i want you understand well all of the following information that i will give you and generate 25 advanced level multiple choice questions with their model answer below each question. here are  the information : Arterial Supply of the Upper Limb
Any artery
1. Origin
2. Course
3. branches• The arterial supply to the upper
limb is delivered via five main vessels
(proximal to distal):
• Subclavian artery
• Axillary artery
• Brachial artery
• Radial artery
• Ulnar arterySubclavian Artery
• The arterial supply to the upper limb
begins as the subclavian artery.
• On the right, the subclavian artery
arises from the brachiocephalic trunk.
On the left, it branches directly from
the arch of aorta.
• The subclavian artery travels laterally
towards the axilla.• It can be divided into three parts based on its
position relative to the anterior scalene
muscle:
• First part – origin of the subclavian artery to the
medial border of the anterior scalene.
• Second part – posterior to the anterior scalene.
• Third part – lateral border of anterior scalene to
the lateral border of the first rib.
• At the lateral border of the first rib, the
subclavian artery enters the axilla – and is
renamed the axillary artery.Axillary Artery
• The axillary artery lies deep to
the pectoralis minor and
is enclosed in the axillary sheath
(a fibrous layer
that covers the artery and the
three cords of the brachial
plexus).• Importantly, the artery can be divided
into three parts based on its position
relative to the pectoralis
minor muscle:
• First part : proximal to pectoralis minor
• Second part: posterior to pectoralis
minor
• Third part: distal to pectoralis minorThe main branches of the axillary
artery include: SAL thoracic+ 3 اتجاهات
First Part Second Part Third Part
• Superior
thoracic
artery
• Thoracoacro
mial
(acromiothor
acic) artery
• Lateral
thoracic
artery
• Subscapular
artery
• Anterior and
posterior
circumflex
humeral
arteries• The anterior and posterior circumflex
humeral arteries form an anastomotic
network around the surgical neck of the
humerus and can be damaged in cases of
fracture.
• Termination: At the lower border of
the teres major muscle, the axillary
artery is renamed the brachial artery.Brachial Artery
• Beginning: The brachial artery is a continuation
of the axillary artery below the lower border of
the teres major.
• It is the main supply of blood for the arm.
• Course: As a continuation of the axillary artery,
the brachial artery runs medial to
the humerus proximally, before moving more
anteriorly to lie between the epicondyles of the
humerus.• Branches: The brachial artery
supplies the content of the arm via
its four branches:
1. profunda brachii artery.
2. nutrient artery to humerus.
3. Muscular branches.
4. superior ulnar collateral artery.
5. inferior ulnar collateral artery.• Termination: it ends at the level of
the neck of the radius about 1cm
distal to the elbow joint.
• At this point, it divides into
the ulnar and radial arteries.• Immediately distal to the teres major, the brachial
artery gives rise to the profunda brachii (deep
artery), which travels with the radial nerve in the
radial groove of the humerus and supplies
structures in the posterior aspect of the upper arm
(e.g. triceps brachii).
• It gives three branches: one ascending and 2
descending (posterior descending branch and
anterior descending branch).
• The profunda brachii terminates by contributing
to an anastomotic network around the elbow joint.Profunda
brachiiRadial and Ulnar Arteries
• The radial and ulnar arteries are formed by the
bifurcation of the brachial artery within the cubital fossa
(at the level of the neck of the radius):
• Radial artery : supplies the posterolateral aspect of the
forearm. It contributes to anastomotic networks
surrounding the elbow joint and carpal bones.
– The radial pulse can be palpated in the distal forearm,
immediately lateral to the prominent tendon of the flexor carpi
radialis muscle.
• Ulnar artery : supplies the anteromedial aspect of the
forearm. It contributes to an anastomotic network
surrounding the elbow joint.
– Also gives rise to the anterior and posterior interosseous
arteries, which supply deeper structures in the forearm.Branches
 radial artery:
• radial recurrent artery.
• Muscular arteries.
• palmar carpal branch.
• superficial palmar branch.
`ulnar artery:
• Ant. & post. ulnar recurrent arteries.
• muscular arteries .
• common interosseous artery.
• dorsal and palmar carpal arteries.• These two
arteries anastomose in the hand
by forming two arches:
1. the superficial palmar arch.
2. the deep palmar arch.Hand: Superficial and Deep Palmar
Arches
• The hand has a rich arterial supply with many
anastomoses between vessels. This allows the
hand to be perfused even when under high
resistance to flow (such as when grasping or
applying pressure).
• The ulnar artery enters the hand
1. anterior to the flexor retinaculum and
2. lateral to the ulnar nerve.• It gives rise to the deep
palmar branch
• continues laterally across
the palm as the superficial
palmar arch.• The radial artery enters the hand
dorsally, crossing the floor of
the anatomical snuffbox.
• It then turns medially and travels
between the heads of the adductor
pollicis muscle.The radial artery branches in the
hand:
1. Dorsal carpal br (at the wrist).
2. to the thumb (princips policis art.),
3. the index finger(radialis indicis art.)
• then continues as the deep palmar
arch.• As a result, two arterial arches are formed:
• Superficial palmar arch: located
anteriorly to the flexor tendons in the hand
and deep to the palmar aponeurosis. It
gives rise to the digital arteries, which
supply the four fingers.
• Deep palmar arch: located deep to the
flexor tendons of the hand. It contributes
to the blood supply to the digits and to the
wrist joint.Venous Drainage of the Upper
Limb
• The venous system of the upper
limb drains deoxygenated blood
from the arm, forearm and hand.
• It can be subdivided into
1. the superficial system and
2. the deep system.Any vein
1.Beginning
2.Course
3.tributaries
4.termination• Superficial Veins
• The major superficial veins of the upper limb are
the cephalic and basilic veins.
• They are located within the subcutaneous tissue of
the upper limb.
1. Basilic Vein
• The basilic vein originates from the dorsal venous
network of the hand and ascends on the medial
side of the upper limb.
• At the middle of the arm, pierce the deep fascia.
• At the lower border of the teres major, continues
as the axillary vein.2. Cephalic Vein
• The cephalic vein also arises from the dorsal venous
network of the hand.
• It ascends the antero-lateral aspect of the upper
limb.
• At the shoulder, the cephalic vein travels between
the deltoid and pectoralis major muscles (known as
the deltopectoral groove), and enters the axilla
region by piercing the clavipectoral fascia.
• Within the axilla, the cephalic vein empties into
axillary vein.
• The cephalic and basilic veins are connected
at the elbow by the median cubital vein.Deep Veins
• The deep venous system of the upper limb is
situated underneath the deep fascia.
• It is formed by paired veins (vena comitantes),
which accompany and lie either side of an artery.
• The deep veins share the name of the artery they
accompany.
• The brachial veins are the largest in size, and
are situated either side of the brachial artery.
• The pulsations of the brachial artery assist the
venous return.Perforating veins
• run between the deep and
superficial veins of the upper
limb, connecting the two
systems.