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

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.

scholarly journals Palmar Arch: Anatomical And Surgical Correlation in Trauma

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.

scholarly journals Study of contributing arteries to superficial palmar arch formation

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.

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

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.

scholarly journals AN ANATOMICAL STUDY OF SUPERFICIAL PALMAR ARCH IN WESTERN RAJASTHAN POPULATION

2020 ◽  
pp. 1-2
Author(s):  
Leena Raichandani ◽  
Dinesh Kumar ◽  
Sushma Kushal Kataria
Keyword(s):  
Radial Artery ◽  
Anatomical Study ◽  
Ulnar Artery ◽  
Palmar Arch ◽  
Variable Contribution ◽  
Palmar Aponeurosis ◽  
Median Artery ◽  
Arteria Princeps Pollicis ◽  
Arteria Radialis Indicis ◽  
Distal Border

The supercial palmar arch is an anastomosis formed mainly by the Ulnar artery with variable contribution from branches of radial Artery. It passes medial to the hook of the hamate, then curves laterally to form an arch that is convex distally and level with a transverse line through the distal border of the fully extended pollicies base. About a third of the supercial palmar arches are formed by the ulnar artery alone; a further third are completed by the supercial palmar branch of the radial artery; and a third by the arteria radialis indicis, a branch of either arteria princeps pollicis or the median artery. The supercial palmar arch is covered by palmaris brevis and the palmar aponeurosis and it is supercial to exor digiti minimi, branches of the median nerve and the long exor tendons and lumbricals.

scholarly journals Bilateral superficial median arteries

1999 ◽  
Vol 194 (3) ◽  
pp. 475-477
Author(s):  
TOSHIO NAKATANI ◽  
ATSUSHI IZUMI ◽  
SHIGENORI TANAKA
Keyword(s):  
Clinical Importance ◽  
Ulnar Artery ◽  
Crossing Over ◽  
Upper Limbs ◽  
Superficial Palmar Arch ◽  
Arterial Variation ◽  
Palmar Arch ◽  
Flexor Muscles ◽  
Median Artery ◽  
Superficial Ulnar Artery

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.

Patterns of Arterial Arcades of the Superficial Palmar Arch: A Study In Embalmed Cadaver Palms

2021 ◽  
Vol 9 (3.3) ◽  
pp. 8097-8102
Author(s):  
Suman Udupi ◽  
◽  
Pushpa Gowda ◽  
Keyword(s):  
Radial Artery ◽  
Index Finger ◽  
Ulnar Artery ◽  
Superficial Palmar Arch ◽  
Palmar Arch ◽  
Artery Cannulation ◽  
Complete Type ◽  
Cardio Vascular ◽  
Interesting Area

Background: The complex and variable pattern of the arterial arcades of the palm form an interesting area of study anatomically and surgically. In the present study arches were classified into complete and incomplete types, the complete type being the most prominent in 88.6% of the palms. Among the complete type, arch formed by ulnar artery alone supplying the thumb and index finger was found in majority of the specimens (50%). The classical or standard superficial palmar arch formed by the superficial palmar branch of radial and ulnar arteries was found in only 28.5%. Different patterns of the arterial arcades of the superficial palmar arch are normally encountered during routine anatomical dissections of the palm which needs to be emphasized and highlighted for a desired surgical out come during microvascular reconstructive surgeries of the palm and during radial artery cannulation. Context: With technological advancements in microsurgical procedures of the hand, fields of anatomical interest like the classification of arterial arcades of the palm, now becomes essential for operating vascular surgeons for a desired surgical outcome Purpose of the study: The present study was taken up to analyze and document varying patterns of the arterial arcades of the superficial palmar arch. Methods and Material: the study was conducted by dissecting 70 randomly obtained formalin fixed cadaver palms. Results: In the present study arches were classified into complete and incomplete types, the complete type being the most prominent in 88.6% of the palms. Among the complete type, arch formed by ulnar artery alone supplying the thumb and index finger was found in majority of the specimens (50%). The classical or standard superficial palmar arch formed by the superficial palmar branch of radial and ulnar arteries was found in only 28.5%. Out of the 70 hands, incomplete arches were found only in 8 hands with an incidence of 11.4%. Conclusion: Knowledge of arterial pattern of the hand is very important to vascular and reconstructive surgeons for effective treatment of injuries of the hand. Such a knowledge of the disposition of the arterial arcades of the palm also enables cardio-vascular surgeons to plan and modify surgical procedures such as radial artery harvesting, cannulation and in preventing the ischemia of hands in such procedures. KEY WORDS: Superficial palmar arch, Arterial arcades, Complete arch, Incomplete arch.

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

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.

Congenital Bilateral Absence of the Radial Artery: A Very Rare Variation in Humans - Phylogenetic and Ontogenetic Aspects

2016 ◽  
Vol 203 (3) ◽  
pp. 194-202 ◽  
Author(s):  
Bettina Pretterklieber ◽  
Gerda Martschini ◽  
Michael L. Pretterklieber
Keyword(s):  
Radial Artery ◽  
Wrist Joint ◽  
Anatomic Variation ◽  
Ulnar Artery ◽  
Caucasian Woman ◽  
Superficial Palmar Arch ◽  
Palmar Arch ◽  
Arterial Blood ◽  
Bilateral Absence ◽  
The Right

In an 80-year-old Caucasian woman, both radial arteries were found to be replaced by an enlarged anterior interosseous artery. Additionally, the right forearm revealed a persistent median artery which formed the superficial palmar arch together with the ulnar artery. In both hands, the replaced radial artery was connected only to the deep but not the superficial palmar arch. In clinical practice, lack of an arterial pulse on the radial aspect of the wrist joint may indicate the presence of this anatomic variation. In this case, arterial blood sample collections, application of contrast media, invasive measurements of blood pressure, and several angiographic interventions cannot be performed via the radial artery. As this is the fourth reported case since 1830, bilateral aplasia of the radial artery appears to be an exceptional variation in humans. Thus, the phylo- and ontogenetic aspects of this anomaly are discussed.

scholarly journals Upper limb arterial pattern: clinical correlation and embryological perspective

2021 ◽  
Vol 20 ◽  
Author(s):  
Laishram Sophia ◽  
Darshita Singh ◽  
Neha Xalxo ◽  
Anjoo Yadav ◽  
Sneh Agarwal ◽  
...  
Keyword(s):  
Upper Limb ◽  
Brachial Artery ◽  
Axillary Artery ◽  
Common Trunk ◽  
New Delhi ◽  
Palmar Arch ◽  
Medical College ◽  
Human Cadavers ◽  
Median Artery ◽  
Development Methods

Abstract Background Variations in the upper limb arterial pattern are commonplace and necessitate complete familiarity for successful surgical and interventional procedures. Variance in the vascular tree may involve any part of the axis artery of the upper limb, including the axillary artery and brachial artery or its branches, in the form of radial and ulnar arteries, which eventually supply the hand via anastomosing arches. Objectives To study the peculiarities of the arterial pattern of the upper limb and to correlate them with embryological development. Methods The entire arterial branching of forty-two upper limbs of formalin fixed adult human cadavers was examined during routine dissection for educational purposes, conducted over a 3-year period in the Department of Anatomy, Lady Hardinge Medical College, New Delhi. Results The study found: 1) One case in which a common trunk arose from the third part of the axillary artery, which immediately splayed into four branches (2.4%); 2) High division of the brachial artery into ulnar and radial arteries, in 3 cases (7.1%); 3) Pentafurcation of the brachial artery into ulnar, interosseus, radial, and radial recurrent arteries and a muscular twig to the brachioradialis in 1/42 cases (2.4%); 4) Incomplete Superficial Palmar arch in 3/42 cases (7.1%); and 5) Presence of a median artery in 2/42 case(4.8%) Conclusions This study observed and described the varied arterial patterns of the upper limb and identified the various anomalous patterns, supplementing the surgeon’s armamentarium in various surgical procedures, thereby helping to prevent complications or failures of reconstructive surgeries, bypass angiography, and many similar procedures.

scholarly journals Distal radial artery ligation for treatment of steal syndrome associated with radiocephalic arteriovenous fistula

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Mahmoud Tolba ◽  
Martin Maresch ◽  
Dhafer Kamal
Keyword(s):  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Hemodialysis Patient ◽  
Ulnar Artery ◽  
Complete Relief ◽  
Retrograde Flow ◽  
Palmar Arch ◽  
Artery Ligation ◽  
Steal Syndrome ◽  
Distal Radial Artery

Abstract We present a case of dialysis associated steal syndrome in a hemodialysis patient with left radiocephalic arteriovenous fistula that caused him severe rest pain. Angiography showed retrograde flow from the ulnar artery to the distal radial artery through a hypertrophied palmar arch. The problem was solved by surgical ligation of the distal radial artery leading to complete relief of patient symptoms without any notable complications.

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