ANASTOMOSIS AROUND THE SURGICAL NECK OF HUMERUS

ASYA'ARI BIN ARIF

AZIMI NAZREEN BIN AZIZUL AZMAN

MUHAMMAD FARID BIN MADZLAN

HUMERUS

Humerus

The upper end The head

- Glenohumeral joint The anatomical neck

- lies between head and greater and lesser tubercles The surgical neck

- oriented in the horizontal plane between the expanded proximal part of humerus and the narrower shaft

Humerus

The greater tubercle and lesser tuberosity

- serve attachment sites for the four rotatory muscles of the glenohumeral joint

The bicipital groove

- seperates lesser and greater tubercles

Anastomosis

The term ‘anastomosis’ means the communication between neighbouring vessels.

Anastomosis may be between arteries and arteries or between arteries and veins.

Axillary Artery

The Axillary Artery The axillary artery is divided into 3 parts for description. The first part is between the lateral border of the first rib and the

superior border of the pectoralis minor muscle. The second part lies deep to the pectoralis minor muscle. The third part extends from the inferior border of the pectoralis minor

muscle to the inferior border of the teres major muscle.

First Part of the Axillary Artery This part is enclosed in the axillary sheath along with the axillary vein. This part of the axillary artery has only one branch, the superior

thoracic artery. This artery helps to supply the first two intercostal spaces and the

superior part of the serratus anterior muscle.

Axillary Artery

Second Part of the Axillary Artery This part of the artery lies deep to the pectoralis

minor muscle. The lateral, medial and posterior cords of the

brachial plexus are so named respective to this part of the axillary artery.

This part of the axillary artery has two branches, the thoracoacromial and lateral thoracic arteries.

Axillary Artery

Third Part of the Axillary Artery This part extends from the inferior border of

the pectoralis minor muscle to the inferior border of the teres major muscle.

It has three branches, the anterior and posterior circumflex humeral arteries and the subscapular artery.

Formation of anastomosis around surgical neck of humerus

1) Anterior circumflex humeral artery

2) Posterior circumflex humeral artery

Both are the branches of the 3rd part of axillary artery.

Anterior circumflex humeral artery

Originates from the lateral side of the 3rd part of axillary artery.

It passes anterior to the surgical neck of humerus and anastomoses with the posterior circumflex humeral artery.

It passes deep to the coracobrachialis and the biceps brachii muscles.

It supplies branches to the surrounding tissues which include the shouder joint and the head of the humerus.

Posterior circumflex humeral artery

Originates from the lateralsurface of the 3rd part of the axillary artery immediately posterior to the origin of the anterior circumflex humeral artery.

It leaves the axilla by passing through the quadrangular space between the teres major, teres minor, and long head of the triceps brachii muscle and the surgical neck of humerus

It curves around the surgical neck of the humerus and supplies the surrounding muscles and the glenohumeral joint.

It anastomoses with the anterior circumflex humeral artery and with branches from the profunda brachii, suprascapular, and thoraco-acromial arteries.

Posterior circumflex humeral artery

Function

Acts as a collateral circulation in cases of obstruction of the blood passage at the axillary artery.

It connects the 3rd part of the axillary artery with the brachial artery.

THANK YOU <3