Recurrent interosseous artery. Arteries of the upper extremities. Axillary, brachial, ulnar arteries, their topography. Ulnar artery, a. ulnaris. Branches of the ulnar artery

Ulnar artery, a. ulnaris. Branches of the ulnar artery

Ulnar artery, a. ulnaris, represents one of the two terminal branches (larger) of the brachial artery. From the starting point to cubital fossa(against the neck of the radius) it fits under m. pronator teres, goes obliquely to the middle third of the forearm, deviating to the ulnar side. In the lower two-thirds it runs parallel to the ulna, first in the space between m. flexor digitorum superficialis, etc. flexor carpi ulnaris, in the lower third, due to the transition of muscles into tendons, its position becomes more superficial (sulcus ulnaris). At the radial side of the pisiform bone, the ulnar artery passes into the canalis carpi ulnaris (spatium interaponeuroticum) and, passing to the palm, is part of the arcus palmaris superficialis.

Branches of the ulnar artery:

1. A. recurrens ulnaris, recurrent ulnar artery, gives two branches - rami anterior et posterior, which pass in front and behind the medial epicondyle, anastomosing with ah. collaterals ulnares superior et inferior. Thanks to these anastomoses, as well as the above anastomoses between the branches of a. profunda brachii and a. radialis in the circumference of the elbow joint, an arterial network is obtained - rete articulare cubiti.

2. A. interossea communis, common interosseous artery, goes to the interosseous membrane, at the proximal edge of which is divided into two branches: a) a. interossea anterior along the anterior surface of the interosseous membrane reaches m. pronator quadratus, pierces the membrane and goes to the rear, where it ends in rete carpi dorsale. At the beginning of my journey a. interossea anterior gives a. mediana (directed to the palm together with p. medianus), ah. diaphyseos radii et ulnae- to the bones of the forearm and rami musculares - to the surrounding muscles; b) a. interossea posterior passes through the upper opening of the interosseous membrane to the back side, gives off a. interossea recurrences, lies between the superficial and deep layers of the extensors and in the wrist area anastomoses with a. interossea anterior.

3. Ramus carpeus palmaris, palmar carpal branch, goes towards the branch of the same name of the radial artery, with which it anastomoses.

4. Ramus carpeus dorsalis, dorsal carpal branch, departs near the pisiform bone, goes under m. flexor carpi ulnaris on the back side towards the branch of the same name a. radialis.

5. Ramus palmaris profundus, deep palmar branch, penetrates under the tendons and nerves of the palm and together with a. radialis (see above) is involved in the formation of a deep palmar arch.

Educational video of the anatomy of the branches of the radial and ulnar arteries of the forearm

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The arteries of the upper extremities supply blood to the bones and soft tissues of the shoulder girdle, the lateral part of the chest wall, as well as the retina and tissues of the upper extremities. Axillary artery, a. axillaris lies in the axillary fossa. It is a continuation of the subclavian and runs from the lower edge of the clavicle to the lower edge of the pectoralis major muscle, and then passes into the brachial artery. The largest vessels extending from it are: 1) superior thoracic artery (a. thoracica superema), which supplies blood to the pectoralis major and minor muscles, intercostal muscles and mammary gland; 2) thoracoacromial artery (a. thoracoacromialis), it approaches the shoulder joint, shoulder and chest muscles;3 ) lateral thoracic artery(a. thoracica lateralis), supplying blood to the fiber of the axillary fossa, chest muscles, mammary gland and lymph nodes; 4) subscapular artery (a. subscapularis), nourishes the skin and muscles of the shoulder girdle, shoulder, shoulder joint and back. Supplies blood to: skin and muscles of the shoulder girdle, shoulder joint, mammary gland, chest cavity. Brachial artery (a. brachialis) continues the axillary artery and branches into vessels that supply the skin and muscles of the shoulder, shoulder and elbow joints. Topography: passes in the medial groove of the biceps muscle, shoulder; runs in the axillary canal between the posterior surface of the humerus and the triceps brachii muscle. Muscular branches depart from the brachial artery, supplying blood to the muscles of the shoulder. This: 1) deep artery of the shoulder (a. profunda brachii) 2) superior ulnar collateral artery (a. collateralis ulnaris superior),;3) inferior ulnar collateral artery (a. collateralis ulnaris inferior) In the ulnar fossa, the brachial artery gives rise to two independent arteries - the ulnar (a. ulnaris) and the radial (a. radialis), located on the palmar side of the forearm. Supplies blood to: skin and muscles of the shoulder, humerus, elbow joint, brachialis, triceps muscles.

Elbow- leaves the cubital fossa into the pronator teres. Topography: lies in the ulnar groove to the wrist joint, passes to the palm, where it forms the superficial palmar arch, anastomosing with the superficial palmar branch of the radial artery. It gives the following branches:

2) common interosseous artery (a. interossea communis) 3) palmar carpal branch (r. carpeus palmaris) 4) deep palmar branch (r. palmaris profundus) Blood supply: ulna, skin and muscles of the forearm, hand, hand joints.

Radial artery - topography: runs in the radial groove in the distal forearm and passes to the back of the bone, then to the palm. The terminal section forms a deep palmar arch, anastomosing with the deep palmar branch of the ulnar artery, and also branches into several vessels:

1) recurrent radial artery(a. recurrens radilis), 2 ) carpal branches(palmar and dorsal), 3) superficial palmar branch (r. palmaris superficialis), 4) artery of the thumb (a,princeps pollicis) splits into 2 palmar digital arteries running to both sides of the thumb. Blood supply: radial bone, muscles and skin of the forearm and hand, joints of the hand. Blood supply to the hand is carried out by the terminal branches of the ulnar and radial arteries, forming the arterial palmar arches - superficial and deep. Superficial palmar arch the arch (arcus palmaris superficialis) is formed by the superficial palmar branches of the ulnar and radial arteries. From the convex side of the arc facing the fingers, three common palmar digital arteries(aa. digitales palmares communes), giving rise to their own palmar digital arteries (aa. digitales palmares propriae) Deep palmar arch(arcus palmaris profundus) is formed from the deep terminal palmar branches of the radial and ulnar arteries. The branch of the ulnar artery is more developed than the deep branch of the radial artery. The arch is located under the tendons of the flexor muscles of the fingers and muscles of the hand on the bones of the wrist. 4 depart from the deep arc palmar metacarpal arteries(aa. metacarpeae palmares), which at the level of the heads of the metacarpal bones connect with the palmar digital arteries.

, , , , , , ), is like a continuation of the brachial artery and departs from it in the ulnar fossa at the level of the coronoid process of the ulna. Having described a gentle arc, it goes down to the medial (ulnar) edge of the forearm and is located between the superficial and deep layers of the muscles of the palmar surface of the forearm. Approximately in the middle of the forearm, the ulnar artery lies in the groove between the superficial flexor digitorum and flexor carpi ulnaris and follows it to the distal forearm, where it passes to the hand. On its way, the ulnar artery gives off a number of branches that supply blood to the muscles of the forearm. In the area of ​​the wrist joint, it is located lateral to the pisiform bone, on the flexor retinaculum, being covered by the palmaris brevis muscle. On the palmar surface of the hand, the ulnar artery turns towards the radial edge and connects with r. palmaris superficialis from a. radialis, forming the superficial palmar arch, arcus palmaris superficialis, located under the palmar aponeurosis.

Throughout its entire length, the ulnar artery is accompanied by two ulnar veins, vv. ulnares.

The following branches begin from the ulnar artery.

1. Ulnar recurrent artery, a. recurrens ulnaris(see Fig.), departs from the medial surface of the initial section of the ulnar artery and is divided into anterior and posterior branches:

• anterior branch, r. anterior, going upward and medially, passes on the brachialis muscle under the pronator teres and, rising upward, anastomoses with a. collateralis ulnaris inferior from a. brachialis, giving off branches to the heads of the flexor muscles starting from the medial epicondyle;
• posterior branch, r. posterior, goes back and up, goes under the superficial flexor digitorum and approaches the ulnar nerve. Following upward along the course of the ulnar nerve, it anastomoses with a. collateralis ulnaris superior; its branches participate in the formation of the elbow articular network.

2. Common interosseous artery, a. interossea communis(see Fig.) begins at the level of the tuberosity of the radius. Sometimes, instead of one artery, there are several small branches. Heading towards the distal end of the forearm, the common interosseous artery, almost at the very beginning of its path, is divided into two branches - anterior and posterior:

• anterior interosseous artery, a. interossea anterior(see Fig.), is directed down the anterior surface of the membrana interossea, located between the deep flexor of the fingers and the long flexor of the thumb. At the upper edge of the pronator quadratus or somewhat distal, the artery pierces the membrana interossea and, emerging on its dorsal surface, takes part in the formation of the dorsal network of the wrist (see Fig.). From the anterior interosseous artery the artery accompanying the median nerve arises, a. comitans n. mediani;
• posterior interosseous artery, a. interossea posterior(see Fig.), moving away from the common interosseous artery, it immediately pierces the membrana interossea and emerges on its dorsal surface distal to the instep support. Here the artery runs between the deep and superficial muscles of the dorsum of the forearm and is accompanied by the posterior interosseous nerve of the forearm, n. interosseus antebrachii posterior, follows to the distal end of the forearm, where it participates in the formation of the dorsal network of the wrist (see Fig.). From the posterior interosseous artery, in the place where it enters the back of the forearm, it departs recurrent interosseous artery, a. interossea recurrences, goes up under the elbow muscle, anastomosing with a. collateralis media; takes part in the formation of the elbow articular network.

3. Palmar carpal branch, r. carpalis palmaris(see Fig.), begins at the level of the head of the ulna or slightly higher, goes down and radially and anastomoses with the branch of the radial artery of the same name (see Fig.).

4. Dorsal carpal branch, r. carpalis dorsalis(see Fig.), begins at the same level with the palmar carpal branch and, passing under the tendon of the flexor carpi ulnaris, is directed to the back of the hand, where it anastomoses with the dorsal carpal branch of the radial artery (see Fig.), taking part in the formation of the dorsal network wrists.

5. Deep palmar branch, r. palmaris profundus, arises from the ulnar artery at the level of the pisiform bone or slightly distal to it, passes between the short flexor of the little finger and the abductor of the little finger muscle, under the tendons of the flexor digitorum. Here it connects with the terminal branch of the radial artery, forming a deep palmar arch.

The superficial and deep arterial arches lie on the palmar surface of the hand.

1. Superficial palmar arch, arcus palmaris superficialis(see Fig. , , ), is formed mainly by the ulnar artery, which, having passed to the palmar surface of the hand, goes under the palmar aponeurosis to the flexor tendons of the fingers. Directing towards the radial edge of the hand, it forms an arc, convex in the distal direction. Having reached the area of ​​the eminence of the thumb, the ulnar artery thins and connects with the end r. palmaris superficialis from a. radialis (see fig.).

From the superficial palmar arch extend common palmar digital arteries, aa. digitales palmares communes, only three. They follow in a distal direction to the interdigital spaces. Each of the arteries at the level of the heads of the metacarpal bones receives the palmar metacarpal arteries, aa. metacarpales palmares, from the deep palmar arch and is divided into two own palmar digital arteries, aa. digitales palmares propriae.

Adjacent proper palmar digital arteries follow along the surfaces of the II-V fingers facing one another.

From the ulnar artery on the hand, in the place where it bends towards the radial edge of the hand, the artery extends to the ulnar surface of the little finger.

In the area of ​​the fingers aa. digitales palmares propriae give branches to the palmar surface of the fingers, as well as to the dorsum of the middle and distal phalanges.

The proper palmar digital arteries of each finger widely anastomose with each other, especially in the area of ​​the distal phalanges.

2. Deep palmar arch, arcus palmaris profundus(see Fig.) is located deeper and proximal to the superficial one. It lies at the level of the bases of the II-V metacarpal bones under the tendons of the superficial and deep flexor digitorum, between the beginning of the adductor pollicis muscle and the flexor pollicis brevis muscle.

The radial artery takes part mainly in the formation of the deep palmar arch. Coming from the first intermetacarpal space onto the palmar surface of the hand, it is directed towards the ulnar edge of the hand and connects with the deep palmar branch from a. ulnaris.

They extend from the deep palmar arch palmar metacarpal arteries, aa. metacarpales palmares, only three. They follow in a direction distal from the arch and are located in the second, third and fourth interosseous metacarpal spaces along the palmar surface of the interosseous muscles. Here, one branch leaves from each artery perforating branch, r. perforans. The latter penetrate through the corresponding interosseous spaces and exit onto the dorsum of the hand, where they anastomose with dorsal metacarpal arteries, aa. metacarpales dorsales.

Each palmar metacarpal artery, following in the interosseous space, bends at the level of the heads of the metacarpal bones towards the palmar surface and flows into the corresponding common palmar digital artery, a. digitalis palmaris communis.

The ulnar artery (a. ulnaris) is a continuation of the brachial artery, from which it departs in the ulnar fossa at the level of the coronoid process of the ulna. Then, on the way to the hand, the artery goes under the pronator teres, giving off muscular branches to it. Next, the artery, accompanied by the ulnar nerve, passes in the distal direction between the superficial and deep flexors of the fingers. Through a gap in the medial part of the flexor retinaculum and under the muscles of the eminence of the little finger, the ulnar artery penetrates the palm. Here it anastomoses with the superficial palmar branch of the radial artery, forming the superficial palmar arch (arcus palmaris superficialis).

The following branches arise from the ulnar artery:

1. muscle branches(rr. musculares) go to the muscles of the forearm;
2. ulnar recurrent artery(a.recurrens ulnaris) originates from the beginning of the ulnar artery and is divided into anterior and posterior branches. The larger anterior branch runs proximally into the medial anterior ulnar groove and anastomoses here with the inferior ulnar collateral artery, a branch of the brachial artery. The posterior branch follows the posterior surface of the elbow joint and anastomoses in the medial posterior ulnar groove with the superior ulnar collateral artery, a branch of the brachial artery;
3. common interosseous artery(a. interossea communis) arises from the ulnar artery at the level of the tuberosity of the radius. This is a short trunk that follows towards the interosseous membrane and is divided into the anterior and posterior interosseous arteries. The anterior interosseous artery (a. interossea anterior) along the anterior surface of the interosseous membrane is directed to the proximal edge of the muscle - the quadratus pronator, and gives off a branch to the palmar network of the wrist. Then the artery pierces the membrane and takes part in the formation of the dorsal network of the wrist. On the forearm it gives off the artery accompanying the median nerve (a. comitans nervi mediani). The posterior interosseal artery (a. interossea posterior) immediately pierces the interosseous membrane and follows in the distal direction between the extensors of the forearm. The recurrent interosseous artery (a. interossea recurrens) departs from it, which rises under the lateral tendon bundles of the triceps brachii muscle to the lateral posterior ulnar groove, where it anastomoses with the middle collateral artery from the deep brachial artery and, like all recurrent arteries, participates in the formation of the ulnar articular networks. With its terminal branches, the posterior interosseous artery anastomoses with the anterior interosseous artery and with the dorsal carpal branches (from the ulnar and radial arteries), takes part in the formation of the dorsal network of the wrist, from which the dorsal metacarpal arteries described above depart;
4. palmar carpal branch(r. carpalis palmaris) departs from the ulnar artery at the level of the styloid process of the ulna and, together with the palmar metacarpal branch from the radial artery and the branch from the anterior interosseous artery, participates in the formation of the palmar network of the wrist, from which these joints are supplied with blood;
5. dorsal carpal branch(r. carpalis dorsalis) starts from the ulnar artery at the same level as the palmar carpal branch, then goes to the back of the hand under the flexor carpi ulnaris tendon, and is also involved in the formation of the palmar carpal network.
6. deep palmar branch(r. palmaris profundus) arises from the ulnar artery near the pisiform bone, pierces the muscle opposing the little finger, and supplies the muscles of the eminence of the little finger and the skin above the little finger. As noted, the terminal section of the ulnar artery, together with the superficial palmar branch of the radial artery, forms the superficial palmar arch. They depart from this arc common palmar digital arteries(aa. digitales palmares communes), and from them - the own digital arteries (aa. digitales palmares propriae), heading to the adjacent sides of neighboring fingers.

The upper extremities are characterized by the presence of anastomoses in the system of subclavian, axillary, brachial, radial and ulnar arteries, providing collateral flow of arterial blood and blood supply to the joints.

Ulnar artery, a. ulnaris, represents one of the two terminal branches (the larger one) of the brachial artery. From its origin in the ulnar fossa (opposite the neck of the radius), it fits under m. pronator teres, goes obliquely to the middle third of the forearm, deviating to the ulnar side. In the lower two-thirds it runs parallel to the ulna, first in the space between m. flexor digitorum superficialis and m. flexor carpi ulnaris, in the lower third, due to the transition of muscles into tendons, its position becomes more

superficial (sulcus ulnaris). At the radial side of the pisiform bone, the ulnar artery passes into the canalis carpi ulnaris (spatium interaponeuroticum) and, passing to the palm, enters

part of arcus palmaris superficialis.

Branches of the ulnar artery:

1. A. recurrens ulnaris, the recurrent ulnar artery, gives off two branches - rami anterior et posterior, which pass in front and behind the medial epicondyle, anastomosing with aa. collaterales ulnares superior et inferior. Thanks to these anastomoses, as well as the above-mentioned anastomoses between the branches of a. profunda brachii and a. radialis in the circumference of the elbow joint, an arterial network is obtained - rete articulare cubiti.

2. A. interossea communis, the common interosseous artery, goes to the interosseous membrane, at the proximal edge of which it divides into two branches:

a) a. interossea anterior along the anterior surface of the interosseous membrane reaches m. pronator quadratus, pierces the membrane and goes to the rear, where it ends in rete

carpi dorsale. At the beginning of his journey a. interossea anterior gives a. mediana (directed to the palm together with n. medianus), aa. diaphysis radii et ulnae - to the bones of the forearm and rami musculares - to the surrounding muscles;

b) a. interossea posterior passes through the upper opening of the interosseous membrane to the back side, giving off a. interossea recurrens, lies between the superficial and deep layers of the extensors and in the wrist area anastomoses with a. interossea anterior.

3. Ramus carpeus palmaris, the palmar carpal branch, goes towards the branch of the same name of the radial artery, with which it anastomoses.

4. Ramus carpeus dorsalis, dorsal carpal branch, departs near the pisiform bone, goes under m. flexor carpi ulnaris on the back side towards the branch of the same name a. radialis.

5. Ramus palmaris profundus, the deep palmar branch, penetrates under the tendons and nerves of the palm and together with a. radialis is involved in the formation of the deep palmar arch.

Arches and arteries of the hand. In the wrist area there are two networks: one palmar, rete carpi palmare, the other dorsal, rete carpi dorsale.

Rete carpi palmare is formed from the connection of the palmar carpal branches of the radial and ulnar arteries and branches from the anterior interosseous.

The palmar carpal network is located on the ligamentous apparatus of the wrist under the flexor tendons; its branches nourish the ligaments and articulationes mediocarpea et radiocarpea.

Rete carpi dorsale is formed from the connection of the dorsal carpal branches of the radial and ulnar arteries and branches from the interosseous; located under the extensor tendons and gives branches:

a) to the nearest joints (rr. articulares); ]

b) in the second, third and fourth interosseous spaces (aa. metacarpeae dorsales); at the base of the fingers, each of them is divided into branches to the fingers (aa. digitales dorsales).

There are two arches on the palm - superficial and deep.

Arcus palmaris superficialis, the superficial palmar arch, is located under the aponeurosis palmaris. Being a continuation of the ulnar artery, the superficial arch

decreases in size towards the radial side, where it includes the superficial palmar branch of the radial artery. From the convex distal side

The superficial arc extends four aa. digitales palmares communes. Three of them go corresponding to the second, third and fourth interosseous spaces, the fourth - to

ulnar side of the little finger. At the fold of skin between the fingers, each of them is divided into two aa. digitales palmares propriae, which are directed along opposite sides

neighboring fingers.

Arcus palmaris profundus, deep palmar arch, located deep under the flexor tendons on the bases of the metacarpal bones and ligaments, proximal

surface arc. The deep palmar arch, being formed mainly by the radial artery, decreases in its caliber, in contrast to the superficial one, towards

on the ulnar side of the hand, where it connects with the relatively thin deep palmar branch of the ulnar artery. From the convex side of the deep arch they extend distally

direction towards three interosseous spaces, starting from the second, three aa. metacarpeae palmares, which merge with the ends of the common palmar folds at the interdigital folds

digital arteries. Three small branches (aa. perforantes) extend from the arch in the dorsal direction through the interosseous spaces (second, third and fourth), which,

moving to the rear, anastomose with aa. metacarpeae dorsales.

The superficial and deep arterial arches represent an important functional adaptation: due to the grasping function of the hand, the vessels of the hand are often

are subject to compression. If blood flow in the superficial palmar arch is disrupted, the blood supply to the hand does not suffer, since blood delivery occurs in such cases through

arteries of the deep arch. The same functional devices are the joint networks, thanks to which blood flows freely into the joint, despite compression

and stretching of blood vessels during its movements. In the area of ​​the upper limb there are rich opportunities for the development of collateral circulation. Collateral vessel

for a. brachialis is a. profunda brachii, for a. ulnaris - a. interossea communis.