Pattern of Variations in Superficial Palmar Arch and its Clinical Importance

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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Bilateral superficial median arteries

American Journal of Anatomy ◽

10.1017/s0021878299004690 ◽

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.

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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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Pattern of Variations in Superficial Palmar Arch and its Clinical Importance

International Journal of Medical and Dental Sciences ◽

10.19056/ijmdsjssmes/2017/v6i2/149900 ◽

2017 ◽

Vol 6 (2) ◽

pp. 1483

Author(s):

Megha Rapotra ◽

Anshu Sharma ◽

Mahesh Sharma

Keyword(s):

Clinical Importance ◽

Superficial Palmar Arch ◽

Palmar Arch

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Anatomical Study of the Superficial Palmar Arch, its Relation to the Kaplan Cardinal Line and Literature Review

Revista Iberoamericana de Cirugía de la Mano ◽

10.1055/s-0038-1676046 ◽

2018 ◽

Vol 46 (02) ◽

pp. 096-105

Author(s):

Claudia Arroyo Berezowsky ◽

Alejandro Gutiérrez ◽

Jimena Fresnedo ◽

José Montero

Keyword(s):

Anatomical Study ◽

Ulnar Artery ◽

Vascular Supply ◽

Superficial Palmar Arch ◽

Palmar Arch ◽

Reconstructive Procedures ◽

Anatomical Variants ◽

Type Ia ◽

Safety Limit ◽

Multiple Variants

Introduction The superficial palmar arch is the main contributor to the vascular supply of the hand. Numerous anatomical variants have been described and there are multiple classifications of the superficial palmar arch available. The Kaplan cardinal line is used occasionally as a reference to identify the deep structures of the hand. However, there are also multiple variants of the line and multiple reports regarding the structures that can be identified with it. Material and Methods Ten anatomical dissections of hands were performed in seven cadaveric specimens. The anatomical variants of the superficial palmar arch were recorded, as well as their relationship with the Kaplan cardinal line. A review of the available literature was made. Results According to the classification by Coleman et al, the most common type was the complete superficial palmar arch, present in seven hands, while the incomplete superficial palmar arch was found in three hands. The most frequent complete palmar arch was type IB, followed by type IIB, and finally type IA and type IIA. The most common relation was with the Kaplan cardinal line type A to the apex of the arch and with type B to the curvature of the ulnar artery. Conclusions There is a great anatomical variability in the superficial palmar arch. There was a greater frequency of the complete superficial palmar arch, with the ulnar artery being the dominant vascular supply. The Kaplan cardinal line can be used as a safety limit to avoid the superficial palmar arch if it is drawn to intersect the pisiform bone. Clinical Relevance It is important to be aware of the anatomical variants of the superficial palmar arch, as well as of its relationship with the superficial structures of the hand to be able to perform invasive or reconstructive procedures and to preserve the vascularity of the hand.

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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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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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The Blood Supply to the Canine Palmar Metacarpal Sesamoid Bones

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632433 ◽

1995 ◽

Vol 08 (02) ◽

pp. 76-81 ◽

Cited By ~ 1

Author(s):

M. A. Cake ◽

R. A. Read

Keyword(s):

Blood Supply ◽

Vascular Supply ◽

Arterial Supply ◽

Sesamoid Bones ◽

Vascular Compromise

SummaryEleven canine forelimbs were examined using either gross dissection or a modified Spalteholz technique to investigate the blood supply of the palmar metacarpal sesamoid bones. In addition, the sesamoid bones, from two prepared skeletons, were examined for the presence of vascular foramina. Multiple vascular foramina were observed over the sesamoid surface. The most consistent elements of the arterial supply were proximal vessels supplying the axial and dorsal abaxial sides of the bone. In addition, palmar and distal sources often made contributions to the blood supply. Various minor or occasional sources were noted. This study demonstrates that the palmar metacarpal sesamoid bones of the dog have an abundant but highly variable vascular supply.The blood supply of the canine palmar metacarpal sesamoid bones was examined, using several methods, in order to evaluate the possible involvement of vascular compromise in sesamoid disease. It was found that the sesamoid bones have an abundant blood supply which is presumably resistant to disruption.

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