22/03/2010
1
ARTERIES & VEINS
of the upper limb
Marc REVOL, 2010
1www.anato.info 2
Arteries and veins of the upper limb
www.anato.info
ARTERIES
The subclavian artery becomes the axillary
artery after crossing the 1st rib
The axillary artery becomes the brachial artery
after crossing the posterior axillary fold
The brachial artery divides just distal to the
elbow into the radial and ulnar arteries.
The ulnar artery gives rise to the common
interosseous artery, which divides into anterior
and posterior interosseous arteries.
The hand is supplied on the palmar aspect by
variable anastomoses between branches of the
radial and ulnar arteries.
3
Arteries and veins of the upper limb
www.anato.info
Brachial artery
� Begins at the distal border of the tendon of teres major
� Ends about 1 cm distal to the elbow joint by dividing into radial and ulnar
arteries.
� Branches :
o Profunda brachii artery
o Nutrient artery of humerus
o Superior ulnar collateral artery
o Middle ulnar collateral artery (if present)
o Inferior ulnar collateral artery
o Muscular branches
4
Arteries and veins of the upper limb
www.anato.info
1. Profunda brachii artery
2. Radial collateral artery
3. Middle collateral branch of profunda brachii
artery
4. Superior ulnar collateral artery
5. Inferior ulnar collateral artery
6. Anterior ulnar recurrent artery
7. Posterior ulnar recurrent artery
8. Radial artery
9. Ulnar artery
10. Radial recurrent artery
11. Ulnar recurrent artery
12. Common interosseous artery
13. Interosseous recurrent artery (& posterior
interosseous artery)
14. Anterior interosseous artery
5
Arteries and veins of the upper limb
www.anato.info 6
Arteries and veins of the upper limb
www.anato.info
22/03/2010
2
7
Arteries and veins of the upper limb
www.anato.info
1. brachial artery
2. Radial artery
3. Radial recurrent artery
4. Ulnar artery
5. Common interosseous artery
6. Ulnar artery
7. Ulnar recurrent artery
8. Interosseous recurrent artery
9. Posterior interosseous artery
10. Anterior interosseous artery
8
Arteries and veins of the upper limb
www.anato.info
Radial artery
� Begins from the brachial artery near the neck of the radius
� passes deep to brachioradialis
� At the wrist it passes in the anatomical snuff box
� Ends in the hand by anastomosis with the deep branch of the ulnar artery,
completing the deep palmar arch
� Branches :
o Radial recurrent artery (anastomoses with the radial collateral
branch of the profunda brachii)
o Muscular branches
o Cutaneous branches
9
Arteries and veins of the upper limb
www.anato.info 10
Arteries and veins of the upper limb
www.anato.info
11
Arteries and veins of the upper limb
www.anato.info 12
Arteries and veins of the upper limb
www.anato.info
Ulnar artery
� Begins from the brachial artery near the neck of the radius
� passes deep to pronator teres, flexor carpi radialis, palmaris longus and
flexor digitorum superficialis
�The ulnar head of pronator teres separates it from the median nerve
� At the wrist it passes in the anatomical snuff box
� Ends in the hand by anastomosis with the superficial palmar branch of the
radial artery, completing the superficial palmar arch.
� Branches :
o Anterior ulnar recurrent artery
o Posterior ulnar recurrent artery
o Common interosseous artery, which divides into anterior
interosseous artery and posterior interosseous artery (which gives
rise to the posterior interosseous recurrent artery) .
o Muscular branches
o Cutaneous branches along the septum between flexor carpi ulnaris
and flexor digitorum superficialis.
22/03/2010
3
13
Arteries and veins of the upper limb
www.anato.info
Anterior interosseous artery
� Begins at the proximal border of the interosseous membrane
� Descends on the anterior aspect of the interosseous membrane with the
anterior interosseous branch of the median nerve, between the contiguous
sides of flexor digitorum profundus and flexor pollicis longus.
� Pierces the interosseous membrane proximal to pronator quadratus
� Distally it anastomoses with the posterior interosseous artery and the
dorsal carpal arch.
� Branches :
o Median artery
o Muscular branches for FDP, FPL, pronator quadratus, and deep
extensor muscles
o Small cutaneous branches for the lower lateral border of the
forearm
14
Arteries and veins of the upper limb
www.anato.info
15
Arteries and veins of the upper limb
www.anato.info
Posterior interosseous artery
� Begins at the proximal border of the interosseous membrane
� Passes dorsally between supinator and abductor pollicis longus
� Descends deep in the groove between extensor carpi ulnaris and extensor
digiti minimi
� Distally it anastomoses with the terminal part of the anterior interosseous
artery and the dorsal carpal arch.
� Branches :
o Multiple muscular branches
o Fascio-cutaneous branches in the intermuscular septum
16
Arteries and veins of the upper limb
www.anato.info
17
Arteries and veins of the upper limb
www.anato.info
VEINSThe venous drainage of the upper limb is composed of
superficial and deep vessels.
The deep veins accompany the arteries. They are
connected to the superficial system by perforating
veins.
The superficial veins starts on the back of the hand as a
dorsal arch.
•The cephalic vein begins at the radial extremity of
the arch. It ascends along the lateral aspect of the
arm, then it pierces the deep fascia to enter the
axillary vein just distal to the clavicle.
•The basilic vein passes along the medial aspect of
the forearm, pierces the deep fascia at the elbow
and joins the venae comitantes of the brachial
artery
•The median cubital vein links the cephalic and
basilic veins in front of the elbow.
18
Arteries and veins of the upper limb
www.anato.info
22/03/2010
4
19
Arteries and veins of the upper limb
www.anato.info
ReferencesDoyle JR, Botte MJ. Surgical anatomy of the hand & upper extremity.
Lippincott Williams & Wilkins, Philadelphia, 2003 (721 p)
Grant’s atlas of anatomy
Williams and Wilkins. Baltimore, 9th edition, 1991 (650 p)
Gray’s anatomy. The anatomical basis of clinical practice.
Elsevier Churchill Livingstone, 39th edition, 2005 (1627 p)
Manuel de chirurgie plastique, reconstructrice et esthétique
Sauramps Médical, 2ème édition, 2009 (874 p)
Netter FH. Atlas d’anatomie humaine.
Icon learning system, 1997, 2ème édition (525 pages)
Schmidt HM, Lanz U. Surgical anatomy of the hand.
Thieme. Stuttgart, 2004 (258 p)
www.anato.info