Artery on the front axillary wall. Plug, axillary artery: topography and branches and fields are bloodsundhed by them

The date: 03.03.2020

The axillary artery is a continuation of the plug-in artery. It begins at the level of the lateral edge of the first rib and ends near the bottom edge of the chest muscle. There she goes into the shoulder artery. Its length is 6-10 cm depending on the age and physique of a person. Next to the artery is the same name of the vein, and together they are surrounded by three beams of nervous plexus. These bundles are covered with a fatty tissue in which the lymph nodes are located.

Anatomy of the axillary region

The axillary artery and its branches are vital vessels that supply a pretty large body of the body. Its length is 6-10 cm depending on the age and physique of a person.

In the axillary yam, this artery has several branches:

top chest artery - supplies blood front muscles that are in intercostal intervals;
the boreacromial artery, which, in turn, is divided into a clavical, deltoid, acromic and thoracic branches (they are saturated with blood relevant sites);
side thoracic artery (second in length of the axillary artery velocity) - supplies blood the side wall of the subclavian fossa and chest;
podlopathic artery (the longest branch) - is divided into an implanial artery and the artery surrounding the blade;
the front and rear arteries are located around the shoulder bone - supply the deltoid muscle and muscles around the shoulder joint.

Possible morbid artery diseases

Mechanical damage are the most common cause of the pathology of the axillary and submerged artery. With mechanical exposure, the wound can be open and closed. For example, knife or gunshot damage to the artery is characterized by a violation of the integrity of the skin and significant blood loss. In addition, it requires immediate surgical treatment.

When blowing stools, hemorrhage in the region of the vascular beam, hematoma, which can cause functional disorders may appear at the point of impact.

Congenital defects can also be causes of axillary artery diseases and its branches.

These include a number of the following diseases:

hypoplasia and aplasia of vessels;
fibrominous dysplasia;
arteriovenous dysplasia;
pathological blood circulation physiology.

Sometimes hemangioma can develop on the axillary artery, which is a benign tumor. Despite its "benignness", it requires treatment. If it has small sizes, cryotherapy or electrocoagulation is used. When the impressive size is achieved, surgical intervention is usually used.

Migrating artery research methods and its branches

To properly diagnose the doctor not only conducts physical research in the axillary region, but also takes into account the history and patient complaints. Usually, the doctor is enough to evaluate the appearance of the affected area and listen to the patient's complaints, and special methods only confirm the correctness of the preliminary diagnosis.

Research methods are divided into:

Instrumental - used in order to clarify the localization, degree of blood flow and the nature of the artery damage. These data are important to select the method of operational intervention.
Functional - used to clarify the degree of arterial failure and ischemia.

Patient complaints can also "tell" about the nature of the disease. If the blood supply to the CNS is broken, but neurological symptoms (tingling, twitching) will prevail in the patient. If the blood does not have enough muscles or organs, then the patient may have painful sensations, the pallor of the affected area, the launch of the veins, gangrene.

Palpation of the pulse on the arteries, including on the axillary artery - a rather important clinical study of blood circulation. Normally, the doctor with a stethoscope can hear the tone of the pulse wave, and systolic noise is observed during the stenosis or aneurysmatic expansion of veins. At the same time, the maximum intensity of noise is characteristic of the affected places.

Instrumental diagnostics implies the use of such methods:

Robies - based on fluctuations in the electrical resistance of the tissues, which change depending on the blood flow of a certain area of \u200b\u200bthe body.
Ultrasonic Doppler - allows you to learn the physiology of blood flow, since moving blood particles have different speeds in different parts.

General principles of treatment

Migrating artery diseases can be treated by such methods:

non-surgical, which include gymnastic exercises, training walking, pharmacological therapy and elimination of risk factors for the further development of pathology;
surgical - prosthetics, shunting, endarterectomy;
interventional radiological interventions - to them include the installation of a stent, balloon dilatation.

It is impossible to use operational methods of treatment in infecting blood, myocardial infarction, heart failure, respiratory, hepatic or renal failure, brainwater disorders. But today, interventional interventions that allow you to quickly and without consequences with many diseases of the arteries can "boast" more popular and efficiency.

It is worth mentioning about complications after conducting interventions on the axillary artery and the branches of the axillary artery. So, most often during operations and after them there are bleeding and hematoma. After reconstructive operations, false aneurysms may be observed, which arise as a result of low-quality seams, the thinning of the walls of the arteries, defects of the prosthesis, local inflammatory processes.

Subclavian artery (a. Subclavia),starting on the right of the shoulder barrel, and to the left of the arc of aorta, envelopes the top of the lung and comes through the top hole of the chest (ATL., 55). On the neck, the plug-in artery appears along with the shoulder nervous plexus and is superficially, which can be used to stop the bleeding and administration of pharmacological preparations. The artery is driving through 1 edge and, passing under the clavicle, falls into the axillary pit, where it is already called cerval. Passing the pit, the artery under the new name - the shoulder - goes on the shoulder and in the area of \u200b\u200bthe elbow joint is divided into its end branches - elbow and radiation artery.

Connected artery gives a number of branches (see atl.). One of them - vertebral artery (a. vertebralis)- departs at the level of the transverse process of the cervical vertebra, it rises vertically upwards and through the holes of the cross-ribric processes of the VI-I of the cervical vertebrae and through a large occipital hole enters the skull's cavity in the subfasting space. On the way, it gives branches penetrating through the vertebral holes to the spinal cord and its shells.

The remaining branches of the plug-in artery nourish their own body and neck muscles. At the level of removal of the vertebral artery from the lower surface of the plug-in artery originates inner chest artery (a. THORACICA INTERNA).It goes to the sternum and descends along the inner surface of the I-VII rib cartilage. The branches of this artery are sent to the staircase muscles of the neck, the muscles of the shoulder belt, thyroid gland, thymus, sternum, diaphragm, to intercostal gaps, chest muscles, arricarde, front mediastone, to trachea and bronchoms, breast, sip, larynx, esophagus, direct muscle Belly, ligaments of liver, skin chest and in the field of navel.

Mortitate artery, a. Axillaris lies in the axillary fossa. It is a direct continuation of a. SUBCLAVIA is located during the lower edge of the clavicle with the subclavian muscle under it below it until the lower edge of the big breast muscle, where continues to the shoulder artery, a. brachialis. The axillary artery is conventionally divided by the front wall of the axillary pits into three parts, which correspond: the first level of the curable-thoracic triangle (from the clavicle to the top edge of the m. Pecturalis minor), the second is the level of the small breast muscle (the outlines m. Pecturalis minor) and the third - The level of the leggings (from the lower edge of a small breast muscle to the lower edge of a large breast muscle). The first part of the axillary artery lies on the upper teeth M. Serratus Anterior, being covered in front of Fascia Clavi-Pectoralis. Kepened and knutrice from the artery lies with a subclavian vein, v. SUBCLAVIA, Kepened and Outside - Shoulder Plexus Stems, Plexus Brachialis.

The following branches depart from this part of the axillary artery.

The highest chest artery, a. THORACICA SUPREMA, begins at the lower edge of the clavicle, heads down and media-but, sending branches to the two top intercostal muscles and anterior toothed muscle, as well as to large and small breast muscles and breasts.

Bradacomial artery, a. ThoracoACromialis, begins at the upper day the edge of a small breast muscle and, proceeding from the depth to the Fascia Clavipectoris surface, immediately divides on the following branches.

a) Acromial branch, Acromialis, is directed upwards and dodged, passes under the big thoracic and deltoid muscles and the hevoyable these muscles. Having reached acromion, Acromialis sends branches to the shoulder joint and together with branches a. Suprascapularis and other arteries take part in the formation of the vascular acromial network, Rete Acromiale.

b) The clavinary branch, Clavicularis, is sent to the region of the clavicle, the blood supply to the connective muscle.

c) Deltaid branch, Deltoideus, goes down and dust, falls in the furrow between m. Deltoideus and m. Pectoralis Major, where hevo-resistant restricting her muscles.

d) Breast branches, Pectoles, follow mostly to large and small breast muscles, partly to the front gear muscle.

The second part of the axillary artery is located directly behind the small thoracic muscle and is surrounded by the back, medial and lateral trunks of the shoulder plexus. From this part of the axillary artery, only one branch is departed - lateral chest artery. Lateral chest artery, a. Thoracica Lateralis, departs from the lower periphery of the axillary artery, is heading down, it goes first behind the small thoracic muscle, and then along its outer edge on the outer surface of the front gear muscle. The artery is heavily suited the lymph nodes and the transshipment of the axillary pits, as well as the front gear, small breast muscle, milk iron (RR. Mamma-Rii Laterales) and anastomizes with AA .. INTERCOSTALES and RR. Pectoles a. thoracoacromialis. The third part of the axillary artery lies behind the big thoracic muscle, on the sublock muscle and the tendons of the wide muscles of the back and a large round muscle; The front of the artery is a cloudless muscle. The branches of the shoulder plexus are located on the sides and ahead of this part of the axillary artery.

The following branches depart from the third part of the axillary artery:

Podlopathic artery, a. Subscapularis, begins at the level of the lower edge of the subband muscle and, heading down, is divided into two branches.

a) artery, envelope shovel, a. Circumflexa Scapulae, goes back, passes through a trilateral hole and, rich the lateral edge of the blade, is directed up into a fiction. It is hevening MM. Subscapularis, Teres Major et minor, Latissimus Dorsi, Deltoideus, Infraspinatus and forms anastomoses with branches a. TRANSVERSA Colli and a. Suprascapularis.

b) Castle artery, a. Thoracodorsalis, continues the direction of the stem of the subband artery. It goes down along the back wall of the axillary fifth on the lateral edge of the blade in the slot between M. Subscapularis and mm. Latissimus Dorsi Et Teres Major to the bottom corner of the blade, ending in the thicker m. Latissimus Dorsi; As stated above, it anastomoses with Profundus a. TRANSVERSAE COLLI.

Front artery, envelope brachial bone, a. Circum-Flexa Humeri Anterior, starts from the outdoor side of the armpit artery, it goes laterally under the closure of the shoulder muscle, and then under the short head of the shoulder's double-headed muscles on the front surface of the shoulder bone; The artery reaches the area of \u200b\u200bthe interbugorkowoy the furrows, where it is divided into two branches: one of them occupies an upward direction, accompanies the tendon of the long head of the two-headed muscles of the shoulder and, enhancing the shoulder joint, goes to the head of the shoulder bone; Another envelopes the outer edge of the shoulder bone and anatomizes with a. Circumflexa Humeri Posterior.

Rear artery, envelope brachial bone, a. Circumflexa Humeri Posterior, departs from the back of the axillary artery next to a. Circumflexa Humeri Anterior. It goes back, passes through a quadrilateral hole, envelopes the rear and outer surface of the surgical neck of the shoulder bone, located along with the axillary nerve, n. axillaris, on the deep surface of the deltoid muscle. A. Circumflexa Humeri Posterior Anastomoses with a. Circumflexa Humeri Anterior, with a. CircumFlexa Scapulae, a. Thora-Codorsalis and a. Suprascapularis. It is blood supply to the articular capsule of the shoulder joint, the deltoid muscle and the skin of this area.

Below from the subclavian artery, branches are departed to the back of the neck and muscles of the back, as well as individual twigs for the spinal cord, which in the spinal cord canal form anastomosis with the branches of the vertebral arteries.

Migratic artery, a. axillaris., Slies in the axillary yam. It is a direct continuation of the plug-in artery and is located throughout the clavicle with the connective muscle below it until the lower edge of the big breast muscle, where continues to the shoulder artery, and. brachialis.

The axillary artery is conditionally divided by the front wall of the axillary cavity into three parts: the first part corresponds to the level of a curable-thoracic triangle, Trigonum ClavipectoRale (from the clavicle to the top edge of a small breast muscle), the second level of a small breast muscle; The third part extends from the lower edge of the small thoracic muscle to the lower edge of the big breast muscle.

The first part of the axillary artery lies on the upper teeth of the anterior toothed muscle, being covered in front of the clergy-breast fascia. Kepened and knutrice from the artery lies with a subclavian vein, v. SUBCLAVIA, Kepened and Outside - Shoulder Plexus Stems, Plexus Brachialis.

The following branches depart from this part of the axillary artery.

1. Top breast, artery, a. Thoracica Superiorit begins at the lower edge of the clavicle, it is directed down and media, sending branches to the two upper intercostal muscles and anterior toothed muscle, as well as to large and small breast muscles and breast.

2. Bradacomial artery, a. thoracoacromialis,it begins at the upper day the edge of a small breast muscle and, proceeding from the depth to the surface of the curady-breast fascia, immediately divided into the following branches:

and) acryal branch, r. acromialis,it is directed up and dodged, passes under the big thoracic and deltoid muscles and blood supply to them. Having achieved acromion, sends branches to the shoulder joint and, anatomosing with branches a. Suprascapularis and other arteries, take part in the formation of the vascular acromial network;

b) clavical branch, R.Clavicular IS,directed to the region of the clavicle; Breakfasts subclavian muscle ;

in) deltaid branch, r. Deltoideus,goes down and dust, passes in the furrow between the deltoid muscle

and the big thoracic muscle and blood supply to these muscles;

d) breast branches, RR. pectoralesfollow mostly to large and small breast muscles, partly to the front gear muscle.

Lateral, chest artery, a. Thoracica Lateralis,From the lower periphery of the axillary artery, it goes down, goes first behind the small chest muscle, and then along its outer edge on the outer surface of the front gear muscle. Breasts lymphatic components and transshipment of the axillary cavity, as well as anterior toothed muscle, small breast muscles, milk gland (lateral branches of the breast, p. Mammarii Laterales)and anastomoses with aa. INTERCOSTALES and RR. Pectoles a. thoracoacromialis.

The third part of the axillary artery lies behind the big thoracic muscle, on the sublock muscle and the tendons of the wide muscles of the back and a large round muscle; The front of the artery is a beak-shaped muscle. The branches of the shoulder plexus are located on the sides and ahead of this part of the axillary artery.

The following branches depart from the third part of the axillary artery.

1. Podlopathic artery, a. Subscapularis,it begins at the level of the lower edge of the subband muscle and, heading down, is divided into two branches. Before the fission of division, the artery gives two or three small sublock branches, RR. Subscapulares, which can also move away from the initial part of the artery, envelope the blade, and end in the subband muscle.

Finite branches of the subband artery:

and) artery, envelope shovel, a. CircumFlexa.scapulaeit goes back and, rich lateral edge of the blades, is directed up, in a fit one. Blood supply to the sublock, big andsmall round muscles, wide back muscle, deltoid and sibwise muscles. Forms anastomoses with branches a. TRANSVERSA CERVICIS and A. suprascapularis;

b) castle artery, a. thorasodorsailscontinues the direction of the stem of the subband artery. It goes down along the back wall of the axillary cavity along the lateral edge of the blade in the slot between the subband muscle, the widest muscle of the back and the big round muscle to the lower corner of the blade. Ending in the thicker of the widest muscles of the back, anastomoses with branches a. TRANSVERSA CERVICIS.

2. Front artery, rich shoulder bone, a. Circumflexa Humeri Anterior,it starts from the outdoor side of the armpit artery, it goes laterally under the berthed-eye-brace muscle, and then under the short head of the two-headed shoulder muscles along the front surface of the shoulder bone. Having achieved the region of the Mercicultural furrow, it is divided into two branches: one of them occupies an upward direction, accompanies the tendon of the long head off the shoulder two-headed muscles and, enhancing the shoulder joint, heads for the head of the shoulder bone; Another branch of the rhytening edge of the shoulder bone and anastomizes with a. Circumflexa Humeri Posterior.

3. Rear artery, envelope brachial bone, a. CircumFlexa Humeri Posterior,departs from the rear surface of the axillary artery next to a. Circumflexa Humeri Anterior. It is directed back, envelopes the rear and outdoor surface of the surgical neck of the shoulder bone, located along with the axillary nerve, paragraph. Axillaris, on the inner surface of the deltoid muscle. Anastomoses with a. Circumflexa Humeri Anterior, a. CircumFlexa Scapulae, a. Thoracodorsalis and a. Suprascapularis. The blood suite of the articular capsule of the shoulder joint, the deltoid muscle and the skin of this area.

Shoulder artery

Shoulder artery , a. Brachialis.Is the immediate continuation of the axillary artery. It begins the level of the lower edge of the big breast muscle, there is a bevel-shaped shoulder muscle ahead, then in the medial elbow furrow, on the surface of the shoulder muscle. Following the muscle down, the shoulder artery reaches the elbow yam. Here she lies in the groove between the round pronator and the shoulder-taverochy muscle under the aponeurosis, and is divided into two branches: rauchery artery a. Radialis,and elbow artery, a. Ulnaris.Sometimes, as an option branching, a. Brachialis is divided into terminal branches above the front elbow area, clutching subcutaneously, and gets the name surface shoulder artery, a. Brachialis superficialis.

The shoulder artery is accompanied by two shoulder veins, VV. Brachiales, and median nerve, p. Medianus. The latter in the upper third of the shoulder lies the duck from the artery, in the middle third of the shoulder - in front, and in the lower third of the shoulder is located along the medial surface of the artery.

Shoulder artery, together with the shoulder veins and the median nerve, forms a vascular-nervous beam of the shoulder.

The following branches depart from the shoulder artery.

1. Deep artery shoulder, a profunda. BRACHII., begins in the upper third of the shoulder from the porch surface of the shoulder artery. Going back, it together with the radial nerve, p. Radialis, spirally envelopes the rear surface of the shoulder bone. Then deep artery shoulder continues in raundic collateral artery, a. Colladeralis Radialis,which comes first behind the lateral intermuscular septal of the shoulder and, giving the branch for the formation of the articular of the elbow, Rete Articulare Cubiti. Anastomoses with a return artery, a. Recurrens Radialis.

Deep artery shoulder gives a number of branches:

and) deltoidal branch, Deltoideus,departs from the initial deployment of the deep artery of the shoulder, passes under the beats and the shoulder muscle and the two-headed muscle of the shoulder, gives them branches and on the front surface of the shoulder bone reaches the deltoid muscle;

b) arteries that feed the shoulder bone, AA. Nutriciae Humeri,guide to the nutrient holes of the shoulder bone. Can be separated directly from the shoulder artery;

in) medium collateral artery, a. COLLATERIS MEDIA,it goes down between the side and medial heads of the three-headed shoulder muscles. Then he jester the side head and, reaching the elbow joint, anastomoses with a. Interossea Recurrens, taking part in the formation of the elbow articular network.

2. Upper elbow collateral artery, a. Collateralis Ulnaris Superior., it begins slightly below the deep artery of the shoulder from the medial surface of the shoulder artery, and sometimes a common trunk with it. Heading the book, the artery comes to the elbow nerve, paragraph Ulnaris, accompanies it to the medial model, where he participates in the formation of the elbow articular network. Breasts the shoulder muscle, the medial head of the arm of the shoulder and the skin of this area; Anastomoses from the medial model with the back branch of the returnability artery, Posterior a. Recurrentis ulnaris.

3. Lower elbow collateral artery, a. Colladeralis ulnaris Inferior., begins in the lower third of the shoulder from the medial surface of the shoulder artery, just above the medial model. Heading the book on the front surface of the shoulder muscle, anastomoses with the front branch of the returnability artery, Anterior a. Recurrentis ulnaris. The fields of the medial model reaches their branches, the medial intertwine shape of the shoulder is performed and takes part in the formation of the elbow articular network.

Beam artery

Raduing artery, a.radialis, departs from the shoulder artery in the area of \u200b\u200bthe elbow. Directing the book, deviates a few dastener and goes along the front surface of the muscles - a round pronator. Having achieved the medial edge of the Muscle's Muscles, the artery takes place between this muscle and the round prone, and then there is a muscle between the shoulder and a radiant brush flayer.

On the sides of the artery there are two radial veins, VV. Radiales.

In the lower third of the forearm of the artery lies the most superficially: covered only by fascia and leather. Here it is easily palpable and can be pressed against the radial bone.

Next, the radiation artery, without losing his descending direction, at the level of the cylinder radiation bone process, is deflected by the post, laying under the tendons of the long muscle, distinguishing the thumb, and the short brushing brushes Then passes under the tender of the long extensor of the thumb, heading on the rear of the brush. Here, the radiation artery changes its direction, the muscles of the first interfallated gap will be performed and goes to the palm surface of the brush; Next, it turns the arcuate towards the elbow edge and connects with the city of Palmaris profundus a. Ulnaris, forming a deep palm arc, Arcus Palmaris profundus. In his go, the radiation artery gives a number of branches, blood supply muscles of the forearm.

I. Rady return artery, a.recurrens Radialis. , It begins on the radial artery in the area of \u200b\u200bthe elbow fossa, departs from its outer surface and is sent to the duck between the shoulder and the shoulder muscles. The branches of the return radiation artery "are sent to the nearby muscles. The lateral supermarket, it anastomoses with a. Colladeralis Radialis (from the deep artery of the shoulder) and the ademption in the formation of the elbow artery network.

2. Palm Captive Branch, R. Carpalis Palmaris, departs from the radial artery at the level of the lower edge of the square Pronator and, heading towards the elbow edge of the forearm, anastomoses with the palm custodine branch, the city of Carpalis Palmaris (from the elbow artery) (see Fig. 805). These arteries take part in the formation of the arterial wrist network. .

3. Surface, palm branch, r. Palmaris superficialis, Begins from radial arterina, the level of the base of the cylinder radiation bone, goes downwards, passes over the muscles of the rise of the thumbs of the brush or turns their thickness and, anatomosing with an elbow artery, forms a surface palm arc, Arcus Palmaris Superficialis. The blood suite also muscles and skin of the rise of the high finger brush.

4. Rear custodial branch, R. Carpalis Dorsalis(See Fig. 763, 764), departs from radial artery and, heading along the back of the base of the brush towards its elbow edge, anastomoses with a rear custod branch from a. Ulnaris (see Fig. 763, 805) and together with it takes part in the formation of the backset of the wrist, Rete Carpi Dorsale.

5. Rear mills artery, aa. Metacarpales Dor Sales,only three - four, depart separately, sometimes spa-respect to the back of the wrist and are directed distal between the tendons of the finger extensor. At the level of the heads of the Metatar Bones, each Metal Artery is divided into two rear finger arteries, aa.digitales Dorsales,the blood supplying back surface of the fingers, the area of \u200b\u200bthe proximal and medium phalange.

6. Artery of big finger, a. Princeps Policis,departs from the radial artery or in the thickness of the interceptional muscle, or at the exit of it on the palm surface and is divided into two, less often on three own palm finger arteries, AA. Digitales Palmares Propriae. The latter are on the palm surface of the side edges of the finger, and sometimes the radiation side of the II finger.

7. Rady artery index finger, a. Radialis Indicis,it departs somewhat medially the previous one, it goes in the furrow between the abdomen of rear interception muscles, is directed distally along the radial surface of the index finger.

Lock artery

Elbow artery a. Ulnaris., It's like a continuation of the shoulder artery and departs from it in the elbow yam at the level of the coronary process of the elbow bone. When describing the gentle arc, it is sent down to the medial (elbow) edge of the forearm and is located between the surface and deep layers of the muscles of the palm surface of the forearm. Around the middle

the forearm of the elbow artery falls into the furrow between the surface flexor of the fingers and the elbow flayer of the wrist and follows it to the distal department of the forearm, where it goes to the brush. On his way, the elbow artery gives a number of twigs, blood supply muscles of the forearm. In the area of \u200b\u200bthe ray-taking joint, it is located laterally of the pea bone, on the folder retainer, being covered with a short palm muscle. On the palm surface of the brush, the elbow artery wocks in the direction of the radial edge, connects to the city of Palmaris Superficialis from a. Radialis, forming a surface palm arc, Arcus Palmaris superficialis located under the palm aponeurosis.

Throughout the elbow artery is accompanied by two elbow veins, VV. Ulnares.

The following branches begin with the elbow artery.

1. Lock return artery, a. Recurrens ulnaris, departs from the medial surface of the entry department of the elbow artery and is divided into the front and rear branches:

and) front branch, Anterior,going up and media, passes on the shoulder muscle under a round pronator and, lifting up, anasto-dishes with a. Colladeralis Ulnaris Inferior from a. Brachialis, giving the branch to the heads of flexor muscle, starting from the medial naphrak;

b) back branch, Posterior,it goes back and upstairs, goes under the surface flexor fingers and is suitable for an elbow nerve. Following the upstream of the elbow nerve, anatomizes with a. Colladeralis Ulnaris Superior; Its branches are involved in the formation of the elbow articular network.

2. General intercepical artery, a. Interossea.communis, begins at the level of the beagrousity of the radiation bone. Sometimes instead of one artery there are several small branches. Heading towards the distal end of the forearm, the general interceptional artery is almost at the very beginning of its path divided into two branches - the front and rear:

and) front intercept, artery, a. Interossea Anterior., headed down the front surface of Membrana Interossea, located between the deep finger bent and the long thumbnail bent. At the upper edge of the square Pronator or several distal arteries, the Membrana Interossea will try and, coming out on her back surface, takes part in the formation of the back of the wrist. From the front interception artery goes artery accompanying the middle nerve, a. comitans n. Median i. ;

b) rear interceptional artery, a. Interossea Posterior., departing from the general intercourse artery, immediately proceeds by Membrana Interossea and goes to her back surface distal than the supinator. Here, the artery goes between the deep and superficial muscles of the rear of the forearm and accompanied by the rear interceptional nerve of the forearm,

n. Interosseus Antebrachii Posterior, follows to the distal end of the forearm, where he participates in the formation of the back of the wrist. From the rear interception artery, in the place where she goes to the rear of the forearm, leaves returning intermetal artery, A, InterSea Recurrens,direct up under the elbow muscle, anatomosing with a. Colladeralis Media; Takes part in the formation of the elbow articular network.

3. Palm Captive Branch, Carpalis Palmaris, It begins at the level of the elbow bone head or somewhat higher, it is sent down and radially and anastomoses with the branch of the radial artery.

4. Rear custodial branch, carpalis dorsalisstarts on the water level with a palm custody and, passing under the tender of the elbow of the wrist, heads on the rear of the brush, where he anastomoses with the rear custod branch of the radial artery , taking part in the formation of the back of the wrist.

5. Deep Palm Branch, Palmaris Profundus,it departs from the elbow artery at the level of the pea bone or several distal than it, passes between a short maiden flexor and a muscle, reducing the little finger, under the tenders of the finger bent. Here it connects with the end branch of the radial artery, forming a deep palm arc.

On the palm surface of the brush, surface and deep arterial arcs are locked.

1. Surface Palm Arc, Circus Palmaris SuppicalialisFormed mainly by the elbow artery, which, passing onto the palm surface of the brush, goes under the palm aponeurosis on the tendons of the fingers. Going towards the radial edge of the brush, it forms an arc facing convexity in the distal direction. Having reached the field of elevation of the thumb, the elbow artery is thinned and connected with the end of Palmaris SuperFicialis from a. Radialis.

From the surface palm arc deposit general palm finger arteries, aa. Digitales Palmares Communes,total three. They follow in the distal direction to interdigital gaps. Each of the arteries at the level of the heads of the Metatar Bones takes palm pine artery, aa. Metacarpales Palmares,from deep palm arc and is divided into two own palm finger arteries, AA. Digitales Palmares Rgoripa.

Related eating palm finger artery followed by one to another surfaces of the II-V fingers.

From the elbow artery on the brush, in the place where it is bent towards the radial edge of the brush, the artery is departed to the elbow surface of the maiden.

In the field of the aa. Digitales Palmares Rhorpae gives branches to the palm surface of the fingers, as well as on the back surface of the middle and distal phalange.

Own Pallet Palcese Arteries of each finger are widely anastomized, especially in the area of \u200b\u200bdistal phalange.

2. Deep Palm Arc, Arcus Palmaris PROFUNDUS, It is deeper and proximal to superficial. It lies at the ground level of II-V Metro bones under the tenders of surface and deep finger bends, between the beginning of the muscle, leading the thumb, and the short brush thumb.

In the formation of deep palm arc, taking care mainly radiation artery. Coming out of the first interpoint gap to the palm surface of the brush, it is heading towards the elbow edge of the brush and is connected to the deep palm branch from a. Ulnaris.

Departed from deep palm arc palm pine arteries, Ai. Metacarpales Palmares,total three. They follow in the ambulance of the arc direction and are located in the second, third and fourth inter-pop particle intervals along the palm surface of the inter-emergency

muscles. Here from each artery is moving one spent branches, Perforans.The latter penetrate through the appropriate intercellate intervals and go to the back surface of the brush, where anastomosor is reary milling arteries, aa.metacarpales Dorsales.

Each palm pillage artery, following in the inter-emergency gap, bends at the level of the heads of the pillage bones toward the palm surface and is poured into the appropriate shared palm finger artery, a. Digitalis Palmaris Communis.

Arterial networks.

From the arteries of the upper limb: a subclavian, axillary, shoulder, radiation and elbow - the number of branches are departed, which, anatomosing among themselves, form arterial networks, Retia Ameriosa,especially well developed in the joints of the joints.

In the circumference of the shoulder joint there is acromician network, Rete Acromiale.It lies in the area of \u200b\u200bthe acromion and is formed by

anastomotic branches between the GRU-Daacromic Artery (branch of the armpit artery) and the suprameal artery (branch of the plug-in artery). In addition, in the circumference of the proximal bone, there is an anastomotic connection between the front and rear arteries, bending the shoulder bone (the branches of the axillary artery).

In the circumference of the elbow joint, two networks are distinguished: the oil joint and the elbow process network, which are combined into one common elbow articular network, Reec Articulare Cubiti. Both networks are formed by the anastomotic branches of the upper and lower elbow collateral arteries (the branches of the shoulder artery), the average and radial collateral artery (the branches of the deep artery of the shoulder) on the one hand, and on the other - the branches of the radiation return artery (the branch of the radiation artery), the elbow return artery ( Branch of the elbow artery) and return interceptional artery (branch of the rear interception artery). The stem of this highly developed anastomotic supply of bones, joints, muscles and the skin of the elbow area.

There are anastomoses of palm cranky branches, radiation and elbow arteries, as well as branches from deep palm arc and anterior interception artery on the palm surface of the wrist apparatus.

On the back surface of the brush, in the area of \u200b\u200bexcess holders, lies networkwrist , rete Ca Pale Dorsale.

The backset of the wrist is divided into the surface backset of the wrist, which occurs under the skin, and the deep back of the wrist, located on the bones and bundles of the wrist joints.

In the formation of the rear network of wrists take part rear custodial branches, RR. Carpales Dorsales., radiation and elbow arteries, as well as front and rear interceptional artery.

From the deep back of the wrist, three are departed rear mills artery, aa. Metacarpales Dorsales,which follow in the distal direction on the second, third and fourth inter-emergency metallic gaps. At the heads of the Metatar Bones, each rear psyched artery is divided into two rear finger arteries, aa. Digitales Dorsales.They go on converted one to another side surfaces of adjacent fingers and branched out within the proximal phalanges.

Migratic arterya. axllldris(Fig. 50) is a continuation of the plug-in artery (from the level I of the rib), located in the depths of the axillary fifth and is surrounded by the barrels of the shoulder plexus. At the lower edge of the tendon of the widest muscles of the back muscle, the axillary artery goes into the shoulder artery. Accordingly, the topography of the anterior wall of the axillary pits, the axillary artery is conventionally divided into three departments. In the first department, at the level of a curady-thoracic triangle, the following artery departs from the axillary artery: 1) the subband branches, rR. sub scapularesbranched in the muscle of the same name; 2) Upper breast artery, a. Thoracica Superiordisintegrates on the branches, which are sent to the first and second intercostal intervals, where the intercostal muscles are incense, and also gives thin branches to the breast muscles; 3) r rd o and k r about m and ally I am an artery thoraco-acromidlis,departs from the axillary artery above the upper edge of the small breast muscle and disintegrates on 4 branches: acromial branch, Acromidlis,takes part in the formation of an acre-allest network, from which the bustling of the acromial-key joint, as well as partially capsule of the shoulder joint; key branch, Claviculdris,non-permanent, nourishes the clavicle and the connective muscle; deltoidal branch, Deltoideus,heavily deltoidal and large breast muscles and the corresponding chest skin sections; breast branches, RR. Pectordlesthey go to large and small breast muscles.

In the second department, at the level of the chest triangle, lateral chest artery departs from the axillary artery, a. thordcica Laterdlis.It descends down the outer surface of the front toothed muscle, in which it branches. This artery also gives lateral branches of the breast, RR. Mammdrii Laterdles.

In the riving triangle (the third department) from the axillary artery, three artery depart: 1) Podlopathic artery, a. subscapuldris- the largest; divided by bloother artery, a. THORACODORSDLIS,which follows along the lateral edge of the blade. It is bloodtained anterior toothed and large round muscles, as well as the widest muscle of the back; and artery, envelope shovel, a. Circumflexa Scapulae,which passes through a three-sided hole on the back surface of the blade to the share "muscle and to other neighboring muscles, as well as to the leather of the scaling area; 2) anterior artery, an envelope brachial bone, a. Circumflexa Anterior Humeri,it passes ahead of the surgical neck of the shoulder to the shoulder joint and to the deltoid muscle; 3) rear artery, envelope brachial bone, a. Circumflexa Posterior Humeri,the larger than the previous one, together with the axillary nerve, heads through a four-sided hole to the deltoid muscle, anastomoses with the branches of the front artery, enveling the shoulder bone, blood supply to the shoulder essence and nearby muscles.

Shoulder arterya. Brachidlis.(Fig. 51), is a continuation of the axillary artery. It begins at the level of the lower edge of the big breast muscle, where the shoulder artery lies ahead of the bezvoid-shoulder muscle. Then the artery is located on the front surface of the shoulder muscle, in the furrow, passing by the medial of the two-headed muscles of the shoulder.

In the elbow jam, at the level of the ray bone, the shoulder artery is divided into its final branch-beam and elbow artery. From the shoulder artery, a number of branches are departed: 1) muscular in E T in and, rR. Musculdresto the muscles of the shoulder; 2) deep artery shoulder, a. PROFUNDA BRDCHII,it begins on the shoulder artery in the upper third of the shoulder, it goes along with the radial nerve in the bell-thoughc channel between the rear surface of the shoulder bone and the three-headed muscle of the shoulder, where he gives several branches: arteries that feed the shoulder bone, AA. Nutriciae Hiimeri, Deltaid Branch, Deltoideus,to the same and shoulder muscles, middle collateral artery, a. COLLATERIS MEDIA,which gives branches to the three-headed arm of the shoulder, takes place in the rear lateral elbow furrow and anastomoses with a return interceptional artery, and raundic collateral artery, a. Colladeralis Radidlis,which is sent to the front lateral elbow furrow, where he anastomoses with a radial return artery; 3) upper elbow collateral artery, a. COLLATERIS ULNARIS SUPERIOR,begins from the shoulder artery below the deep artery of the shoulder. She accompanies the elbow nerve, falls into the medial rear elbow furrow, anastomoses with the rear branch of the elbow return artery; 4) Lower elbow collateral artery, a. COLLATERIS ULNARIS INFERIOR,it begins on the shoulder artery just above the medial brace of shoulder bone, it is directed media to the front surface of the shoulder muscle and anastomoses with the front branch of the elbow return artery. All collateral arterys are involved in the formation of the elbow articular network, from which the elbow joint is bustling, next to the lying muscles and skin in this joint.

Mortitate artery, a. axillaris. (Fig. ,,,, See Fig.,), Locals in the axillary. It is a direct continuation of the plug-in artery and is located throughout the clavicle with the connective muscle below it until the lower edge of the big breast muscle, where continues to the shoulder artery, and. brachialis.

The following branches depart from this part of the axillary artery.

1. Top chest artery, a. Thoracica Superior.It begins at the lower edge of the clavicle, it is directed down and media, sending branches to the two top intercostal muscles and anterior toothed muscle, as well as to large and small breast muscles and breast.

2. Bradacomial artery, a. thoracoachromialis, it begins at the upper day the edge of a small breast muscle and, proceeding from the depth to the surface of the curable-breast fascia, immediately divided into the following branches:

acromial branch, r. Acromialis., goes up and dust, passes under the big thoracic and deltoid muscles and blood supply to them. Having achieved acromion, sends branches to the shoulder joint and, anatomosing with branches a. SuprasCapularis and other arteries, take part in the formation of the vascular acromial network (see Fig.,);
clavical branch, r. clavicularis, directed to the region of the clavicle; heavily suits the connective muscle;
deltaid branch, r. Deltoideus., goes down and dust, passes in the furrow between the deltoid muscle and the big thoracic muscle and blood supply to these muscles;
breast branches, RR. Pectales., follow mostly to big and small breast muscles, partly to the front gear muscle.

Lateral chest artery, a. Thoracica Lateralis., (See Fig.,), From the lower periphery of the axillary artery is sent down, it takes at first behind the small chest muscle, and then along its outer edge on the outer surface of the front gear muscle. The blood supply to the lymph nodes and the transshipment of the axillary cavity, as well as the front gear muscle, the small breast muscle, the milk gland ( lateral branches of the breast, RR. Mammarii Laterales) And anastomoses with AA. INTERCOSTALES and RR. Pectoles a. thoracoacromialis.

From the third part of the axillary artery, the following branches depart (see Fig.,).

1. Podlopathic artery, a. subscapularis., begins at the level of the lower edge of the subband muscle and, heading down, is divided into two branches. Before the fission of division, the artery gives two or three small sublock branches, RR. Subscapulares, which can also move away from the initial part of the artery, envelope the blade, and end in the subband muscle.

Finite branches of the subband artery:

artery, envelope shovel, a. Circumflexa Scapulae., go back and, rich the lateral edge of the blade, is directed upwards, into the fit one. Heavily ducts grazing, greater and small round muscles, the widest muscle of the back, deltoid and sibinate muscles. Forms anastomoses with branches a. TRANSVERSA CERVICIS and A. Suprascapularis (see Fig.,);
castle artery, a. thoracodorsalis, continues the direction of the trunk of the subband artery. It goes down along the back wall of the axillary cavity along the lateral edge of the blade in the slot between the subband muscle, the widest muscle of the back and the big round muscle to the lower corner of the blade. Ending in the thicker of the widest muscles of the back, anastomoses with branches a. TRANSVERSA CERVICIS.

2. Front artery, envelope brachial bone, a. Circumflexa Humeri Anterior., It starts from the outdoor side of the armpit artery, it goes laterally under the beak-shoulder muscle, and then under the short head of the two-headed shoulder muscles along the front surface of the shoulder bone. Having reached the region of the Merciculturous groove, it is divided into two branches: one of them occupies an upward direction, accompanies the tendon of the long head of the two-headed muscles of the shoulder and, enhancing the shoulder joint, goes to the head of the shoulder bone; Another branch envelopes the outer edge of the shoulder bone and anatomizes with a. Circumflexa Humeri Posterior.

3. Rear artery, envelope brachial bone, a. Circumflexa Humeri Posterior., departs from the rear surface of the axillary artery next to a. Circumflexa Humeri Anterior. Heads back, envelopes the rear and outdoor surface of the surgical neck of the shoulder bone, located along with the axillary nerve, n. Axillaris, on the inner surface of the deltoid muscle. Anastomoses with a. Circumflexa Humeri Anterior, a. CircumFlexa Scapulae, a. Thoracodorsalis and a. Suprascapularis. The blood suite of the articular capsule of the shoulder joint, the deltoid muscle and the skin of this area.