Angiology thoracic member

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L & rsquo; ARTERY AXILLARY

I- Introduction :

Large artery located in the axilla, is a passageway between & rsquo; subclavian artery and the & rsquo; brachial artery.
Nouricière is a street in the shoulder region.

II- origin :

It follows the & rsquo; subclavian artery in the middle of the clavicle posterior edge.

III- Path :

L & rsquo; axillary artery diagonally crosses the axilla

IV- Termination :

It continues at the lower edge of the pectoralis major by & rsquo; artery
brachial.

V- Reports :

It affects relationships with the walls of the axilla and axillary neurovascular elements.
a- Compared with the walls :
– In the axilla
It is related to the walls of the axilla
– it is far from the back wall formed by the subscapularis muscles, small
round, large roundabout and the latissimus dorsi.
– It is close to the inner wall at the top formed by the first five odds, intercostal muscles and serratus anterior muscle.
And is close to the outer wall at the bottom formed by the biceps and coracobrachialis. -It is pressed against the anterior wall formed by two superimposed muscular planes :
– superficial : Muscle grand pectoral
– deep : Muscle sub keyboard and pectoralis minor, these two muscles are united by the fascia clavi-pectoro-axillary.
b-Report with axillary neurovascular elements :
– The axillary vein :
Located inside of the artery that accompanies all his ride.
– The brachial plexus : It surrounds the & rsquo; artery
– The secondary trunks anteromedial, anterolateral and posterior are located in
outside, inside and back of the & rsquo; artery
– The terminal branches are arranged around & rsquo; artery :
. The median forward
. The radial nerve and axillary back
. The ulnar nerve, medial cutaneous of the & rsquo; forearm and medial cutaneous arm inside
.The musculocutaneous outside.
– Groups axillary lymphonoeuds are arranged in five groups :
– side group
– scapular sub group
– paramammasre group
– intermediate group
– infra clavicular group

axillary artery

Vl- collateral branches :

It provides six important collateral branches
higher or the highest thoracic artery : Irrigates chest and breast area.
thoracoacromial artery (acromioclavicular chest): Is divided into 2 branches, thoracic and acromial. Chest branch runs in, is distributed to the pectoral, The acromial branch outside door, under the deltoid.
lateral thoracic artery (lower rib, or external breast) : is distributed to the pectoral, serratus and intercostal.
subscapularis artery (lower scapular) : bifurcates circumflex scapular artery and thoracodorsal.
anterior humeral circumflex artery : that bypasses the front of the surgical neck of the & rsquo; humerus to gain the deep surface of the deltoid where it ends.
Circumflex artery posterior humeral which passes through the quadrilateral huméro- triceps to win, with axillary nerve, deep to the deltoid muscle where it ends.

Femoral BRACHIAL (humeral)

I- lntroduction :

This is the artery of the arm.
It is more supreficielle (used in taking the blood pressure).

II- Origin :

It follows the & rsquo; axillary artery at the lower edge of the large muscle
pectoral.

III- Path :

It runs through the anterior medial arm & rsquo; an almost vertical path in the channel brachial Cruveilhier

IV- Termination :

It ends in the anterior region of the elbow slightly below the & rsquo; joint space by dividing into 2 branches ; ulnar artery and radial artery.

V- Reports :

a- arm-Level Reports :
It runs through the anterior medial portion of the arm in the brachial channel Cruveilhier.
1- Reports with the walls of cana! Brachial Cruveilhier
Forward and outside : coracobrachialis muscle up and down the biceps. Backward : the medial partition intermuscular.
Inside : L & rsquo; brachial fascia.
2- Relationship with neurovascular structures
Is related to its satellite veins.
The median nerve : it is anterolateral up and becomes anteromedial down.
The ulnar nerve : antero- medial top then passes behind the partition
medial intermuscular into the posterior compartment of the bottom arm.
The medial cutaneous nerve of the forearm : the. media is? up then becomes extra fascial down.
b- elbow to reports :
L & rsquo; artery runs in the furrow or internal bicipital groove or it ends a little below / joint space by dividing into 2 ulnar artery branches
and racial artery.
1- Rapports in the internal bicipital clicker :
Outside, le tendon du muscle biceps brachial. Inside, the pronator teres muscle
Backward, le muscle brachial.
Forward, fascial expansion brachial biceps
– neurovascular Report
In connection with its two satellite veins and media nerve – inside

brachial artery

Vl- collateral branches :

* deltoid branch
* lifeblood of / humerus
* deep artery of arm (deep artery hurnérale}
* artery proximal ulnar collateral (upper medial collateral)
* artery distal ulnar collateral (medial collateral lower)

RADIAL ARTERY

I- Introduction :

– It is the side fork leg artery Brachial.

II- Origin :

She was born è 3cm below the joint line in the medial bicipital groove of the elbow.

III- Path :

– It traverses the side portion of the anterior compartment of the forearm until wrist. -It bypasses outside the & rsquo; joint radiocarpal,
– then it passes through the first interosseous space to terminate in the palmar lodge hand.

IV- Termination :

It ends in the deep palmar lodge hand in s & rsquo; ie anastomosing with deep palmar branch of & rsquo; ulnar artery to give the & rsquo; arcade deep palmar.

V- Reports :

1- Reports at the & rsquo; downstream arm :
a- In his 2/3 top of the forearm
She walks up and down
Forward muscles :
– brachial prior.
– tendon du muscle biceps
– court supinateur
– around pronateur
– superficial flexor digitorum
– long flexor thumb
– Square pronator
Behind the :
– Power-radiation (Long supinateur)
– Fascia brachial (brachial fascia)
Outside of :
– flexor carpi radialis (Grand palmar)
It is accompanied by two satellite veins and outside the branch
anterior radial nerve.
b- In the 1/3 lower s & rsquo; forearm
It becomes shallow and lies in the groove of the radial pulse laterally limited by the tendon of brachioradialis radiaie (long supinateur) and medially the radial flexor carpi (flexor carpi).
It is accompanied by two satellite veins and the anterior branch of
nerf radio! that is outside
2- Reports at the wrist :
– It bypasses the & rsquo; wrist joint, then advances in the "anatomical snuffbox" limited by the inside of the extensor tendon of the thumb.
Outside the tendon of the long abductor of the thumb and the thumb extensor.
– Joins the first space through which to enter the palms.

WE- collateral branches :

• radial recurrent artery
• lateral palmar carpal branch (anterior carpal artery)
• superficial palmar branch (radio-palmar artery),
• lateral dorsal carpal branch (l & rsquo; dorsal artery radio).
• dorsal metacarpal artery of thumb.
• main artery of thumb (interosseous 1 space)
• Radial artery of & rsquo; index.

L & rsquo; ulnar artery (CUBITAL)

I- lntroduction :

It represents the medial branch of bifurcation & rsquo; Brachial artery With & rsquo; radial artery, they represent the two arteries of the & rsquo; forearm Aimed at & rsquo; forearm and hand

II- Origin :

She was born in 3cm below the & rsquo; joint space in the medial bicipital groove of the elbow

III- Path :

Elle s & rsquo; Ecarte off angle droit de l & rsquo; ax artériel brachial-radial. It descends in the medial part of the anterior compartment of the & rsquo; forearm.
At the wrist it travels in the Guyon or ulnar canal.

IV- Termination :

It ends in the palm of the hand in s & rsquo; anastomosing with the superficial palmar branch of & rsquo; s radial artery to give & rsquo; superficial palmar arch.

V- Reports :

1- Reports at the & rsquo; forearm :
a- reports to 1/3 top of the & rsquo; forearm :
She obliquely downwards and inwards, it is related :
Backward :
– The brachialis and biceps tendon deep common -Fléchisseur fingers
Forward
– around pronateur
– Arcade common flexor area! In finger in
The flexor carpi ulnaris (ulnaris)
b- reports to 2/3 lower the & rsquo; forearm :
It is vertical, it is related :
Backward :
– deep flexor digitorum -The pronator quadratus
Forward :
l & rsquo; artery is covered by two fascia :
– superficial fascia of the & rsquo; forearm
– Fascia which covers the common area Flexor! fingers
Inside :
– The flexor carpi ulnaris (ulnaris)
2- Reports to lodge wrist GUYON or ulnar channel :
Inside: pisiform
Backward: the carpal flexor
Forward : l & rsquo; fibrous expansion of the volar carpal flexor

WE- collateral branches :

• Trunk recurrent ulnar arteries
• Common interosseous artery
• Rameau dorsal carpal media! (carpal dorsal artery)
• Rameau carpal palmar medial or anterior transverse carpal artery
• deep palmar Rameau.

THE STREETS OF HAND

I- Introduction :

The vascular system is complex hand with multiple anastomoses.
the hand of the arteries from radial and ulnar arteries, which are united by three anastomoses.
– Superficial palmar arch
– Deep palmar arch
– Arcade dorsal you carpe

II- Superficial palmar arch :

C & rsquo; is & rsquo; anastomosis between & rsquo; ulnar artery and the palmar surface of the branch & rsquo; radial artery.
1- Constitution reports :
a- PAL ms ire superficial branch of racial artery (artery palmar radio) :
Inconstant born opposite the radial styloid process, walks on the abductor pollicis brevis muscle, s & rsquo; anastomosis with & rsquo; ulnar artery to form the & rsquo; superficial palmar arch in palmar average lodge.
b- L & rsquo; ulnar artery :
Out of the ulnar walks channel between the & rsquo; palmar fascia and muscles of the & rsquo; hypothenar.
Accompanied medially by the superficial branch nerve ulnar then turns in the middle palmar lodge for s & rsquo; anastomose with the twig e superficial palmar forming the & rsquo; arcade superficial palmar which lies between & rsquo; palmar fascia average forward and flexor tendons back.
2- collaterals :
– The 3 palmar digital arteries common
Each divides the lower edge of superficial transverse metacarpal ligament in 2 palmar digital own arteries that run along the adjacent edges of fingers 2 at 5.
– palmar digital artery Sow own finger medial

Arteries of the hand

III- Deep palmar arch :

C & rsquo; is & rsquo; anastomosis between the & rsquo; radial artery and the deep palmar branch of & rsquo; ulnar artery.
1- Constitution reports:
a- The deep palmar branch of & rsquo; ulnar artery :
Nait below the & rsquo; pisiform bone, is doing inside pass under the & rsquo; arcade hypothenar muscles and enters the hypothenar lodge accompanied by the deep branch of the ulnar nerve, it describes a curved concave outside between the flexor and the forward & rsquo; opposing back.
b- The radial artery :
She arrives at hand bypassing the outer edge of carp.
Below the & rsquo; styloid process enters the anatomical snuffbox, through the first interosseous space.
Passes under the & rsquo; arcade 1 volar interosseous muscle.
Then under the & rsquo; arch formed by the 2 Heads of & rsquo; adductor pollicis.
O & rsquo; anastomosis with the deep palmar branch of & rsquo; ulnar artery to form I'arcade deep palmar which responds to backlog 3 metacarpals and interosseous spaces and forward to the & rsquo; deep palmar fascia that separates the flexor tendons deep.
2- collateral :
* Palmar metacarpal arteries
3 arteries 2nd 3rd 4th interosseous space which travels in front of the interosseous muscles and join the palmar digital arteries common at their termination
* Palm piercing in number 3
Through the & rsquo; s intermetacarpal space & rsquo; anastomosing with the dorsal metacarpal arteries
• Palm recurring upward for the carp

Arcade back of the hand

IV Arcade palmar-dorsal :

This is the & rsquo; anastomosis between the dorsal carpal branch of the radial artery and the dorsal carpal branch of & rsquo; ulnar artery.
It is located behind the carpal bones and covered by the extensor tendons
1- Constitution :
Union branches carpal medial and lateral branch carpal medial dorsal : arises from the & rsquo; ulnar artery Twig carpal lateral dorsal : born of & rsquo; radial artery
2- collateral :
• 3 dorsal metacarpal arteries for the areas 2,3,4éme metacarpal dorsal interosseous Each gives three collateral
Two dorsal digital arteries for the corresponding fingers and a perforating branch that joins the & rsquo; arcade deep palmar
• Digital artery dorsal medial 5th finger
• The ascending branches on the dorsum of the wrist

VEIN OF CHEST MEMBER

I- Overview :

The venous system of the upper limb consists of two networks : A deep venous system.
A superficial venous network.

II- The deep venous system :

The deep veins follow arteries path each artery is accompanied by two satellite veins except the & rsquo; axillary artery is accompanied by a single vein

III- The superficial venous network :

He understands :
– The superficial veins of the fingers and hand
– The veins of the & rsquo; forearm
– The veins of the arm
A- The finger vein :
1- backbone :
It consists of :
– The subungual network
– Veins perished nail
– Finger veins to the number of two or a single median vein, proceed along the edges or the dorsal side of the fingers.
– L & rsquo; Digital Arcade receives digital veins
2- palmar network : less developed than that of the back.
B- The veins of the hand :
1- backbone :
– metacarpal veins proceed along the dorsal surface of the corresponding metacarpal spaces
– l & rsquo; dorsal venous arch resulting from the & rsquo; anastomosis between the metacarpal veins
– the cephalic vein of the thumb and the little finger vein salvatelle flow at the ends of the dorsal venous arch and leave the surface more accessory radial duct and the cubital vein or superficial ulnar.
2- The palmar veins : less developed than dorsal veins ; flow into the dorsal vein pattern of the hand.
C- The veins of the forearm and elbow crease :
Three times four manifolds
– The superficial radial vein -The radial accessory vein
– The superficial ulnar vein -The median vein
D- The veins of the arm :
Two veins run through the front of the arm
– The basilica vein in the arm ends in s & rsquo; abouchant in the brachial vein
– The cephalic vein ends in the axilla in s & rsquo; abouchant in the axillary vein.

Veins of the thoracic member

THE LYMPHATIC MEMBER OF CHEST

I- Introduction :

The lymphatic system includes -The upper limb lymph nodes -The superficial and deep lymphatic vessels superficial and deep
1- The superficial lymph nodes :
– The nodes above-medial epicondyle
– The nodes of the furrow deltopectoral
– The superficial posterior nodes of & rsquo; shoulder
2- The deep lymph nodes :
The nodes of the & rsquo; forearm
– The radial and ulnar nodes nodes -The interosseous
The nodes of the elbow crease
The antecubital node
The lateral bicipital groove node
The nodes of the arm
The humeral nodes
The axillary nodes
– The lateral lymph node group
– The group of lymph nodes subscapulaire
– The group of lymph nodes para-breast
– The central lymph node group
– The group of lymph nodes apical
Superficial lymph vessels :
Born lymph capillary network of the skin are subcutaneous.
At fingers lymph drains to collector side of each finger them earn the dorsum of the hand
A hand the collectors of the dorsal and palmar flow into the collectors of & rsquo; forearm.
At & rsquo; forearm three groups has collectors
lateral or radial collectors
medial collectors or collectors means ulnar or median prior
To the arm
The lymph collectors proceed along the anteromedial aspect of the arm up & rsquo; in the & rsquo; shoulder
At & rsquo; shoulder
The lymph collectors are earlier and later lead to the pit of the & rsquo; armpit or they perforate the fascia before flowing into the central axillary nodes and sub scapular
The deep lymphatic vessels :
Satellites are deep blood vessels and nerves
Drain lymph bones, joints, muscles, fascia and nerves of the upper limb and the & rsquo; shoulder form deep lymph trunks If flow into the axillary lymph nodes
The efferent vessels of axillary lymph nodes follow the path of the & rsquo; artery and axillary vein and come together to form the trunk collector terminal subclavian which flows into the large lymphatic vein and right into the thoracic duct on the left. These two flow into the corners venous jugular-subclavian.

Cours du Dr N.BENLEGHIB – Faculty of Constantine

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