectoral branch
(b) Deltoid branch
(c) Acromial branch
(d) Clavicular branch

38. BRANCHES OF THORACO-ACROMIAL
ARTERY:
(a) Pectoral Branch:
Passes between the pectoral muscles.
Supplies the pectoral muscles and the breast.
(b) Deltoid Branch:
Runs in the deltopectoral groove along with the cephalic
vein.

40. (c) Acromial Branch:
 Crosses the coracoid process and ends by joining the
anastomoses over the acromion.
(d) Clavicular Branch:
 Runs supermedially deep to the pectoralis major.
 Supplies the sternoclavicular joint & subclavius.

42. (3) LATERAL THORACIC ARTERY:
 Branch of 2nd
part.
 It emerges at, and runs along the lower border of
pectoralis minor.
 In females, the artery is large and gives off the lateral
mammary branches to the breast.

44. (4) ANTERIOR CIRCUMFLEX HUMERAL
ARTERY:
 A small branch arising from the 3rd
part of axillary artery.
 It passes laterlly in front of the intertubercular sulcus of
the humerus.
 Anastomoses with the posterior circumflex humeral
artery around the surgical neck of the humerus.

46. (5) POSTERIOR CIRCUMFLEX HUMERAL
ARTERY:
 Branch of 3rd
part.
 Much larger than anterior artery.
 It runs backwards.
 Passes through the quadrangular intermuscular space.
 Ends by anastomosing with the anterior circumflex
humeral artery around the surgical neck of the
humerus.

48. (6) SUBSCAPULAR ARTERY:
 It is the largest branch of the axillary artery, arising from
3rd
part.
 It runs along the lower border of the subscapularis.
 Ends near the inferior angle of the scapula.
 It supplies the latissimus dorsi and the serratus anterior.

50. SHOULDER JOINT
Anastomosis occurs between branches of first part of
Subclavian and third part of Axillary arteries;
 Branches from Subclavian Artery:
1) Suprascapular artery
2) Superficial cervical artery
 Branches from Axillary Artery:
1) Subscapular artery
2) Anterior circumflex humeral artery
3) Posterior circumflex humeral artery

51. BRANCH OF SUBSCAPULAR
ARTERY:
Circumflex Scapular Artery:
Larger than the continuation of the main artery.
Passes through the triangular intermuscular space.
Winds round the lateral border of scapula.
Further 2 Branches:
One branch to the subscapular fossa.
Another branch to the infraspinous fossa.
Both take part in the anastomoses around the scapula.

52. SHOULDER JOINT

53. BRACHIALARTERY
Origination:
Begins at the lower border of teres major muscle as a
continuation of Axillary artery.
Termination:
Terminates opposite the neck of the radius in the cubital
fossa by dividing into Radial and Ulnar arteries.

55. RELATIONS OF BRACHIALARTERY
Anteriorly:
1)Coracobrachialis
2)Biceps brachi
It is crossed by;
•In upper part: Medial cutaneous nerve of arm
•In middle part: Median nerve
•In lower part: Bicipital aponeurosis

58. RELATIONS OF BRACHIAL
ARTERY
Posteriorly:
1)Triceps brachii
2)Brachialis
3)coracobrachialis (insertion)
4)Radial nerve
5)Profunda brachii artery

59. RELATIONS OF BRACHIAL
ARTERY
Laterally: (2 parts)
In upper part: Median nerve, Coracobrachialis & biceps brachi
In lower part: Tendon of biceps
Medially: (2 parts)
In upper part: Ulnar nerve & Basilic vein
In lower part: Median nerve

60. RELATIONS OF BRACHIAL
ARTERY
 At the elbow, the structures from medial to the lateral
side are;
(1) median nerve
(2) Brachial artery
(3) Biceps brachii tendon
(4) Radial nerve on a deeper plane (MBBR)

62. ARTERY
1) Muscular branches
2) Nutrient artery to humerus
3) Profunda Brachii artery (accompanies the radial nerve)
4) Superior ulnar collateral branch (accompanies the ulnar nerve)
5) Inferior ulnar collateral (or supratrochlear) branch
6) Terminal branches (ends by)
(i) Radial artery
(ii) Ulnar artery

63. ES
OF
BRACHIA
L
ARTERY

64. PROFUNDA BRANCHII ARTERY
 Deep branchial artery
 Large branch of brachial artery
Origination:
Just below the teres major
Termination:
Divide into terminal branches as it pierces lateral
intermuscular septum in arm and accompany radial nerve.

65. BRANCHES OF PROFUNDA BRACHII
ARTERY:
(1) Ascending (deltoid) branch
(2) Anterior descending (radial collateral)
(3) Posterior descending (middle collateral)
(4) Nutrient artery to humerus

66. ELBOW JOINT
Anastomosis occurs between branches of Brachial, Radial and
Ulnar arteries:
 Branches from Brachial Artery:
1) Profunda Brachii artery
2) Superior ulnar collateral artery
3) Inferior ulnar collateral artery
 Branches from Ulnar and Radial Arteries:
1) Radial & ulnar recurrent arteries
2) Posterior interosseous recurrent artery

67. JOINT

68. SUBDIVISION OF
ANASTOMOSES
The anastomoses can be subdivided into following parts;
(1) In front of the lateral epicondyle of the humerus
(2) Behind the lateral epicondyle of the humerus
(3) In front of the medial epicondyle of the humerus
(4) Behind the medial epicondyle of the humerus

69. ANASTOMOSIS AROUND
ELBOW JOINT

70. RADIALARTERY
 Smaller terminal branch of Brachial artery.
Origination:
 Begins in the cubital fossa & passes below
Brachioradialis muscle.
Termination:
 Continues in hand as deep palmar arch

71. RELATIONS IN FOREARM
 It lies deep to brachioradialis but in lower part it becomes
superficial between brachioradialis tendon (laterally) and flexor
carpi radialis tendon (medially).
 Its bed is formed by biceps, supinator, pronator, F.D.S, F.P.L,
pronator quadratus & styloid process of radius.
 At wrist it winds backward and passes anteriorly into the palm
between two heads of 1st
dorsal interossei muscle.
 Then it joins deep branch of ulnar artery to form Deep Palmar
Arch.

72. RELATIONS IN HAND
 Enters the dorsum of hand deep to extensor
retinaculum.
 Leaves the dorsum of hand by turning forward between
proximal ends of 1st
and 2nd
metacarpal bones.
 In palm curves medially between two heads of adductor
pollicis and continues as deep palmar arch.

73. BRANCHES IN FOREARM
1) Muscular branches
2) Radial recurrent branch
3) Palmar carpal branch
4) Superficial Palmar branch (Joins ulnar artery to form
Superficial Palmar Arch)
5) Dorsal carpal branch

74. RADIA
L
ARTER
Y

75. BRANCHES IN HAND
 In The Dorsum Of Hand:
(1) First dorsum metacarpal artery (thumb & index finger)
(2) Communicating branch (anastomose around wrist joint)
 In The Palm:
(1) Radialis indicis
(2) Princeps pollicis artery
(3) Deep palmar branch

76. ULNAR ARTERY
Larger terminal branch of Brachial artery.
Origination:
Begins in the cubital fossa & descends through anterior
compartment of forearm.
Termination:
It ends by forming Superficial Palmar Arch with
Superficial Palmar branch of Radial artery.

77. RELATIONS IN FOREARM:
 It goes down & medially deep to P.T, F.C.R, P.L, F.C.U,
F.D.S.
 Its bed is formed by brachialis (in upper part only) &
F.D.P. (in lower part).
 In lower part it becomes superficial by coming in
between tendons of F.C.U. and F.D.S.

78. RELATIONS IN HAND:
 It enters the palm in front of flexor retinaculum.
 lateral to ulnar nerve and pisiform bone.

79. BRANCHES IN FOREARM:
1) Muscular branches
2) Anterior & posterior ulnar recurrent arteries
3) Palmar & dorsal carpal branches
4) Common Interosseous artery (largest branch)
a) Anterior Interosseous artery
b) Posterior Interosseous artery

80. BRANCHES IN HAND:
1) Superficial palmar branch
2) Deep Palmar branch
(arise in front of flexor retinaculum and passes
between abductor digiti minimi & flexor
digiti minimi then, Joins radial artery to
form Deep Palmar Arch)

81. ULNAR
ARTER
Y

82. ULNAR
ARTERY
BRANCH
ES

83. AREAS OF
ULNAR
&
RADIAL
ARTERIES
SUPPLY

84.  DEEP PALMAR ARCH
Formation:
From lateral side:
By direct continuation of Radial artery.
From medial side:
The Arch on medial side is completed by deep branch of
the ulnar artery.

85. RELATIONS:
1) Deep to long flexor tendons.
2) Superficial to metacarpal bones & interossel.
3) Deep branch of ulnar nerve lies with in its
concavity.

86. BRANCHES:
1) Three palmar metacarpal arteries
2) Three Perforating branches
3) Recurrent branches

87. DEEP
PALMA
R
ARCH

88.  SUPERFICIAL PALMAR ARCH
Formation:
From medial side:
Direct continuation of Ulnar artery.
From lateral side:
The Arch is completed by superficial palmar branch of the
radial artery.

89. RELATIONS:
Superficially:
1)Palmaris brevis
2)Palmar aponeurosis
Inferiorly:
1)long flexor tendons of finger
2)lumbricals
BRANCHES:
 Four digital arteries

90. SUPERFICI
AL
PALMAR
ARCH

91. AREAS OF
UPPER LIMB
ARTERIES
PULSATION

92. ANY
QUESTIONS. . . ???

93. THANK
YOU