Page 27 - Libro 2

1 — Vascular Anatomy
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then continues posteriorly on the left side of the tra- chea and curves downward, becoming the descend- ing aorta.
The first and largest branch of the aortic arch is the brachiocephalic artery (see Fig. 1-4). The bra- chiocephalic artery is typically 4 to 5 cm in length. At the sternoclavicular joint, the artery divides into the right CCA and the right subclavian artery. The second branch of the aortic arch is the left CCA. The last branch of the aortic arch is the left subclavian artery.
The subclavian arteries give rise to branches that supply the brain, the neck, thoracic wall, and the shoulder, including the vertebral and internal mam- mary arteries (Fig. 1-10). Beyond the outer border of the first rib, the subclavian artery becomes the axil- lary artery. From the axilla to approximately 1 cm below the elbow joint, the artery is known as the brachial artery. The largest branch of the brachial artery is the deep brachial artery, or profunda bra- chii. The brachial artery ends by dividing into the radial and ulnar arteries near the neck of the radius.
Thyrocervical trunk Dorsal scapular artery
Suprascapular artery Right subclavian artery
Thoracoacromial trunk
Posterior humeral circumflex artery Anterior humeral circumflex artery Axillary artery
Subscapular artery Brachial artery
Circumflex scapular artery
Radial artery
Deep palmar arch
The ulnar artery is usually slightly larger than the radial artery. The ulnar artery continues distally and courses along the ulnar border of the wrist. Beyond this point, the artery becomes the superficial palmar arch (Fig. 1-11). Major branches of the ulnar artery include the ulnar recurrent and interosseous arteries in the forearm, the palmar and dorsal carpal branch- es at the wrist, and the deep palmar and superficial palmar arch of the hand. The radial artery passes along the radial aspect of the forearm to the wrist, and then winds around the lateral aspect of the wrist to the dorsum of the wrist. It continues distally to join the deep palmar branch of the ulnar artery to form the deep palmar arch (Fig. 1-12). Branches of the radial artery include the radial recurrent, mus- cular, palmar carpal, and superficial palmar arteries. The superficial and deep palmar arches of the hand are continuations of the ulnar and radial arteries, re- spectively. The superficial palmar arch is completed by a branch of the radial artery. The deep palmar arch is completed by a branch of the ulnar artery. Both systems supply the digital arteries.
Right vertebral artery
Common carotid arteries
Left subclavian artery Brachiocephalic trunk
Internal thoracic artery
Lateral thoracic artery Thoracodorsal artery
Ulnar artery
Superficial palmar arch
Digital arteries
Figure 1-10 Diagram of the upper extremity arterial system.