Anatomical & Physiological Anatomical & Physiological Substantiations of Substantiations of

Operative Interventions on Operative Interventions on the Vesselsthe Vessels

Three Topographic RulesThree Topographic Rules 1.1.Vascular-Nervous Bundle Sheath is Vascular-Nervous Bundle Sheath is Formed by Solid & Fibers Connective Formed by Solid & Fibers Connective

TissueTissue

2.2.Sheath of the Vascular-Nervous Sheath of the Vascular-Nervous Bundle is Triangular in Shape.Bundle is Triangular in Shape.

3.3. Apex of Sheath Directs to Bone & Apex of Sheath Directs to Bone & Closely Attaches to Periosteum.Closely Attaches to Periosteum.

Vascular Ramification Depends on Vascular Ramification Depends on Limb SkeletonLimb Skeleton

Lesghaft’s Rules of Vascular-Lesghaft’s Rules of Vascular-Nervous Bundle OrganizationNervous Bundle Organization

All main arterial trunks are situated on All main arterial trunks are situated on the concave or flexion surfaces of the the concave or flexion surfaces of the body & limbs.body & limbs.

Vascular ramification depends on limb Vascular ramification depends on limb skeleton structure & is connected by skeleton structure & is connected by arterial archers on peripheral part of limb.arterial archers on peripheral part of limb.

All arterial trunks ramify on their way.All arterial trunks ramify on their way. Moveable parts of body have dense Moveable parts of body have dense

arterial net & roundabout collaterals.arterial net & roundabout collaterals.

Arterial Supply of Upper Limb (schemes)Arterial Supply of Upper Limb (schemes)

Variants of Subclavian Artery Variants of Subclavian Artery Ramification (Roentgen Image)Ramification (Roentgen Image)

Axillary & Partly Brachial Artery Axillary & Partly Brachial Artery (Roentgen Image)(Roentgen Image)

Exposure of the First Portion of Exposure of the First Portion of Axillary ArteryAxillary Artery

Collateral CirculationCollateral Circulation R. Descendens A.Transversa R. Descendens A.Transversa

colli-colli- A. Subscapularis (A.Circumflexa A. Subscapularis (A.Circumflexa

Scapulae)Scapulae) A.Transversa Scapulae A.Transversa Scapulae

(A.Subclavia)-A.A.Circumflexae (A.Subclavia)-A.A.Circumflexae Scapulae et Humery PosteriorScapulae et Humery Posterior

Exposure of Brachial ArteryExposure of Brachial Artery

Collateral CirculationCollateral Circulation

A.Profunda Brachii-A.Profunda Brachii-A.recurrens RadialisA.recurrens Radialis

A.A.Collaterales Ulnaris A.A.Collaterales Ulnaris Superior et Inferior-Superior et Inferior-A.Recurens Ulnaris A.Recurens Ulnaris

Exposure of the Brachial Artery in Exposure of the Brachial Artery in the cubital fossathe cubital fossa

Collateral CirculationCollateral Circulation Rete Articularis CubitiRete Articularis Cubiti A.Collateralis RadialisA.Collateralis Radialis A.A.Collateralis Ulnaris Superior et A.A.Collateralis Ulnaris Superior et

InferiorInferior A.A.Recurrens RadialisA.A.Recurrens Radialis A.A.Recurrens UlnarisA.A.Recurrens Ulnaris A.A.Recurrens InterosseaA.A.Recurrens Interossea

Brachial Artery Ramification Brachial Artery Ramification (Roentgen Image on the Level of (Roentgen Image on the Level of

Cubital Fossa) Cubital Fossa)

Variants of Brachial Artery Variants of Brachial Artery Bifurcation (Roentgen Image) Bifurcation (Roentgen Image)

Collateral CirculationCollateral Circulation After A.Ulnaris LigationAfter A.Ulnaris Ligation A.Radialis, A.Interossea Anterior,A.Radialis, A.Interossea Anterior, Arcus Palmaris ProfundusArcus Palmaris Profundus

After A.Radialis LigationAfter A.Radialis Ligation A.Ulnaris, A. Interossea Anterior,A.Ulnaris, A. Interossea Anterior, Arcus Palmaris SuperficialisArcus Palmaris Superficialis

Artery of Hand Artery of Hand (Angioroentgen Image)(Angioroentgen Image)

Lower Limb Arterial Supply Lower Limb Arterial Supply (schemes)(schemes)

Femoral Artery Femoral Artery (Angioroentgen Image & Schemes)(Angioroentgen Image & Schemes)

Exposure of the Femoral Artery Exposure of the Femoral Artery under the Inguinal Ligament under the Inguinal Ligament

Collateral CirculationCollateral Circulation A.Glutea Inferior-A.Circumflexa Femoris A.Glutea Inferior-A.Circumflexa Femoris

LateralisLateralis A.Pudenda Externa-A.Pudenda InternaA.Pudenda Externa-A.Pudenda Interna A.Obturatoria-A.Circumflexa Femoris A.Obturatoria-A.Circumflexa Femoris

MedialisMedialis A.Circumflexa Ilii Superficialis-A.Circumflexa Ilii Superficialis-

A.Circumflexa Ilii ProfundaA.Circumflexa Ilii Profunda A.Epigastrica Inferior-A.Epigastrica A.Epigastrica Inferior-A.Epigastrica

SuperficialisSuperficialis

Exposure of the Femoral Artery in Exposure of the Femoral Artery in the Adductor Canalthe Adductor Canal

Collateral CirculationCollateral Circulation A.Profundae Femoris-Rete A.Profundae Femoris-Rete

Articularis Genus (a.genus Articularis Genus (a.genus superior lateralis, a.genus superior lateralis, a.genus superior medialis, a. genus superior medialis, a. genus inferior lateralis, a. genus inferior lateralis, a. genus inferior medialis, a.recurrens inferior medialis, a.recurrens tibialis anterior)tibialis anterior)

Popliteal Artery Popliteal Artery (Angioroentgen Image)(Angioroentgen Image)

Exposure of the Popliteal Artery in Exposure of the Popliteal Artery in the Popliteal Fossathe Popliteal Fossa

Artery of the Leg & FootArtery of the Leg & Foot(Angioroentgen Image)(Angioroentgen Image)

Exposure of the Anterior Tibial Exposure of the Anterior Tibial Artery in the Leg Middle ThirdArtery in the Leg Middle Third

Exposure of the Posterior Tibial Exposure of the Posterior Tibial Artery in the Middle ThirdArtery in the Middle Third

Lower Limb Venous SystemLower Limb Venous System

Superficial & Deep Femoral VeinsSuperficial & Deep Femoral Veins

Superficial Leg VeinsSuperficial Leg Veins

Thank You for AttentionThank You for Attention