Arterial Anatomy of the Extremities

13 Arterial Anatomy of the Extremities



The evaluation of arterial disease of the extremities requires knowledge of vascular anatomy. This chapter provides this basic information for the upper and lower extremities. Normal anatomy, common variants, and major collateral routes16 are illustrated, primarily by representative arteriograms. The chapter is formatted as a series of captioned illustrations, with the bulk of the instructional material contained within the figure captions.


It is increasingly common for arterial anatomy and pathology to be depicted noninvasively in a clinical setting with computed tomography or magnetic resonance imaging. Image quality with these modalities approaches that of catheter angiography. Because conventional arteriography remains the gold standard, angiographic images are used in this chapter, as they best depict anatomic detail.


The following terms are used to describe extremity anatomy in this chapter. The arm is the portion of the upper extremity between the shoulder and elbow. The forearm is the portion between the elbow and wrist. The thigh is the portion of the lower extremity between the hip and knee, and the calf is the portion between the knee and ankle.



Upper Extremity



Normal Features


The normal arterial anatomy of the upper extremity is depicted graphically in Figure 13-1. Figures 13-2 to 13-5 are detailed arteriographic views of specific regions of the upper extremity arterial tree, beginning at the aorta and extending to the digits. These figures should be reviewed carefully, because their legends provide the instructional content.




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FIGURE 13-3 The subclavian artery (Su) becomes the axillary artery (Ax) at the lateral margin of the first rib. The axillary artery, in turn, becomes the brachial artery (B) after crossing the inferolateral margin of the teres major muscle.3 The thyrocervical (TC) and costocervical (CCT) trunks are noteworthy branches of the subclavian artery, because they may be mistaken for the vertebral artery (V) during duplex examination. The multiple branches that supply the scapular musculature serve as collaterals when the subclavian or innominate arteries are obstructed. CH, circumflex humeral artery; DB, deep brachial artery; DS, dorsal scapular artery; IM, internal mammary artery; SS, subscapular artery.





Mar 5, 2016 | Posted by in ULTRASONOGRAPHY | Comments Off on Arterial Anatomy of the Extremities
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