Page 143 - Libro vascular I

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PERIPHERAL VASCULAR ULTRASOUND
Right common carotid artery Right vertebral artery
Right subclavian artery
Brachiocephalic trunk
Left common carotid artery Left subclavian artery
Left vertebral artery
Thyrocervical trunk
Internal thoracic artery
Axillary artery
Anterior and posterior humeral circumflex arteries
Deep brachial artery
Radial recurrent artery
Radial artery
Deep palmar arch
Proper digital arteries
Figure 10.2
Clavicle
1st rib (projecting back into page)
Subclavian artery
Sternum
Aortic arch
Brachial artery
Ulnar recurrent artery
Common interosseous artery
Ulnar artery
Superficial palmar arch
Common palmar digital arteries
The arterial anatomy of the arm and hand.
Figure 10.1 The arterial anatomy of the aortic arch and subclavian artery.
between the clavicle and first rib to become the axillary artery. The diameter of the SA ranges from 0.6 to 1.1 cm. The SA has a number of important branches, including the vertebral artery and inter- nal thoracic artery (also referred to as the mam- mary artery), which is frequently used for coronary artery bypass surgery.
The axillary artery becomes the brachial artery as it crosses the lower margin of the tendon of the teres major muscle, at the top of the arm. The diameter of the axillary artery ranges between 0.6 and 0.8cm. The brachial artery then runs distally on the medial or inner side of the arm in a groove between the triceps and biceps muscles. The deep brachial artery divides from the main trunk of the brachial artery in the upper arm and acts as an important collateral pathway around the elbow if the brachial artery is occluded distally. The brachial artery runs in a medial to lateral course over the inner aspect of the elbow (cubital fossa) and then divides, 1–2 cm below the elbow, into the radial and ulnar arteries. The ulnar artery dives deep beneath the flexor tendons in the upper forearm. The radial artery runs along the lateral side of the forearm toward the thumb and is palpable at the wrist. The ulnar artery runs along the medial side of the forearm and is sometimes the dominant vessel of the forearm. The common interosseous artery is an important branch of the ulnar artery in the upper forearm as
it can act as a collateral pathway if the radial and ulnar arteries are occluded. The radial artery sup- plies the deep palmar arch in the hand, and the ulnar artery supplies the superficial palmar arch. There are usually communicating arteries between the two systems. In some people only one of the wrist arteries will supply the palmar arch system. The fingers are supplied by the palmar digital arter- ies. There are a number of anatomical variations in the arm, which are shown in Table 10.1. The arms