Arterial Supply Upper Limb

Subclavian Artery



- on right arises from brachiocephalic trunk behind right sternoclavicular joint

- on left arises from the arch of the aorta



- outer border first rib as axillary artery


First part

- origin of artery to medial aspect scalenus anterior

- on right arches above the clavicle / lies on the pleura / RLN wraps about it

- vertebral artery / thyrocervical trunk branches


Second part

- behind scalenus anterior


Third part

- from lateral scalenus anterior to outer border first rib

- behind subclavius and the subclavian vein

- trunks of brachial plexus around it


Access / Proximal control

- must remove central portion clavicle


Axillary Artery



- Outer border first rib



- lower border teres major to become brachial artery



- axillary vein medial and anterior

- covered by P major and minor


Second part

- behind P major

- cords of the brachial plexus suround the second part


Third part

- below P major

- medial to conjoint tendon

- median nerve is lateral, median branch median crosses artery

- ulna nerve is medial



- thoracoacromial

- subscapular

- anterior and posterior circumflex humeral


Access / Proximal control

- divide P major from humerus

- divide P minor from medial coracoid

- take conjoint tendon from coracoid / coracoid osteotomy


Brachial Artery



- lower border tendon T major



- division radial and ulna at elbow / neck of the radius



- initially medial to humerus

- at elbow is midpoint between 2 epicondyles

- 2 venae commitantes

- basilic vein runs with it in upper part of arm / is superfical to fascia distally

- medial nerve is medial to nerve in lower part of arm

- crossed by lacertus fibrosis

- biceps tendon medial



- profunda brachii to run with radial nerve

- superior and inferior ulna collateral


Radial artery



- cubital fossa between BR and PT

- continuation of the brachial artery

- smaller than ulna artery


Relation forearm

- runs under brachioradialis

- runs over biceps / PT / FDS / FPL and PQ

- emerges between BR and FCR at the wrist

- accompanied by venae commitantes

- radial recurrent branch / leash of Henry to BR


Relations wrist

- runs under APL and EPB to dorum of wrist

- over volar aspect of scaphoid

- passes between 2 heads first dorsal interossei and Adductor Pollicis

- branches princeps pollicis and radialis indicis


Relations hand

- anastomoses with deep branch ulna artery

- forms deep carpal arch on the base of the metacarpals

- branches are the volar metacarpal arteries


Ulna artery


Larger branch


Relations elbow

- passes deep to two heads pronator teres

- median nerve passes superficial to it and the ulna head PT


Relations forearm

- lies on FDP between FDS and FCU

- runs with 2 venae comitantes

- emerges on radial side of the FCU with the ulna nerve medial to the artery

- posterior interosseous artery: passes dorsally between oblique ligament and interosseous membrane

- anterior interosseous artery: runs on interosseous membrance before passing dorsally proximally to PQ


Relations wrist

- passes into Guyon's canal on transverse carpal ligament

- roof is volar carpal ligament / pisiform medial

- becomes the superficial volar arch


Superficial volar arch

- runs at distal end transverse carpal ligament

- deep to palmar aponeurosis / superficial to FDS tendons

- 3 common volar arteries which each divide into two common digital arteries