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ARTERIES & VEINS

of the upper limb

Marc REVOL, 2010

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Arteries and veins of the upper limb

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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.

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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

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Arteries and veins of the upper limb

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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

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Arteries and veins of the upper limb

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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

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Arteries and veins of the upper limb

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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

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Arteries and veins of the upper limb

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Arteries and veins of the upper limb

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Arteries and veins of the upper limb

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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.

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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

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Arteries and veins of the upper limb

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Arteries and veins of the upper limb

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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

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Arteries and veins of the upper limb

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Arteries and veins of the upper limb

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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.

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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)

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