On this model, or vessel plaque, I want to discuss some of the major vessels of the body.
There are some things that we can see on this plaque a little better than the other.
And some on the other that were better than this.
And again I'm going to start looking at the area of the heart.
And we're going to start with arteries and we're going to work our way out.
Then we'll do veins.
And then will come back.
Starting at the heart of course we have the ascending aorta.
The aortic arch.
And then the descending or thoracic aorta.
That aorta will descend posterior to the heart and as it passes through the diaphragm at
the T12 vertebral level it will become abdominal aorta.
We will talk about that shortly.
Going back to the aortic arch, we have the three branches of the aortic arch.
The brachiocephalic trunk.
Keep in mind brachial means arm, cephalic means head, brachiocephalic trunk basically
means the arm and head trunk.
It passes posterior to the vein here, which we haven’t named yet.
I will talk about that in a few minutes, to divide into the right common carotid artery
and the right subclavian artery.
So here's brachiocephalic trunk dividing into right common carotid and right subclavian
arteries.
The second branch of the aortic arch is the left common carotid artery.
And it will move upward in the neck and branch into internal and external carotid arteries.
On this plaque we can't see the internal, and mostly what we see of the external that
I'm going to focus on is a branch called the facial artery which runs across the mandible
and up into the face.
So brachiocephalic trunk, left common carotid artery, and then left subclavian artery.
Left subclavian artery will supply blood to the left upper extremity.
Now the subclavian arteries only run as far as the lateral border of the first rib.
And here's our first rib.
Right there it then changes names.
So we have subclavian artery to here.
Then it becomes axillary artery.
Your armpit is known as the axilla.
The artery running through the armpit is the axillary artery.
Let's hop over to the right side for a second.
Again subclavian artery to here.
Because here's our first rib.
Then axillary artery.
Axillary artery runs until the lower border of the teres major muscle.
However we don't have the muscles on this model.
So we don't have anything to go by for that landmark.
However there is a branch of the axillary artery that goes behind the surgical neck
of the humerus.
Right here we have our surgical neck of our humerus and we can see a branch right here
going posterior to that surgical neck of the humerus.
That is called the posterior circumflex humeral artery.
That is the last branch of the axillary artery.
So we know that at this point this was still axillary.
So somewhere right in here this artery changes to the brachial artery, which literally means
the arm artery.
So the artery of the arm.
Brachial artery passes along in the anterior arm and as it gets near the elbow passes in
the cubital fossa anterior to the elbow and branches into the radial artery, which follows
along the radius, and the ulnar artery, following along the ulnar.
Now there are several branches in that area.
Some are depicted on this model others are not.
We are not responsible for those branches in A&P II.
Now as we get down into the wrist we will see branches from the ulnar artery and branches
from the radial artery form arches within the hand.
There is a superficial palmar arterial arch and a deep palmar arterial arch.
On this model they only depict one palmar arterial arch.
And then from there we have the arteries that will go out to supply the digits.
If I look at the left upper extremity on this model, or this particular plaque, we see some
things that we didn't get to see real clear on the right side.
Subclavian to here, at first rib.
Axillary to about here.
Now they didn't show the branching of the posterior circumflex humoral artery.
Here's the artery coming behind the surgical neck of the humerus, so we will make the assumption
that should've been connected right here.
So axillary to here.
Then brachial.
The brachial artery again we said runs down the anterior arm.
But about midway down the shaft of the humerus it sends off a branch that also will go posterior
to the humerus in what is called the radial or the spiral groove.
That is called the deep brachial artery, also known as the profunda brachii.
So on this model right here this is our profunda brachii artery traveling in what is known
as the radial or spiral groove.
Again we follow the brachial artery and as we get to the elbow, pass anterior to the
elbow and divide into radial and ulnar arteries.
But on this plaque we pronated this forearm so we lose the relationship so I'm not going
to continue on with the vessels on this side.
So what we saw on this plaque that we didn't see real well on the other was this deep brachial
artery, or the profunda brachii artery.
Let's start with the superior vena cava and talk about blood supply coming back to the
heart.
The superior vena cava was formed by the union of the left brachiocephalic vein and the right
brachiocephalic vein.
This left brachiocephalic vein was formed from the union of the left subclavian vein
and the left internal carotid vein.
The same on the right except instead of left its right.
So here we had the right internal, excuse me not carotid but jugular, internal jugular
vein and right subclavian vein.
On this side we had the left subclavian vein and the internal jugular vein, left internal
jugular vein, to make a left brachiocephalic vein right brachiocephalic vein.
The left subclavian vein came from left axillary vein which came from left brachial vein.
So the naming is the same as we had with the arteries which were going out.
And the landmarks are the same.
But we can see the subcutaneous veins on this plaque which are necessary to know if you're
going to be a phlebotomist, or if you're going to donate blood, if you're going to put in
lines for IVs.
So starting near the wrist, running along the medial aspect of the forearm and then
the medial aspect of the arm and ultimately into the brachial vein,we will see the basilic
vein.
So here we have the basilic vein along the medial aspect of the forearm and the arm.
Along the lateral and slightly posterior in the forearm we will see the cephalic vein.
And then it travels along the lateral aspect of the arm.
And then goes over into the axillary vein.
So here is our cephalic vein traveling to the axillary vein.
The other vein we can see in this forearm is the anterior median vein of the forearm.
And as it nears the elbow, this pattern is highly variable, but on this plaque we can
see it forms what is called the median basilic vein heading over to the basilic vein, and
the median cephalic vein heading over to the cephalic vein.
So if you're wanting to put an IV's or draw blood at that cubital region it is important
to know the pattern of your particular patient.