Neurovasculature of the upper limb (2024)

Upper limb arteries

The main artery supplying blood to the upper limb is the subclavian artery. The trunk of the subclavian artery is continuous throughout the entire upper limb. During its pathway, the artery changes its name based on the region it supplies. Thus the major named arteries of the upper limb are:the subclavian artery, the axillary artery, the brachial artery, and the ulnar and radial arteries.

Upper limb veins

Veins usually accompany main arteries, which is also the case here. Since the veins convey blood from periphery to the heart, we’ll discuss the main veins of the upper extremity starting from the hand to the shoulder.

The hand has two venous networks that drain it. There are deep veins which accompany the arteries, and superficial veins which anastomose into a dorsal venous network. This superficial network is located at the dorsum of the hand. The basilic vein originates from the medial side of the dorsal venous network, while the cephalic vein originates from the lateral side.The two mentioned veins, basilic and cephalic, are the main veins of the forearm. They are superficially located, with basilic traveling through the ulnar, and cephalic traveling through the radial, side of the forearm. Besides these two, the median forearm vein assists in draining the forearm. It travels through the middle of the forearm. All three veins of the forearm tribute to the brachial veins.

The veins that drain the arm are the paired brachial veins. The brachial veins are deep veins that are positioned like some kind of bodyguards around the brachial artery - one travels along its medial side and the other along the lateral. Their tributaries are the veins of the forearm and the veins that accompany the branches of the brachial artery. All of them together tribute to the axillary vein.

The main vein of the shoulder is the axillary vein, which conveys blood from the shoulder and arm. It begins at the lower margin of the teres major muscle formed from the basilic vein and later the cephalic vein, gathering tributaries within the shoulders. It ultimately becomes the subclavian vein at the lateral border of the first rib.

Nerves of the upper limb

The upper limb is supplied by a nervous network called the brachial plexus. This plexus is made by the merging of the anterior rami from the lower four cervical nerves and the first thoracic nerve (C5-T1).The plexus is anatomically divided into roots, trunks, divisions, cords and finally, the terminal branches.

Terminal branches of the brachial plexus are:

• The musculocutaneous nerve: innervates the anterior compartment of the arm, including the skin of the lateral side of the forearm.
• The axillary nerve: innervates the deltoid, long head of the triceps brachii and teres minor muscles. Provides sensory innervation for the shoulder joint and the skin covering region of the deltoid muscle.
• The median nerve: innervates the anterior compartment of the forearm (except for the flexor carpi ulnaris and medial half of the flexor digitorum profundus), the thenar eminence (opponens pollicis, abductor pollicis brevis, flexor pollicis brevis), lateral lumbricals, and the skin of the lateral hand.
• The radial nerve: innervates the posterior compartments of the arm and forearm, skin of posterior arm, forearm and the dorsolateral part of the hand.
• The ulnar nerve: innervates the flexor carpi ulnaris and medial half of the flexor digitorum profundus, the hypothenar eminence (opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis, palmaris brevis), medial lumbricals, dorsal and palmar interossei, adductor pollicis, and the skin of the medial hand.

Now take a look at this cadaveric image to see how the brachial plexus looks like in the actual human body.

Find out more about brachial plexus and its branches and reinforce your knowledge about the upper limb neurovasculature with the following learning materials:

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Articles within this topic:

• Antebrachial cutaneous nerves
• Anterior interosseous artery
• Arterial anastomoses of the upper extremity
• Axillary artery
• Axillary nerve
• Axillary vein
• Basilic vein
• Brachial artery
• Brachial plexus
• Brachial vein
• Cephalic vein
• Circumflex scapular artery
• Clinical case: Brachial artery injury
• Clinical case: Brachial plexus injury
• Clinical case: Pectoralis minor syndrome
• Clinical case: Raynaud’s syndrome
• Clinical case: Ulnar nerve subluxation
• Common interosseous artery
• Cubital fossa
• Deep brachial artery
• Deep palmar arch
• Dorsal scapular nerve
• Lateral pectoral nerve
• Long thoracic nerve
• Medial pectoral nerve
• Median antebrachial vein
• Median cubital vein
• Median nerve
• Musculocutaneous nerve
• Posterior circumflex humeral artery
• Posterior interosseous artery
• Radial artery
• Radial nerve
• Radial veins
• Recurrent branch of median nerve
• Subclavian artery: Regional approach and mnemonic
• Subclavian vein
• Subscapular artery
• Superficial palmar arch
• Suprascapular nerve
• Thoracoacromial artery
• Thoracodorsal nerve
• Ulnar artery
• Ulnar nerve
• Ulnar veins
• Veins of the upper limb