Option 1

Aorta: divisions, topography, branches of the aortic arch.

Option 2
Common, external carotid artery: topography, branches, anastomoses.

Option 3
The maxillary artery: topography, branches.

Option 4
Internal carotid artery: topography, branches.
 SUBCLAVIAN AND AXILLARY ARTERIES.
ARTERIES OF THE SHOULDER, FOREARM AND HAND:
TOPOGRAPHY, BRANCHES, ANASTOMOSES, AREAS OF
BLOOD SUPPLY
 Subclavian artery, a. subclavia

It is the main source of the arterial supply of the upper limb

Origin:
 Left arises from the aortic Arch
 Right arises from the brachiocephalic trunk
• At lateral border of the first rib, it is continuous in the axilla as the axillary artery a. axillaris
• Main branches:
 Vertebral artery A. vertebralis to supply CNS
 Internal thoracic artery A. thoracica interna to supply mammary gland & the thoracic wall
Subclavian artery, a. subclavia
Subclavian artery is divided into three parts by
anterior scalene muscle :
First part: from origin of artery to anterior scalene
muscle
The branches of first part :
 a. vertebral artery - a. Vertebralis
 thyrocervical trunk – truncus thyrocervicalis
 internal thoracic artery – a. thoracica interna
Second part is located behind the anterior scalene
muscle.
The branches of Second part - costocervical trunk –
truncus costocervicalis
Third part is located the part lateral to anterior scalene
muscle before lateral border of first rib.
The branches of Third part
The transverse cervical artery of the neck, A.
transversa colli
 Vertebral Artery A. vertebralis :
Branch of the first part of subclavian artery
Passes through foramina transverseria of the
upper six cervical vertebrae
Enters cranium through foramen magnum.
At the lower border of the pons, it joins the
vessel of the opposite side to form the basilar
artery a. basilaris.
Branches of vertebral artery:
Meningeal branches supply bone and dura
mater in posterior cranial fossa.
Posterior spinal artery, a. spinalis
posterior
Anterior spinal artery a. spinalis
anterior..
Posterior inferior cerebellar a. cerebelli
inferior posterior artery largest branch of
vertebral which supplies:
• Cerebellum
• Medulla oblongata
• Choroid plexus of fourth ventricle.
• Medullary arteries to medulla oblongata.
 Basilar Artery, a. basilaris

It is formed by union of the two vertebral arteries at the

pons.
Its branches are:
Pontine arteries, Aa. Pontis, to pons.
Labyrinthine artery to internal ear
Anterior inferior cerebellar artery (AICA), a. inferior
anterior cerebelli, for cerebellum, pons & upper
medulla.
Superior cerebellar artery
, a superior cerebelli, for cerebellum, pons & pineal
gland.
Posterior cerebral artery is joined by
posterior communicating branch of internal
carotid.
Its cortical branches supply:
Inferolateral & medial surfaces of temporal
lobe
lateral & medial surfaces of occipital lobe
(visual cortex).
Its central branches supply:
 Thalamus
 Lentiform nucleus
 Midbrain
 Pineal gland
 Medial geniculate bodies.
 Choroidal branch for choroid plexus of
lateral & third ventricles.
 Branches of internal carotid artery
 Ophthalmic artery supplies:
 The eye
 Frontal area of scalp
 Ethmoid and frontal sinuses
 Dorsum of nose.
 Posterior communicating artery join the
posterior cerebral artery, forming part of
circle of Willis.
Choroidal artery
• Enters inferior horn of lateral
ventricle to form choroid plexus.
• It gives branches to:
• Crus cerebri
• Lateral geniculate body
• Optic tract
• Internal capsule.
 Blood Supply of the Brain
The brain is supplied by:
Two internal carotid arteries
Two vertebral arteries.
• They lie within subarachnoid space
• Their branches anastomose on inferior surface of brain to form Circle of Willis.
 Circle of Willis:
 It lies in the interpeduncular fossa at the base of the
brain.
 It is formed by the anastomosis between the two
internal carotid arteries and the two vertebral
arteries.
• It allows blood that enters by either internal carotid
or vertebral arteries to be distributed to any part of
both cerebral hemispheres.
 Circle of Willis:
Anterior
Cerebral arterial
Frontal lobe circle
(circle of Willis)
Optic chiasma
• Anterior
Middle communicating
cerebral artery
artery • Anterior
cerebral artery
Internal
carotid • Posterior
artery communicating
artery
Mammillary
body • Posterior
cerebral artery
Temporal Basilar artery
lobe Vertebral artery
Pons
Occipital lobe
Cerebellum
Posterior
Major arteries serving the brain (inferior view, right side
of cerebellum and part of right temporal lobe removed)
Anterior cerebral artery
• It enters longitudinal fissure of the
cerebrum where it joins artery of opposite
side by anterior communicating artery.
 Cortical branches supply:
• All the medial surface of the cerebrum till
parieto-occipital sulcus
• 1 inch of lateral surface (leg area).
 Central branches supply:
• Parts of lentiform
• Caudate nuclei
• Internal capsule.
Middle cerebral artery
• It is largest branch of internal carotid,
runs in lateral cerebral sulcus.
 Its cortical branches supply:
• Entire lateral & orbital surfaces of cortex
• Except:
• 1 inch of lateral supplied by anterior
cerebral artery
• Occipital pole and inferolateral surface of
hemisphere supplied by posterior cerebral
artery
• Thus supplies all body except the (leg
area).
Internal Thoracic Artery, а. thoracica interna

It supplies anterior wall of body from

clavicle to umbilicus.
It is a branch of first part of subclavian
artery.
It descends vertically on pleura behind
costal cartilages and ends in 6th
intercostal space by dividing into 2
branches
superior epigastric artery, a.
epigastrica superior
musculophrenic arteries, а.
musculophrenica
Internal Thoracic Artery, а. thoracica interna

Branches
1. Two anterior intercostal arteries, rami intercostales
anterior, for upper six intercostal spaces
2. Pericardiophrenic artery , a. рericardiacophrenica
accompanies phrenic nerve & supplies Pericardium.
3. Mediastinal arteries supply contents of anterior
mediastinum
4. Superior epigastric artery, a. epigastrica superior,
enters vagina m. recti abdominis of anterior abdominal
wall & supplies rectus muscle as far as umbilicus
5. Musculophrenic artery, а. musculophrenica, runs
around costal margin of diaphragm & supplies lower
intercostal spaces & diaphragm
 Branches of the subclavian artery

Thyrocervical trunk, Тruncus costocervicalis (2nd part):

The deep cervical artery, a. cervicalis profunda is thin and short

A. cervicalis profunda

Тruncus costocervicalis
The supreme intercostal artery , a. intercostalis suprema - it
A. transversa colli supplies blood to the deep muscles of the neck, spinal cord, spinal
cord membranes, intercostal muscles
A. intercostalis suprema The transverse cervical artery of the neck, A. transversa colli (3
отдел) – it supplies blood m. platysma, m. omohyoideus, m.
rhomboideus minor et major, musculus levator scapulae , musculus
trapezius and musculus serratus anterior .
 Axillary Artery, arteria axilláris

it is a continuation of the subclavian

artery
Begins at lateral margin of 1st rib.
 To the lower border Teres major.
Major Branches
• Superior Thoracic Artery.
• Thoracoacromial Artery.
• Lateral Thoracic Artery.
• Subscapular Artery.
• Anterior Circumflex Humeral and
• Posterior Circumflex Humeral.
 The artery is located in the axillary cavity. The branches of the artery are studied according
to the topography of the anterior wall of the axillary cavity.

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2
2

1. Trigonum clavipectorale. 2. Trigonum pectorale. 3. Trigonum subpectorale

 1. At the level of the Trigonum clavipectorale begin :
 superior thoracic artery a. thoracica superior
 thoracoacromial artery–a. thoracoacromialis

2. At the level of the Trigonum pectorale begin

lateral thoracic artery– a. thoracica lateralis

3. At the level of the Trigonum subpectorale begin

three arteries :
 the scapular artery– a. Subscapularis:
 The circumflex scapular artery (a. circumflexa
scapule)
 The thoracodorsal artery (a. Thoracodorsalis)
 The posterior circumflex humeral artery , a.
circumflexa humeri posterior
 The anterior circumflex humeral artery, a.
a. circumflexa scapule
circumflexa anterior
--
a. Thoracodorsalis
Foramen trilaterum Foramen quadrilaterum
a. circumflexa humeri posterior

a. circumflexa scapule
 Upper limb arteries

 Axillary artery:
 continuation of
subclavian artery
 passes through the
axilla and continues
in the arm as the
brachial artery.

 Brachial a. brachialis
 Descends close to the medial side of the humerus
 Passes in front of the elbow joint (cubital fossa).
 At the level of neck of radius, it divides into two terminal branches
• Radial, arteria radialis
• Ulnar, arteria ulnaris
 Brachial Artery, a. brachialis

 Arises at the lower margin of Teres

major, at the anatomic neck of the
humerus.
 Major Branches
• Profunda Brachial, a. profunda brahii
• Superior and Inferior Ulnar
collateral arteries. A. collateralis
uinaris superior and A. collateralis uinaris
inferior
• Muscular
• Terminates opposite the neck of
radius by dividing unto the Radial and
Ulnar Arteries
 Upper limb arteries

 Ulnar
 The larger
terminal
branch
 Radial
 The smaller
terminal
branch
 Palmar Arches:
formed by both
ulnar & radial
arteries.
 superficial
Deep
 Radial artery, arteria radialis

Begins from the brachial artery at the level of the neck of the
radius in the cubital fossa
 Descends downward and laterally, rests on deep muscles of
the forearm.
 At the wrist it passes in the anatomical snuff box (fovea
radialis).
 Ends in the hand by anastomosis with the deep branch of
the ulnar artery, completing the deep palmar arch
 Branches :
 Radial recurrent artery (anastomoses with the radial
collateral branch of the profunda brachii)
 Muscular branches
 Superficial palmar branch to complete the superficial
palmar arch wit hulnar artery
 In the palm it gives radialis indicis and princeps pollicis
 Branches of the radial artery, arteria radialis :

1. Radial recurrent artery a. radialis recurrens

2. The superficial palmar branch r. palmaris superficialis
1 3. Palmar carpal branch Ramus carpeus palmaris
4. Dorsal carpal branch Ramus carpeus dorsalis
5. The artery of the large the
finger of the hand A. princeps pollicis

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5

2
 Ulnar artery, arteria ulnaris
Begins from the brachial artery at the level of the neck of the
radius in the cubital fossa
 It descends through the anterior compartment of the forearm
 enters the palm superficial to the flexor retinaculum.
 Ends in the hand by forming the superficial palmar arch
anastomosing with the superficial palmar branch of the radial
artery.
 Branches :
 Anterior ulnar recurrent artery
 Posterior ulnar recurrent artery
 Common interosseous artery, which divides into anterior
interosseous artery and posterior interosseous artery (which
gives rise to the posterior interosseous recurrent artery) .
 Muscular branches.
 Cutaneous branches
 Branches sharing in arterial anastomosis around the wrist
joint
 Branches of the ulnar artery, arteria ulnaris :

1. Ulnar recurrent artery -A. recurrens ulnaris

2. Common interosseous artery - A. interossea communis
1 3. Anterior interosseous artery - a. interossea anterior
4. Deep palm branch - Ramus palmaris profundus
2 5. Palmar carpal branch - Ramus carpeus palmaris
3 6. Dorsal carpal branch- Ramus carpeus dorsalis

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In movable places, the arteries form Rete and anastomoses.

1
 Anastomosis around elbow joint
Anastomosis occurs between branches of Brachial,

Radial and Ulnar arteries:

 Branches from Brachial Artery:

o Profunda Brachii artery

o Superior ulnar collateral artery

o Inferior ulnar collateral artery

 Branches from Ulnar and Radial Arteries:

o Radial & ulnar recurrent arteries

o Posterior interosseous recurrent artery

 Superficial Palmar Arch, arcus palmaris superficialis
Direct continuation of Ulnar artery.
 On the lateral side it is completed by superficial
palmar branch of the radial artery.
 It is superficially placed in palm in front of the long
flexor tendons.
 It gives four digital arteries
Common palmar finger arteries -aa. digitales
palmares communes
Own palmar finger arteries - aa. digitales
palmares propriae
 Deep Palmar Arch, arcus palmaris profundus
Direct continuation of Radial artery.
 On the medial side it is completed by deep
branch of the ulnar artery.
 It is deeply placed in palm in front of the
metacarpal bones & Interosseous muscles.
 Branches:
 Palmar,
 Metacarpal arteriae metacarpales palmares.,
Perforating & Recurrent aa. perforantes
 superiorly sharing in anastomosis around the
wrist joint
 inferiorly joining digital branches of the
superficial palmar arch
Aa. digitales palmares propriae

Aa. digitales palmares communes

Aa. metacarpales palmares

Arcus palmaris superficialis

Arcus palmaris profundus

A. radialis

A. ulnaris
 R. vertebral artery R. common carotid artery
Thyrocervical trunk L. common carotid artery
L. vertebral artery
Suprascapular artery
L. subclavian artery
R. subclavian artery
Axillary artery
Thoracoacromial artery

Thoracoacromial artery
(pectoral branch) Aortic arch
Costocervical trunk

Anterior and posterior Brachio-

circumflex humeral cephalic
arteries trunk
Internal
thoracic
artery
Brachial artery
Anterior
Posterior intercostal
intercostal
arteries
arteries
Deep artery of arm Lateral
thoracic
Descending thoracic aorta
artery
Subscapular
artery
Anastomosis
Common
interosseus
artery

Radial artery Ulnar artery

Deep palmar arch

Metacarpal arteries
Superficial palmar arch
(a) Schematic flowchart Digital arteries

Figure 19.23a
Vertebral artery Common carotid
Thyrocervical trunk arteries
Suprascapular artery Left subclavian artery
Costocervical trunk Right subclavian artery
Thoracoacromial artery Brachiocephalic trunk
Axillary artery Posterior intercostal
Posterior circumflex arteries
humeral artery Anterior intercostal
Anterior circumflex artery
humeral artery Internal thoracic artery
Subscapular artery Descending aorta
Brachial artery Lateral thoracic artery
Deep artery of arm Radial artery
Common Ulnar artery
interosseous
artery
Deep palmar arch
Superficial palmar arch
Digital arteries