Bilateral superficial median arteries

A superficial artery may be present in the forearm, arising from the axillary, brachial or superficial brachial arteries and crossing over the origin of the flexor muscles of the forearm to reach the palm (Adachi, 1928; Bergman et al. 1988). When this superficial artery continues as the normal ulnar artery accompanying the ulnar nerve at the wrist, it is referred to as the superficial ulnar artery, with an incidence of ∼4%. When the artery passes below or superficial to the flexor retinaculum in the middle of the forearm, sometimes continuing to join the superficial palmar arch, it is called the superficial median artery, with an incidence of ∼1%. We have observed a relatively rare variation involving the presence of a superficial median artery in both upper limbs. We discuss the clinical importance and the developmental aspects of this arterial variation.

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Study of contributing arteries to superficial palmar arch formation

Indian Journal of Clinical Anatomy and Physiology ◽

10.18231/j.ijcap.2021.061 ◽

2021 ◽

Vol 8 (4) ◽

pp. 280-283

Author(s):

Bangale Sridevi P

Keyword(s):

Radial Artery ◽

Surgical Procedures ◽

Vascular Graft ◽

Ulnar Artery ◽

Upper Limbs ◽

Superficial Palmar Arch ◽

Palmar Arch ◽

Superficial Branch ◽

Median Artery

The superficial palmar arch (SPA) is formed predominantly by the ulnar artery with a contribution from the superficial palmar branch of the radial artery.: To study contributing arteries in superficial palmar arch formation and variations in its formation.: Study comprised of 30 upper limbs from 15 cadavers. Palmar arches in them were dissected following classical incisions and dissection procedures of Cunninghams’ manual.: SPA was formed by superficial branch of ulnar artery only in 13.33% specimens, by superficial branch of both ulnar and radial artery in 70% specimens, by superficial branch of ulnar and persistent median artery in 13.33% specimens and was formed by superficial branches of ulnar and radial arteries with persistent median artery in 3.33% specimens. SPA was complete in 80% and was incomplete in 20% specimens.: The arch formation is highly variable. Knowledge of contribution to the SPA will be helpful to the reconstructive hand surgical procedures such as arterial repairs, vascular graft applications and re-implantations.

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Superficial Ulnar Artery Crossing Over the Palmaris Longus Tendon at the Wrist in a Cadaver: A Case Report

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835518720074 ◽

2018 ◽

Vol 23 (01) ◽

pp. 137-139

Author(s):

Kotaro Sato ◽

Kenya Murakami ◽

Yoshikuni Mimata ◽

Yuki Kikuchi ◽

Ryunosuke Oikawa ◽

...

Keyword(s):

Axillary Artery ◽

Ulnar Artery ◽

Crossing Over ◽

Arterial Variation ◽

Ulnar Side ◽

Technical Procedure ◽

Palmaris Longus ◽

Palmaris Longus Tendon ◽

Arterial Damage ◽

Superficial Ulnar Artery

Superficial ulnar artery (SUA) is defined as arterial variation of an ulnar artery of high origin that lies superficially in the forearm. Because an SUA may be mistaken for a superficial vein, there is a risk of arterial damage. During routine dissection of the cadaver, we incidentally detected a case of unilateral SUA in the left arm. SUA arose from the axillary artery and descended superficial to the axillary artery and median nerve. At the wrist, the SUA crossed over palmaris longus (PL) tendon from the radial side to the ulnar side. In this cadaver, the PL tendon was located on the ulnar side and was thicker than the flexor carpi radialis tendon. Clinicians should check for the presence of SUA before any technical procedure, because lack of awareness of its presence can have serious consequences.

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ABSENCE OF SUPERFICIAL PALMAR ARCH WITH PERSISTENT MEDIAN ARTERY - A CASE REPORT

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703814 ◽

2014 ◽

Vol 04 (03) ◽

pp. 109-111

Author(s):

Kavitha K. ◽

Prima D'Souza ◽

Vishal Kumar ◽

Keyword(s):

Case Report ◽

Ulnar Artery ◽

Anatomical Variations ◽

Arterial Supply ◽

Vascular Pattern ◽

Superficial Palmar Arch ◽

Undergraduate Medical Students ◽

Palmar Arch ◽

Surgical Emergencies ◽

Median Artery

AbstractThe anatomical variations in the arterial supply of the palm are frequently reported. One such variation reported during routine dissection for undergraduate medical students in our college is the absence of superficial palmar arch and presence of persistent median artery. The arterial supply to the palm is in the form of superficial and deep palmar arches. In the present case the median artery and ulnar artery supplies the palm without forming an arch on the left extremity. Awareness of variations in the vascular pattern of the palm is clinically important in case of angiographic procedures and surgical emergencies.

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VARIATIONS OF THE SUPERFICIAL PALMAR ARCH: A CLINICO-ANATOMICAL CONSIDERATION

International Journal of Anatomy and Research ◽

10.16965/ijar.2020.231 ◽

2020 ◽

Vol 8 (4.2) ◽

pp. 7817-7822

Author(s):

Pooja Dawani ◽

◽

Anita Mahajan ◽

Sabita Mishra ◽

Neelam Vasudeva ◽

...

Keyword(s):

Radial Artery ◽

Blood Supply ◽

Myocardial Revascularization ◽

Ulnar Artery ◽

Vital Role ◽

Superficial Palmar Arch ◽

Palmar Arch ◽

Human Cadavers ◽

Median Artery ◽

Digital Caliper

Introduction: The superficial palmar arch plays a vital role in the blood supply to the hand. The knowledge of variations in the pattern of superficial palmar arch and its branches, and caliber of these arteries, has become more important for surgeons in reconstructive hand surgeries and radial artery harvesting for myocardial revascularization. The aim of this study was to observe the variations and measure the diameter of contributing arteries of the arches. Materials and methods: In the present study, thirty hands from formalin fixed adult human cadavers were dissected. Normal pattern as well as variations in the arteries contributing to the arch, completeness of arch, and the branching pattern were observed and noted. With the help of a digital caliper, the diameters of ulnar and radial arteries and median artery were taken at the level of the wrist and statistical analysis of the results was done. Results: It was observed that in 96.7 % cases, the superficial palmar arch was complete where there was anastomosis between the arteries forming the arch. In 3.3% cases, the arch was incomplete. The complete arch was divided into radioulnar (36.7%), ulnar (56.7%) and medianoulnar (3.3%) types. The diameter of superficial palmar branch of radial artery was found to be significantly less than the diameter of ulnar artery. (p=0.003). Conclusion: The data obtained on variations and morphometry of superficial palmar arches will certainly be useful in planning and choosing appropriate and safe surgical procedures to prevent inadvertent outcome. KEY WORDS: Palmar arch, blood supply, Hand, radial artery, myocardial revascularization.

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Palmar Arch: Anatomical And Surgical Correlation in Trauma

International Journal of Medical and Surgical Sciences ◽

10.32457/ijmss.2016.029 ◽

2018 ◽

Vol 3 (3) ◽

pp. 951-958

Author(s):

Agustín Algieri ◽

Rubén Algieri ◽

Homero Bianchi ◽

María Ferrante ◽

Carolina Brofman

Keyword(s):

Radial Artery ◽

Ulnar Artery ◽

Anatomical Variations ◽

Morphometric Study ◽

Superficial Palmar Arch ◽

Palmar Arch ◽

Complete Section ◽

Starting Point ◽

Classic Pattern ◽

Median Artery

The irrigation of the palm is provided by arterial arches (shallow and deep) that are made more frequently by the ulnar or radial arteries described as setting a classic pattern. Anatomical variations are described in shaping both arches, most often in the superficial palmar arch; may be the same complete or incomplete. The objective of this work is the anatomical description of the palmar arches, their different patterns and variations in conformation, and their clinical and surgical implications. A descriptive, observational and morphometric study of the arteries involved in the formation of the palmar arches was done in the Faculty of Medicine, University of Buenos Aires. One hundred1(00) cadaveric preparations fixed in formalin solution, of the Third Chair of Anatomy were used. A retrospective analysis of cases with lesions / s artery / main / s that make the palmar arches in the Emergency Hospital of Moron, between 2015-2016 s was also carried out. Most frequently the radial artery forms the deep palmar arch with the deep palmar branch of the ulnar artery. Superficial palmar arch is the most variable. It was complete in 56 % and the most common presentation (83 %) is one that is formed by the anastomosis of the ulnar artery and the superficial palmar branch of the radial artery. The rest of the anastomosis are between ulnar artery and median artery (9%), between deep branch of radial artery and ulnar artery (5 %); triple anastomosis between ulnar artery, median artery and superficial palmar branch of the radial artery (2 %), and anastomosis between the median artery and superficial palmar branch of the radial artery without participation of the ulnar artery (1 %). The rest of the sample (44 %) can be termed as incomplete. The B1a and B1b subtypes were the most found. Two cases, one entire section of the radial artery at the wrist and the other with complete section of ulnar artery with involvement of the ulnar nerve are described. It is essential to a proper understanding of the palmar arches for a suitable surgical approach to hand. The importance of the presence or absence, as well as different variations of palmar arterial arch lies in its clinical application as surgical starting point in the treatment of trauma and other diseases in which there is engagement of arteries.

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Traumatic injury of radial and ulnar artery with perfusion of the hand through the median artery: a case report

Colombia Medica ◽

10.25100/cm.v52i2.4521 ◽

2021 ◽

Vol 52 (2) ◽

pp. e5024521

Author(s):

Daniela Calderón Ardila ◽

Daniel Raúl Ballesteros Larrota ◽

María Andrea Calderón Ardila ◽

Luis Ernesto Ballesteros Acuña

Keyword(s):

Young Male ◽

Ulnar Artery ◽

Vascular Lesions ◽

Superficial Palmar Arch ◽

Palmar Arch ◽

Anatomical Variant ◽

Anterior Interosseous Artery ◽

Left Limb ◽

Interosseous Artery ◽

Median Artery

Case description: A young male patient with a complete section of the ulnar and radial arteries preserved the perfusion of the hand through an anatomical variant, the median artery, identified by angiotomography. Clinical Findings: A wound in the distal third of the left forearm with present pulses and adequate hand coloration. An angiotomography of the upper left limb showed a median artery originating as a continuation of the anterior interosseous artery and ending in the palm of the hand with an incomplete superficial palmar arch. Treatment and Outcomes: Ligation of both radial and ulnar arteries was performed. It was not possible to follow up with the patient. Clinical Relevance: Forming the superficial and deep palmar arches, the irrigation of the hand comes from the ulnar and radial arteries, which can compromise the viability of the limb when injured. The median artery is present in 0.6-21.1% of the population, originates from the anterior interosseous artery (branch of the ulnar), accompanies the median nerve in its path and ends in the palm joining the superficial palmar arch. Diagnostic imaging is a key tool for assessing arterial circulation and characterizing upper limb vascular lesions. Knowledge of the anatomical variations of the arterial supply of the hand, including variability of the superficial palmar arch, is crucial for the safety and success of hand surgeries.

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Pattern of Variations in Superficial Palmar Arch and its Clinical Importance

International Journal of Medical and Dental Sciences ◽

10.18311/ijmds/2017/18836 ◽

2017 ◽

Vol 6 (2) ◽

pp. 1483

Author(s):

Megha Rapotra ◽

Anshu Sharma ◽

Mahesh Sharma

Keyword(s):

Clinical Importance ◽

Vascular Supply ◽

Microvascular Surgery ◽

Arterial Supply ◽

Upper Limbs ◽

Superficial Palmar Arch ◽

Palmar Arch ◽

Composite Tissue

Background: Superficial palmar arch (SPA) is an important arterial anastomotic arcade which is the dominant vascular supply to the majority of the palmar muscles.Objectives: Keeping the importance of these variations in mind this study was designed to find out the pattern of superficial palmar arterial arches.Materials and Methods: A total of 40 adults upper limbs of unknown sex were observed for the variations in the pattern of superficial palmar arches on right and left side and were compared with the previous data.Results: A complete superficial palmar arch was encountered in 72.5% (n=29/40) of specimens and an incomplete SPA was observed in 27.5% (n=11/40) of specimens. Conclusion: Knowledge of the variations in the arterial supply of hand is essential in advent of microvascular surgery for revascularisation, replantation and composite tissue transfers.

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A Cadaveric Study of Superficial Palmar Arch with Surgical Importance

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48300.15325 ◽

2021 ◽

Author(s):

Hemamalini Shetty ◽

K Pushpalatha

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Graft ◽

Ulnar Artery ◽

Upper Limbs ◽

Artery Bypass Graft ◽

Superficial Palmar Arch ◽

Palmar Arch

Introduction: Arterial supply of hand is by two arterial anastomotic arches formed by radial and ulnar arteries and their branches. The anastomoses between the branches of radial and ulnar arteries such as palmar carpal and dorsal carpal arches at the wrist and superficial and deep palmar arches in the palm, maintain a rich arterial supply to the wrist and palm. Effective collateral circulation in palm is essential in peripheral arterial diseases such as Raynaud’s disease and in harvesting radial artery or the ulnar artery for Coronary Artery Bypass Graft (CABG) surgery. Aim: To observe the variations in the formation of superficial palmar arch. Materials and Methods: A descriptive study was performed on 45 formalin fixed upper limbs of both sex in the Department of Anatomy, JSS Medical College, Mysuru, Karnataka, India. The study was conducted during routine dissection of upper limbs for undergraduates as per the Cunningham’s manual for practical anatomy. Few rare variations in the formation of superficial palmar arch and the arterial pattern of hand were noticed. The variations found were classified according to Coleman and Anson classification. Results: Out of 45 limbs, complete arch was found in 36 limbs and incomplete arch in nine limbs. In complete arch type, we found an arterial arcade, bifurcation of ulnar artery and in incomplete arch type, radial-radial anastomosis. Another rare findings of highly tortuous ulnar artery in forearm and in the palm. Conclusion: The findings in the variations of superficial palmar arch are essential in microvascular surgery, forearm fasciocutaneous flap, radial artery and ulnar artery harvesting in coronary artery bypass graft procedure.

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