The arterial supply to the upper limb is delivered via fve main vessels (proximal to distal):

Subclavian artery

Axillary artery

Brachial artery

Radial artery

Ulnar artery

In this artclee we shall look at the anatomy of the arteries of the upper limb – their anatomical coursee
branches and clinical correlatonss

By OpenStax College [CC BY 3s0]e via Wikimedia Commons

Fig 1 – Schematc demonstratng the arterial supply to the upper limbs

Subclavian Artery

The arterial supply to the upper limb begins as the subclavian arterys On the righte the subclavian artery
arises from the brachiocephalic trunks On the lefe it branches directly from the arch of aortas

The subclavian artery travels laterally towards the axillas It can be divided into three parts based on its
positon relatve to the anterior scalene muscle:

First part – origin of the subclavian artery to the medial border of the anterior scalenes

Second part – posterior to the anterior scalenes

Third part – lateral border of anterior scalene to the lateral border of the frst ribs

At the lateral border of the frst ribe the subclavian artery enters the axilla – and is renamed the axillary
arterys

By TeachMeSeries Ltd (2021)

Fig 2 – Anatomical course of the subclavian arterys When the vessel crosses the frst rib (not shown)e it is
renamed the axillary arterys

Axilla: Axillary Artery

The axillary artery lies deep to the pectoralis minor and is enclosed in the axillary sheath (a fbrous layer
that covers the artery and the three cords of the brachial plexus)s

Importantlye the artery can be divided into three parts based on its positon relatve to the pectoralis
minor muscle:

First part – proximal to pectoralis minor

Second part – posterior to pectoralis minor

Third part – distal to pectoralis minor

The main branches of the axillary artery include:

First Part Second Part Third Part

Superior thoracic artery Thoracoacromial artery

Lateral thoracic artery

Subscapular artery

Anterior and posterior circumfex arteries

The anterior and posterior circumfex humeral arteries form an anastomotc network around the
surgical neck of the humerus and can be damaged in cases of fractures

At the lower border of the teres major musclee the axillary artery is renamed the brachial arterys

By TeachMeSeries Ltd (2021)

Fig 3 – The axillary artery has three partse named according to its positon relatve to the pectoralis
minor muscles

Clinical Relevance: Axillary Artery Aneurysm

An axillary artery aneurysm is a dilaton of the vessel to more than twice its original sizes It is a rare but
serious conditone with the potental to cause vascular compromise of the upper limbs

The dilated porton of the axillary artery can compress the brachial plexuse producing neurological
symptoms such as paraesthesia and muscle weaknesss

The defnitve treatment of an axillary artery aneurysm is surgicals It involves excising the aneurysm and
reconstructng the vessel wall using a vascular grafs

Upper Arm: Brachial Artery

The brachial artery is a contnuaton of the axillary artery past the lower border of the teres majors It is
the main supply of blood for the arms

Immediately distal to the teres majore the brachial artery gives rise to the profunda brachii (deep artery)e
which travels with the radial nerve in the radial groove of the humerus and supplies structures in the
posterior aspect of the upper arm (esgs triceps brachii)s The profunda brachii terminates by contributng
to an anastomotc network around the elbow joints

The brachial artery proper descends down the arms As it moves through the cubital fossae underneath
the bicipital aponeurosise the brachial artery terminates by bifurcatng into the radial and ulnar arteriess

By TeachMeSeries Ltd (2021)

Fig 4 – The anatomical course and major branches of the brachial arterys Note its relaton to the median
nerve as it descends the arms

Clinical Relevance: Occlusion or Laceraton of the Brachial Artery

The arm has relatvely good anastomotc supplys This means that it is well protected from ischaemia in
cases of temporary or partal occlusion of the brachial arterys
Howevere if the artery is completely occluded (or severed)e the resultng ischaemia can cause necrosis of
forearm muscless Muscle fbres are replaced by scar tssue and shorten considerably – this can cause a
characteristc fexion deformitye called Volkmann’s ischaemic contractures

Forearm: Radial and Ulnar Arteries

The radial and ulnar arteries are formed by the bifurcaton of the brachial artery within the cubital fossa:

Radial artery – supplies the posterolateral aspect of the forearms It contributes to anastomotc networks
surrounding the elbow joint and carpal boness

The radial pulse can be palpated in the distal forearme immediately lateral to the prominent tendon of
the fexor carpi radialis muscles

Ulnar artery – supplies the anteromedial aspect of the forearms It contributes to an anastomotc
network surrounding the elbow joints

Also gives rise to the anterior and posterior interosseous arteriese which supply deeper structures in the
forearms

These two arteries anastomose in the hand by forming two arches – the superfcial palmar arche and the
deep palmar archs

By TeachMeSeries Ltd (2021)

Fig 5 – Arterial supply to the forearm via the radial and ulnar arteriess Note the positon of the ulnar
nerve relatve to the ulnar arterys

Hand: Superfcial and Deep Palmar Arches

The hand has a rich arterial supply with many anastomoses between vesselss This allows the hand to be
perfused even when under high resistance to fow (such as when grasping or applying pressure)s

Arterial supply to the hand begins with the ulnar and radial arteriess The ulnar artery enters the hand
anteriorly to the fexor retnaculum and laterally to the ulnar nerves It gives rise to the deep palmar
branch and contnues laterally across the palm as the superfcial palmar archs
The radial artery enters the hand dorsallye crossing the foor of the anatomical snufoxs It then turns
medially and travels between the heads of the adductor pollicis muscles The radial artery supplies a
branch to the thumbe the index fnger and to the superfcial palmar arch – it then contnues as the deep
palmar archs

As a resulte two arterial arches are formed:

Superfcial palmar arch – located anteriorly to the fexor tendons in the hand and deep to the palmar
aponeurosiss It gives rise to the digital arteriese which supply the four fngerss

Deep palmar arch – located deep to the fexor tendons of the hands It contributes to the blood supply to
the digits and to the wrist joints

By TeachMeSeries Ltd (2021)

Fig 1s4 – Arterial supply to the hande via the superfcial and deep palmar arches

Fig 6 – Arterial supply to the hande via the superfcial and deep palmar arches

Quiz

Arterial Supply to the Upper Limb

Queston 1 of 3

A woman is undergoing an axillary clearances During the operatone the axillary artery is identfed within
the axillary sheaths Which of the structures listed below is also found within the axillary sheath?

Axillary vein

Axillary nerve

Axillary lymph nodes

Lateral cord of brachial plexus

Report