Upper Limb

I. ARTERIAL SUPPLY (Figure 18-1)

A. The subclavian artery extends from the arch of the aorta to the lateral border of the first rib. It has the following branches:

1. Internal thoracic artery, which is continuous with the superior epigastric artery, which anastomoses with the inferior epigastric artery (a branch of the external iliac artery). This pathway provides a route of collateral circulation if the abdominal aorta is blocked (e.g., postductal coarctation of the aorta).

2. Vertebral artery

3. Thyrocervical trunk, which has three branches:

a. Suprascapular artery, which participates in collateral circulation around the shoulder b. Transverse cervical artery, which participates in collateral circulation around the shoulder c. Inferior thyroid artery (see Chapter 20 IV A 1)

B. The axillary artery is a continuation of the subclavian artery. It extends from the lateral border of the first rib to the inferior border of the teres major muscle. The tendon of the pectoralis minor muscle crosses the axillary artery anteriorly. The axillary artery gives off the following branches:

1. Thoracoacromial artery

2. Lateral thoracic artery

3. Anterior humeral circumflex artery

4. Posterior humeral circumflex artery

5. Subscapular artery, which gives off the circumflex scapular artery

C. The brachial artery is a continuation of the axillary artery. It extends from the lateral border of the teres major muscle to the cubital fossa. The brachial artery has the following branches:

1. Deep brachial artery. A midshaft fracture of the humerus may damage the deep brachial artery and radial nerve as they travel together on the posterior aspect of the humerus in the radial groove.

2. Radial artery

3. Ulnar artery

D. Superficial palmar arch

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Pregnancy Guide

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