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Wheeless' Textbook of Orthopaedics
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Arterial Development of the Limbs



- See:
      - Adult Upper Limb Arteries:

- Discussion: Upper Limb Development;
    - subclavian artery projects into the early upper limb bud & forms
          subclavian-axillary-brachial   trunk;
    - its distal portion becomes interosseous artery that initially supplies
          plexus of arteries in the primitive hand;
          - branch of trunk artery, median artery, temporarily replaces interosseous
                artery in supplying the hand;
          - subsequently, ulnar and then radial arteries are formed & supplies
                  forearm and of superficial & deep palmar arches of hand;
    - deep branch of brachial artery   & arteries about shoulder
          & elbow arise relatively late as branches of primary axial vessel;

- Discussion: Lower Limb Development:
    - umbilical artery it gives off small branch, ischiadic artery, that temporarily
          serves supplies the growing limb;
    - external iliac artery, arising from umbilical artery slightly proximal to ischiadic,
          soon provides most of the blood supply to the limb and goes on to
          successively,   femoral , popliteal, & posterior tibial artery;
      - anastomosis is formed as popliteal artery   passes near ischiadic,
          artery and the lower part of ischiadic becomes peroneal   artery;
          - anterior tibial artery is subsequently formed;
    - persisting distal portions of ischiadic artery   become peroneal &
            inferior genicular   arteries;
    - proximal portion persists as branch of   inferior gluteal artery, which lies
          anastomoses w/ lateral & MFCA   & first perforating branch of
          deep femoral artery;
          - anastomosis sometimes called cruciate or crucial anastomosis;
    - early vascular plexus of foot is supplied by ischiadic artery
          - as this connection regresses, plexus is supplied by posterior tibial;
          - later, new anterior tibial artery   reaches foot & comes to supply
                dorsal arcuate artery & its branches, & posterior tibial artery
                supplies the plantar arteries.




Original Text by Clifford R. Wheeless, III, MD.