Arterial supply of the upper limb till the hand. I want to know the exact beginning point from the heart till the prefer arteries in the hand. You may come across anastomosis as well. So explain that too I guess there are three anastomosis in the upper limb so explain in easy language. And if I am missing anything kindly cover it up and give me good mnemonics to learn.

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Arterial Supply of the Upper Limb - Complete Guide

The Big Picture: Route from Heart to Fingers

Heart (Left Ventricle)
  → Aorta (Arch of Aorta)
    → Brachiocephalic trunk (Right side) / Direct from aorta (Left side)
      → Subclavian Artery
        → Axillary Artery (at lateral border of Rib I)
          → Brachial Artery (at lower border of Teres Major)
            → Radial Artery + Ulnar Artery (at cubital fossa)
              → Palmar Arches → Digital Arteries → Fingers

1. AORTA to SUBCLAVIAN ARTERY

Right side: Aortic arch → Brachiocephalic trunk → splits into right common carotid + right subclavian artery
Left side: Aortic arch → left subclavian artery directly (it is the 3rd branch of the aortic arch)

2. SUBCLAVIAN ARTERY

The subclavian artery is divided into 3 parts by the anterior scalene muscle:

Part	Location	Mnemonic
1st part	Medial to anterior scalene	"1 branch"
2nd part	Behind anterior scalene	"2 branches possible"
3rd part	Lateral to anterior scalene - ends at lateral border of Rib I	"3rd = dorsal scapular may arise here"

Branches of Subclavian (Remember: VIT C D):

V - Vertebral artery
I - Internal thoracic (mammary) artery
T - Thyrocervical trunk (gives suprascapular + transverse cervical + inferior thyroid)
C - Costocervical trunk (gives deep cervical + supreme intercostal)
D - Dorsal scapular artery (from 3rd part or thyrocervical trunk)

At the lateral border of Rib I, the subclavian becomes the Axillary Artery.

3. AXILLARY ARTERY

Axillary artery and its 3 parts in relation to pectoralis minor - Gray's Anatomy for Students

The axillary artery is divided into 3 parts by pectoralis minor muscle:

Part	Location	Number of Branches
1st	Proximal to pec minor	1 branch
2nd	Behind pec minor	2 branches
3rd	Distal to pec minor	3 branches

Mnemonic: "1 branch, 2 branches, 3 branches" OR "She Takes Lunch, So After School, Popsicle Arrives Promptly"

Branches of the axillary artery - Gray's Anatomy for Students

Branches (mnemonic: "S T L S A P A" - Some Times Lawyers Steal All People's Assets):

Superior thoracic (1st part) - supplies upper axillary walls
Thoraco-acromial (2nd part) - divides into pectoral, deltoid, clavicular, acromial branches
Lateral thoracic (2nd part) - supplies medial/anterior axillary wall + breast in women
Subscapular (3rd part) - the LARGEST branch; divides into circumflex scapular + thoracodorsal arteries
Anterior circumflex humeral (3rd part) - wraps around surgical neck of humerus
Posterior circumflex humeral (3rd part) - passes through quadrangular space with axillary nerve; larger of the two circumflex arteries

At the lower border of teres major, the axillary artery becomes the Brachial Artery.

4. BRACHIAL ARTERY

Runs in the anterior compartment of the arm
Starts medially in the proximal arm, then moves to the midline distally
Lies medial to biceps tendon in the cubital fossa - this is where you feel the pulse for blood pressure!
Ends just distal to the elbow (in the cubital fossa) where it bifurcates

Branches of Brachial Artery (mnemonic: "P U N" - Profunda, Ulnar collaterals, Nutrient):

Profunda brachii (deep brachial) - the largest branch; passes through the triangular interval with the radial nerve, travels along the radial groove of the humerus; terminates as radial and middle collateral arteries
Superior ulnar collateral artery - accompanies the ulnar nerve around the medial epicondyle
Inferior ulnar collateral artery - arises above the elbow
Nutrient artery to the humerus
Muscular branches

At the cubital fossa (just below the elbow), the brachial artery bifurcates into Radial and Ulnar arteries.

5. RADIAL ARTERY

Passes laterally down the forearm along the radius
At the wrist, it crosses the scaphoid bone in the anatomical snuff box (where you feel the radial pulse)
Enters the palm between the 1st and 2nd metacarpals
Forms the deep palmar arch (mainly)

Key branches:

Radial recurrent artery (anastomoses with radial collateral around elbow)
Muscular branches
Palmar carpal branch + Dorsal carpal branch (for carpal arches)
Superficial palmar branch (contributes to superficial palmar arch)
Princeps pollicis - main artery to the thumb
Radialis indicis - to radial side of index finger
Deep palmar arch (terminal branch)

6. ULNAR ARTERY

Passes medially down the forearm
At the wrist, it passes through Guyon's canal (between pisiform and hook of hamate)
Forms the superficial palmar arch (mainly)

Key branches:

Ulnar recurrent artery (anterior + posterior divisions for elbow anastomosis)
Common interosseous artery - a major branch that divides into:
- Anterior interosseous artery - runs on the interosseous membrane (main blood supply to deep forearm muscles)
- Posterior interosseous artery - passes through the gap above the interosseous membrane into the posterior forearm
Muscular branches
Palmar carpal + Dorsal carpal branches
Superficial palmar arch (terminal branch)
Deep branch (contributes to deep palmar arch)

7. IN THE HAND - The Palmar Arches

Radial and ulnar arteries with superficial and deep palmar arches - Imaging Anatomy Atlas

Superficial Palmar Arch

Mainly formed by: Ulnar artery (the dominant contributor)
Completed by the superficial palmar branch of radial artery
Lies superficial to the flexor tendons (deep to palmar aponeurosis)
Level: roughly at the level of the outstretched thumb tip
Gives off 3 common palmar digital arteries (for 2nd-5th fingers)
These split into proper palmar digital arteries (one for each side of adjacent fingers)

Deep Palmar Arch

Mainly formed by: Radial artery (the dominant contributor)
Completed by the deep branch of ulnar artery
Lies deep to the flexor tendons, on the metacarpal bases
About 1 cm proximal to the superficial arch
Gives off 3-4 palmar metacarpal arteries which join the common digital arteries distally
Also gives off princeps pollicis and radialis indicis

Simple way to remember which arch is dominant: "Ulnar = Superficial, Radial = Deep" Mnemonic: "URDS" - Ulnar-Radial, Deep-Superficial

THE THREE ANASTOMOSES OF THE UPPER LIMB

Anastomosis 1: Around the Scapula (Scapular Anastomosis)

Location: Posterior chest/scapular region

Why it matters: If the subclavian artery is blocked proximal to the thyrocervical trunk, blood can still reach the axillary artery via this route.

Vessels involved:

Suprascapular artery (from thyrocervical trunk of subclavian) passes OVER the superior transverse scapular ligament
Circumflex scapular artery (from subscapular artery of axillary) passes through the triangular space
These two meet on the posterior surface of the scapula

Mnemonic: "Supra goes OVER, Circumflex goes UNDER (the ligament)"

Anastomosis 2: Around the Elbow (Periarticular Elbow Anastomosis)

Location: Around the elbow joint

Why it matters: If the brachial artery is damaged above the elbow, this network maintains blood supply to the forearm.

Vessels involved - Think ABCD pairs (each collateral meets a recurrent):

Collateral (coming DOWN)	Recurrent (going UP)
Radial collateral (from profunda brachii)	Radial recurrent (from radial artery)
Middle collateral (from profunda brachii)	Posterior interosseous recurrent (from posterior interosseous)
Superior ulnar collateral (from brachial)	Posterior ulnar recurrent (from ulnar)
Inferior ulnar collateral (from brachial)	Anterior ulnar recurrent (from ulnar)

Mnemonic: "RIMS meets RPPA" - or just remember 4 collaterals (2 from profunda + 2 from brachial) meet 4 recurrents (1 radial + 1 posterior interosseous + 2 ulnar) around the elbow.

Anastomosis 3: In the Hand (Palmar Arch Anastomosis)

Location: The palm

Why it matters: Either the radial or ulnar artery alone can supply the entire hand through cross-connections. This is tested by the Allen test / Barbeau test before radial artery procedures.

Four levels of anastomosis in the wrist and hand:

Palmar carpal arch - radial + ulnar palmar carpal branches meet across the carpals
Dorsal carpal arch - radial + ulnar dorsal carpal branches meet (dorsal carpal arch arises from radial in 80% of people)
Superficial palmar arch - ulnar artery + superficial palmar branch of radial
Deep palmar arch - radial artery + deep branch of ulnar

Mnemonic: "2 arches in the wrist, 2 arches in the palm"

MASTER MNEMONIC - The Whole Route

"Archie Bought Banana Rice Under Palms"

Aorta
Brachiocephalic (right) or direct from arch (left)
Subclavian - VIT C D branches
Axillary (at Rib I) - S-T-L / S-A-P = "Some Times Lunch / Stops All Progress"
Brachial (at teres major) - Profunda + Ulnar collaterals + Nutrient
Radial + Ulnar (at cubital fossa) - Common interosseous from ulnar
Palmar arches (Superficial = Ulnar dominant, Deep = Radial dominant) → Digital arteries

QUICK SUMMARY TABLE

Artery	Begins	Ends	Key Branch
Subclavian	Brachiocephalic / Aortic arch	Lateral border Rib I	Vertebral, Internal thoracic, Thyrocervical
Axillary	Lateral border Rib I	Lower border Teres Major	Subscapular, Circumflex humeral arteries
Brachial	Lower border Teres Major	Cubital fossa	Profunda brachii, Ulnar collaterals
Radial	Cubital fossa	Deep palmar arch	Princeps pollicis, Superficial palmar branch
Ulnar	Cubital fossa	Superficial palmar arch	Common interosseous artery

Sources: Gray's Anatomy for Students; Imaging Anatomy: Bones, Joints, Vessels and Nerves (Vol. 3)

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