Arterial and Venous Systems: Anatomy and Relationships
Arterial System
Radial Artery Branches
- Recurrent radial artery
- Muscular artery
- Palmar carpal branches
- Superficial palmar branch
- Principal artery of the thumb
- Dorsal carpal branch
- Artery of the first dorsal metacarpal space
Ulnar Artery
- More voluminous than the radial artery
- From the ulnar fossa
- Inferior and medial
- Passes the flexor retinaculum
- Forms the palmar arch
Ulnar Artery Branches
- Recurrent ulnar artery
- Common interosseous artery (anterior and posterior)
- Muscular branches
- Palmar carpal branch
- Dorsal carpal branch
- Deep palmar branch
Aortic System
Thoracic Aorta
- Descending aorta
- Thoracic and abdominal aorta
- Aortic bifurcation until L4
Thoracic Aorta Relationships
Posterior: Vertebral column
Anterior: Left lung
Right: Azygos vein
Left: Left pleura and lung
Branches of the Thoracic Aorta
Visceral: Bronchial, esophageal, pericardial, mediastinal
Parietal: Superior phrenic, posterior intercostal, subcostal
Abdominal Aorta
- Continuation of the thoracic aorta
- Aortic hiatus of the diaphragm
- Deviates to the left
- At the level of the umbilicus (L4), it divides into common iliac arteries
Branches of the Abdominal Aorta
Celiac trunk, superior mesenteric artery, gonadal artery, inferior mesenteric artery
Abdominal Aorta Relationships
Posterior: Lumbar spine, anterior longitudinal ligament, lumbar veins
Anterior: Retroperitoneum, L1, left renal vein
Right: Inferior vena cava
Left: Ascending duodenum, left crus of the diaphragm
- Iliac vein and artery, one is longer: the right iliac artery, the left iliac vein
Abdominal Aorta Branches
Parietal: Inferior phrenic (intended for the diaphragm), lumbar, median sacral
Visceral: Celiac trunk (common hepatic, left gastric, splenic), superior and inferior mesenteric, middle adrenal, renal, gonadal
Common Iliac Artery
- Known as primitive
- Aortic bifurcation
- Obliquely down to the sacroiliac joint
- Approximately 5cm long
- Right is longer than the left
Common Iliac Artery Relationships
Anterior: Ureter
Posterior: Common iliac vein
Right: Bowel
Left: Sigmoid mesocolon
Internal Iliac Artery
- Also known as the hypogastric artery
- Origin: Lumbosacral joint
- Descends in front of the sacrum
- Approximately 4cm long
Internal Iliac Artery Branches
- Urethral artery
- Two trunks: anterior and posterior
Anterior Trunk
Inferior vesical, uterine, vaginal, middle rectal, umbilical, obturator, internal pudendal, inferior gluteal
Posterior Trunk
Goes posteriorly, branches into the iliolumbar, lateral sacral, and superior gluteal arteries
External Iliac Artery
Branches: Inferior epigastric, deep circumflex iliac
- Continues the direction of the common iliac artery
- Approximately 12cm long
- Becomes the femoral artery
Femoral Artery
- Continuation of the external iliac artery
- Posterior to the inguinal ligament
- Passes through the adductor canal and inguinal trigone
- Ends at the adductor hiatus, becoming the popliteal artery
Femoral Artery Branches
Superficial epigastric, superficial circumflex iliac, external pudendal, femoral, descending genicular (genu = knee)
Popliteal Artery
Branches: Genicular, sural
- Continuation of the femoral artery
- Starts at the adductor hiatus
- Ends at the lower border of the popliteus muscle
- Bifurcates into the anterior and posterior tibial arteries
Anterior Tibial Artery
- Continuation and forms the dorsalis pedis artery (between the 1st and 2nd metatarsals)
- Anterior branch of the popliteal artery
- Becomes the dorsalis pedis artery in the foot
Anterior Tibial Artery Branches
Recurrent tibial anterior, recurrent tibial posterior, medial malleolar, lateral malleolar, dorsal artery of the foot (dorsalis pedis) – (Radial pulse: flexor carpi radialis)
Anterior Tibial Artery Relationships
In the superior 2/3, it descends on the interosseous membrane. In the inferior 1/3, it is more superficial
Posterior Tibial Artery
- Posterior and bulkiest branch of the popliteal artery
- Starts at the inferior border of the popliteus muscle
- Ends between the medial malleolus and the medial process of the calcaneal tuberosity
- Becomes the medial and lateral plantar arteries
Posterior Tibial Artery Branches
Circumflex fibular branch, nutrient artery of the fibula, fibular artery, perforating branch, malleolar and calcaneal branches, medial and lateral plantar arteries, plantar metatarsal arteries, common and proper palmar digital arteries
Venous System
(Artery behind, vein ahead) (The veins run toward the heart)
Subclavian Vein
- Continuation of the axillary vein
- Anteromedial in relation to the artery
- Passes in front of the anterior scalene muscle
- Forms the brachiocephalic vein with the internal jugular vein
Brachiocephalic Vein
- Two: left and right
- Formed by the junction of the internal jugular and subclavian veins
- Merge to form the superior vena cava
- Where the external jugular vein drains: right subclavian and brachiocephalic veins
Axillary Vein
- Provides venous return for the upper limb
- Formed by the union of the brachial and basilic veins
Veins of the Upper Limbs
(Superficial veins: medial basilic, lateral cephalic)
- Comprise a deep network and a superficial network
- Perforating veins communicate between the two networks
Deep Venous Network of the Upper Limb
- Two veins for each artery
- In the hand, there are two veins for each metacarpal artery
- Two radial and two ulnar veins
- Two brachial arteries
Superficial Venous Network of the Upper Limb
- Located under the subcutaneous tissue
- Not satellite to arteries
- Connected by perforating veins with the deep network
- Run from the toes to the root of the upper limb
Upper Limb Veins
- Superficial veins of the fingers
- Superficial veins of the dorsum of the hand and palm
- Superficial veins of the forearm (intermediate, cephalic, basilic)
- Superficial veins of the elbow
- Superficial veins of the arm