Anatomical & Physiological Substantiations of Operative Interventions on the Vessels Associate-professor Slabyy O.B.

Three Topographic Rules 1 Three Topographic Rules 1.Vascular-Nervous Bundle Sheath is Formed by Solid & Fibers Connective Tissue

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

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

Vascular Ramification Depends on Limb Skeleton

Lesghaft’s Rules of Vascular-Nervous Bundle Organization All main arterial trunks are situated on the concave or flexion surfaces of the body & limbs. Vascular ramification depends on limb skeleton structure & is connected by arterial archers on peripheral part of limb. All arterial trunks ramify on their way. Moveable parts of body have dense arterial net & roundabout collaterals.

Arterial Supply of Upper Limb (schemes)

Variants of Subclavian Artery Ramification (Roentgen Image)

Axillary & Partly Brachial Artery (Roentgen Image)

Exposure of the First Portion of Axillary Artery

Collateral Circulation R. Descendens A.Transversa colli- A. Subscapularis (A.Circumflexa Scapulae) A.Transversa Scapulae (A.Subclavia)-A.A.Circumflexae Scapulae et Humery Posterior

Exposure of Brachial Artery

Collateral Circulation A.Profunda Brachii-A.recurrens Radialis A.A.Collaterales Ulnaris Superior et Inferior-A.Recurens Ulnaris

Exposure of the Brachial Artery in the cubital fossa

Collateral Circulation Rete Articularis Cubiti A.Collateralis Radialis A.A.Collateralis Ulnaris Superior et Inferior A.A.Recurrens Radialis A.A.Recurrens Ulnaris A.A.Recurrens Interossea

Brachial Artery Ramification (Roentgen Image on the Level of Cubital Fossa)

Variants of Brachial Artery Bifurcation (Roentgen Image)

Collateral Circulation After A.Ulnaris Ligation A.Radialis, A.Interossea Anterior, Arcus Palmaris Profundus After A.Radialis Ligation A.Ulnaris, A. Interossea Anterior, Arcus Palmaris Superficialis

Artery of Hand (Angioroentgen Image)

Lower Limb Arterial Supply (schemes)

Femoral Artery (Angioroentgen Image & Schemes)

Exposure of the Femoral Artery under the Inguinal Ligament

Collateral Circulation A.Glutea Inferior-A.Circumflexa Femoris Lateralis A.Pudenda Externa-A.Pudenda Interna A.Obturatoria-A.Circumflexa Femoris Medialis A.Circumflexa Ilii Superficialis-A.Circumflexa Ilii Profunda A.Epigastrica Inferior-A.Epigastrica Superficialis

Exposure of the Femoral Artery in the Adductor Canal

Collateral Circulation A.Profundae Femoris-Rete Articularis Genus (a.genus superior lateralis, a.genus superior medialis, a. genus inferior lateralis, a. genus inferior medialis, a.recurrens tibialis anterior)

Popliteal Artery (Angioroentgen Image)

Exposure of the Popliteal Artery in the Popliteal Fossa

Artery of the Leg & Foot (Angioroentgen Image)

Exposure of the Anterior Tibial Artery in the Leg Middle Third

Exposure of the Posterior Tibial Artery in the Middle Third

Lower Limb Venous System

Superficial & Deep Femoral Veins

Superficial Leg Veins

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