Arteries

From their comparative frequency and surgical interest, the peculiarities of this artery, especially such as affect its trunk, deserve particular attention.

The axillary artery [a. axillaris], that part of the artery of the upper limb which intervenes between the subclavian and the brachial portions, lies obliquely upon the upper and lateral part of the thorax, extending from the outer border of the first rib to the lower margin of the tendons of the latissimus dorsi and teres major muscles. In this course it passes through the axilla or axillary space, and its direction varies with the position of the limb : when the arm hangs freely by the side, the vessel describes a curve having its concavity towards the chest; when the arm is at right angles with the trunk, the vessel is nearly straight, and if the limb be still more elevated, the concavity of the curve described by the vessel is directed upwards.

In the operation for tying the brachial artery, the known direction of the vessel, and the inner margin of the biceps muscle chiefly aid in determining its position. In consequence of the thinness of the parts which cover the artery, and the position of the basilic and median basilic veins, with respect to it. even the integuments must be divided with care.

The three large branches which arise from the first part of the subclavian artery spring from the parent trunk very close to each other, and are deeply seated at their origin under cover of the internal jugular vein. They proceed, however, from different sides of the parent vessel, pursue different directions, and are distributed to remotely separate parts.

The brachial artery gives some unnamed branches, which are directed outwards and backwards to the muscles in its immediate neighbourhood, viz., to the coraco-brachialis, biceps, and brachialis anticus; the following, which incline inwards, have received names, and require description.

The subclavian artery is so deeply placed, its connexions with important parts are so intimate and varied, and the branches are so large in proportion to the length of the trunk, that operations on this vessel present, in most cases, considerable difficulties to the surgeon. But the difficulties, it will be found, vary in different cases.

The axillary artery, gives off several branches, which supply the neighbouring structures. They consist of the branches furnished to the muscles on the chest (external thoracic) ; a large branch to the shoulder (subscapular) ; and two to the upper part of the arm (anterior circumflex and posterior circumflex). The branches are not constant in their number, Size, or mode of origin.

In the neck the internal carotid artery usually gives no branch ; whilst within the carotid canal it sends a small offset to the tympanum, which anastomoses with the tympanic and stylo-mastoid arteries; within the cavernous sinus, some small branches, named arteries receptaculi, proceed from it to supply the walls of the sinus and the adjacent dura mater. One of these, distributed to the dura mater, is the anterior meningeal.

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