The vascularization of

upper limb
Mr. Sbai Mohamed Ali
 Axillary artery
Origin: lower edge middle of the clavicle from
the subclavian artery
Diagonal path from top to bottom and from inside to outside
Termination: lower border of the pectoralis major by the artery
brachial
Collateral branches: 6
Superior thoracic artery, Thoracoacromial artery, Thoracic artery
lateral, A. scapular, A. anterior circumflex and A.
Circumflex post
Reports: before: aponeurosis of the small pectoral
subscapularis, teres major and latissimus dorsi
interior: serrated anterior
external: coracobrachial and scapula joint
humérale
Anteroposterior cut of the axillary region
Horizontal section of the axillary region
 6. Acromial bridge

7. Acromiothoracic artery

8. Br. for the deltoid

9. Superior thoracic artery.

1 Artère axillaire
2 Anterior circumflex artery

3 Posterior circumflex artery

10. Inferior scapular artery

4 Brachial artery
11. External mammary artery

12. Circumflex scapular artery

5 Deep brachial artery

13. Thoracodorsal artery
The richness of the vascularization of the
the root of the member is supported by
a developed anastomotic network
between these collaterals and two arteries
of extra axillary origin.
This is about AMI (b) issued directly
from the subclavian (1) and the artery
upper scapula (a) coming from
from the thyrocervical trunk (2).
3 anastomotic networks
The extra-scapular branches
restore downstream traffic in
case of insufficiency or obstacle on
the main trunk of the axillary artery
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 Brachial artery
Origin: lower edge of the pectoralis major from
the axillary artery

Straight path in the brachial canal

Termination: divides 3 cm below the bend of the elbow

in radial artery and ulnar artery
 Brachial artery
Reports: before: biceps
SIMI then triceps muscle
brachial fascia
external: coracobrachial then brachial
Relations with the nerves:
The median nerve runs along the lateral edge of the artery then the
crosses and becomes internal
The ulnar nerve is internal then posterior in the brachial compartment.
post
The radial nerve is posterior and runs with the humeral artery.
deep
 Horizontal section of the Arm
1/3 my – 1/3
inf

Reports of the artery

Brachiale
 Collateral branches: 5
deltoid
A. nourishment of the humerus,
A. deep humeral,
A. proximal ulnar collateral
distal ulnar collateral
 Brachial Artery.

Deep humeral artery.

Radial collateral artery.

Middle collateral artery.

Superior ulnar collateral artery.

Inferior ulnar collateral artery

Supra olecranon anastomosis

 Periarticular circle of the elbow
Medial peri-epicondylar network: anastomosis between some
collateral branches of the brachial artery and the artery
ulnar
the proximal and distal ulnar collateral arteries
brachial and the ulnar recurrent of the ulnar artery which
give two recurring branches ant and post
Lateral peri-epicondylar network: anastomosis between artery
deep humeral, interosseous artery and radial artery,
Supra-screen network
 Superior collateral ulnar artery.

Inferior ulnar collateral artery

Anterior recurrent ulnar artery.

Radial recurrent artery

Posterior ulnar recurrent artery.

Interosseous recurrent artery

Radial artery

Cubital artery
Brachial Artery.

12 Anterior recurrent ulnar artery

Recurrent radial artery

Interosseous recurrent artery

Posterior interosseous artery 11 Posterior ulnar recurrent artery

10 Anterior interosseous artery

Radial artery
Cubital artery
 Radial artery
Origin: born in view of the radius neck 3 cm from the fold of the
code
Descend laterally in the antebracial region anterior.
Termination: deep palmar arch
Collateral branches: 7
Radial recurrent artery, anterior transverse artery of the wrist or branch
palmar carpal, dorsal carpal or carpal branch
dorsal, A. palmar radio A. lateral dorsal digital of
thumb, first dorsal metacarpal artery and A.
thumb principle
 Arterial vascularization
of the front arm
4 Posterior interosseous artery

10 Anterior interosseous artery

5 Radial Artery

9 Cubital Artery

7 Superficial Palmar Arches

6 Deep Palm Arches

 cubital artery
Origin: born in view of the radius neck 3 cm from the fold of the
code
Descend medially in the anterior antebrachial region.
Termination: superficial palmar arch
Collateral branches: 5
A. ulnar recurrent, trunk of the interosseous, branch
palmar carpal or transverse cubital, carpal branch
dorsal or dorsal cubitus, deep palmar branch or
palmar cuboid
Report: passes under the pronator circle then under the arch
from the FCS then descends between the FCS and the FUC
 Anterior Transverse Artery of the Wrist

Radial Artery

Palmar Radio Artery

Ulnar palmar artery

7 Superficial Palmar Arches

6 Deep Palmar Arches

Cubital Artery

Arterial vascularization
of the wrist
 Superficial palmar arch
Constitution: ulnar artery and superficial palmar branch
from the radial artery = radio palmar artery

Collateral branches: 4
• 3 proper palmar digital arteries = arteries
interdigital spaces of the 2nd, 3rd, and 4th interdigital space
• Medial digital artery of the 5th finger
medial collateral artery of the 5th finger
Arterial vascularization of the hand
 Deep palmar arcade
Constitution: radial artery and deep palmar branch of
the ulnar artery

Collateral branches:
• Palmar metacarpal arteries = interosseous arteries,
join the common palmar digital arteries
• Main artery of the thumb = interosseous artery of 1er
space: gives the two collateral palmar arteries of the
thumb, often gives the radial collateral artery of the index finger
• Perforating branches anastomose with the arteries
dorsal metacarpal,
 Dorsal arch of the carpus
Carpal bone
medial dorsal = ulnar artery
dorsal of
the ulnar artery + carpal branch
lateral dorsal or dorsal artery of
catch the radial artery

Collateral branches:
• Dorsal metacarpal arteries
dorsal interosseous arteries
• Medial collateral artery of the 5th
finger
 Veins of the upper limb

Superficial veins

Deep veins
 Veins of the upper limb
Superficial veins
•Nail venous network
•Pulp venous network
•Dorsal metacarpal veins
•Dorsal venous network of the
main
•Basilic vein and cephalic vein
•Superficial veins of the front
brassiere
 Veins of the upper limb
Superficial veins
Nail venous network
Pulp venous network
Metacarpal veins
dorsal
Dorsal venous network of the
main
Basilic and cephalic vein
Superficial veins of
the forearm
 Cephalic vein
• Origin: dorsal face of
thumb, drains the dorsal network
by hand
• Path: lateral bicipital groove,
deltopectoral groove and
traverse the clavicular fascia
pectoral (clavicular triangle)
pectoral
• Termination: axillary vein
after describing a cross
• Receives the cephalic vein
median and the vein
céphalique accessoire
 Basilic vein
• Origin: dorsal side
from the 5th, drain it
dorsal network of the
main
• Path: bicipital groove
medial
• Termination: third
proximal of the arm in
the brachial vein
medial
 Median antebrachial vein
• Origin: front face
wrist, drains the network
palmar venous
• Journey: in the interstice that
separate the muscles
epicondylar and
epitrochlear
• Termination: division at
level of the elbow fold in
cephalic median vein
and median basilica which
respectively earn the
cephalic and the basilica
 Veins of the upper limb

Deep veins

Brachial veins

Axillary vein
 Veins of the upper limb
Brachial veins
• Born at the bend of the elbow
from the meeting of the veins
ulnar and radial
• termination: vein
axillary
• The brachial vein
medial or humeral
receives the basilic vein
 Veins of the upper limb
Axillary vein
• Born on the edge of the great
pectoral by the meeting of
2 humeral veins
• Termination: lower edge of the
muscle under keyboard in vein
under Clavière
• Pathway on the medial edge
of the axillary artery
• Receives the veins
circumflexes, sub
scapular, thoracic
lateral and cephalic
 Lymphatics of the upper limb
Lymph nodes
Superficial ganglia
Deep ganglia

Lymphatic vessels
Superficial
Deep
 Lymphatics of the upper limb
Lymph nodes
Superficial ganglions
•Epitrochlear ganglia
•Ganglia of the deltoid groove
pectoral
•Posterior ganglia
superficial shoulder
 Lymphatics of the upper limb
Lymph nodes
Deep ganglia
•Ganglia of the forearm and of
arms: anterior cubital, radial,
interosseous and humeral.
•Axillary ganglia: 5 groups
Humeral group
Thoracic group
Shoulder group
Central group
Subclavian group
either apical or terminal
•Scapular ganglia
 Lymphatics of the upper limb
Lymph nodes
Deep ganglia
•Axillary ganglia: 5 groups
Humeral group
Thoracic group or ME
or lateral thoracic
Scapular group or
subscapular
Central group
Subclavian group
or apical or terminal
 Lymphatics of the upper limb

Lymphatic vessels
•Superficial
Located in the cellular tissue
subcutaneous
Draining the skin
•Profound
Satellites of the arteries and the
deep veins
Draining the lymph from the structures
deep
THANK YOU