Blood Vessels of the upper limb

1. a.subclavia
2. a.axillaris
3. a.brachialis
4. a. Radialis
5. a.ulnaris
• Arteries
– Carry blood from the
heart to the body
• Veins
– Return blood from the
capillary beds to the
heart
• Capillaries
– Simple endothelial
tubes connecting
arterial and venous
sides of the circulation
 Axillary Artery

• The axillary artery

begins at the lateral
border of the first
rib as a
continuation of the
subcla
 Arteri Axillaris
• Branches
First Part (1 branch)
1 superior
thoracic a.
(supreme thoracic a.)

Second Part(2 branches)

2 thoracoacromial a.
3 lateral thoracic a.

Third Part (3 branches)

4 subscapular a.
5 anterior humeral circumflex a.
6 posterior humeral circumflex a.
 Arteries of the Arm

• a.brachialis
• A.profunda brachii
(branches not shown on diagram)
• anterior branch
• posterior branch
• A.collateralis ulnaris
superior
• A.collateralis ulnaris
inferior
• Rr.musculares
 Arteries of Forearm

• 1 a.brachialis
• 2 a.radialis
– 3 a. recurrens radialis
– 4 a.superficial radialis
– 5 a.profunda radialis
• 6 ulnar
– 7 a. recurrens ulnaris ant/sup
– 7 a. recurrens ulnaris post/inf
– 8 a. interosseous communis
• 9 a. interosseous posterior
• 10 a.interosseous anterior
– 11 superficial branch
– 12 deep branch
Arteries of the Hand

• There are two arteries

entering the hand and
these are the:
1. radial
2. ulnar.
Together, the branches of
these arteries form two
arterial arches:
1. superificial
2. deep.
• Arcus Palmaris Superficialis :
- a.ulnaris
- Ramus palmaris superficialis a.radialis

• Percbgkan 3 aa digitales palmares

communis

percbgkan 3 aa digitalis propriae

• Arcus palmaris profundus
- ramus palmaris profundus a.ulnaris
- a.radialis
• Percabangan:3
aa.metacarpales palmares
 Venous Blood Supply

• cephalic vein (1) just

posterior to the styloid
process of the radius at
the wrist. This is the site
most often used for a cut
down in the upper limb.
• frequently, the cephalic
and basilic veins (2) can
be seen on either side of
the elbow where the
medial cubital vein is
located.
 Venous Blood Supply
• Superficial
1. v. cephalica
2. v.medina cubiti
3. v. basilia
– Superficial palmar venous
arch

3
• Deep
– Subclavian v.
– Axillary v.
– Radial and ulnar v.
– Deep palmar venous arch
 The Brachial Plexus

• Provides innervation of the upper limb

• Ventral rami of spinal nerves C5-8 and T1
form the plexus
 cervical

thoracal

lumbal
Conus medullaris

Cauda equina
Filum terminale internum

Filum terminale externum

 C1
n.Spinalis C1

n.Spinalis C8
n.SpinalisT1 Plexus brachialis

Plexus lumbalis

Plexus sacralis
 Substantia grisea
Subs. alba Fila radicularis radix post
Radix post.

Ganglion spinale

Ramus dorsalis n.spinalis

Ramus ventralis
• Roots (ventral rami)
• Trunks(truncus)
• Divisions
• Cords (fasciculus)
• Branches
 Roots Combine Forming Trunks
Which Then Split Into Divisions

C5 Anterior Division
Truncus sup
C6 Posterior Division

Anterior Division
C7 Truncus medius
Posterior Division

C8 Anterior Division
Truncus inferior
T1 Posterior Division
 Divisions Form Cords

• Anterior Lateral Cord (fasciculus)

Upper
• Posterior

• Anterior Medial Cord (fasciculus)

Middle • Posterior

• Anterior Posterior Cord (fasciculus)

Lower
• Posterior
 Cords Form Branches

• Lateral Cord Musculocutaneous n.

Median n.

• Medial Cord Ulnar n.

• Posterior Cord Radial n.

Axillary n.
Cabang terminal plexus brachialis
• n.musculocutaneus (C5-7)
• n.medianus (C5-Th.1)
• n.ulnaris (C8- Th.1)
• n.radialis (C5 – Th.1)
The Brachial Plexus – Innervation
of the Upper Limb
• N.Axillaris (fasciculus Posterior)
– Runs posterior to the neck of the humerus
– Deltoid and teres minor
– Skin over inferior half of deltoid

• Musculocutaneous Nerve (Terminal

Branch of Lateral Cord)
– Anterior arm
– Innervates arm flexors
– Distal to elbow, becomes cutaneous –
sensation on lateral forearm
The Brachial Plexus - Innervation
of the Upper Limb
• Median Nerve (Lateral & Medial Cords)
– Travels with brachial artery in arm, with radial
artery in forearm
– Muscles of flexor compartment of forearm
except flexor carpi ulnaris and medial flexor
digitorum profundus.
– Through carpal tunnel to 5 intrinsic muscles of
hand
– Skin of lateral 2/3 of hand on palm side and
dorsum of fingers 2 and 3
 The Brachial Plexus –
Innervation of the Upper Limb
• Ulnar Nerve (Medial cord)
– Descends along medial side of arm
– Passes posterior to medial epicondyle =
“funny bone”
– Runs with ulnar artery in forearm
– Innervates flexor carpi ulnaris and medial
flexor digitorum profundus in forearm
– Intrinsic muscles of hand except for 5
– Skin of medial 1/3 of hand anteriorly and
posteriorly
The Brachial Plexus – Innervation
of the Upper Limb

• Radial Nerve (Posterior Cord)

– Largest branch of brachial plexus
– Humerus in radial groove supplying posterior
compartment of arm
– Curves anteriorly around lateral epicondyle,
dividing into superficial and deep branch
– Superficial branch to skin on dorsolateral
surface of hand
– Deep branch to extensor muscles of forearm
Cutaneous Innervation of Hand

ventral
dorsal
 Surface Anatomy of Upper Limb

• Anatomical snuffbox( = Tabatiere

Anatomicum_
– Defined by tendons of thumb extensors
• Extensor pollicis brevis
• Extensor pollicis longus
• Floor
–Scaphoid, styloid of radius
• Contents – radial artery
Carpal Tunnel
• Carpus is concave
anteriorly
• Carpal ligament
covers the
concavity forming
the carpal tunnel
• Contents are flexor
tendons with their
synovial sheaths
and median nerve