Multiple Arterial Variants: Common interosseous artery arising from the radial artery and ulnar artery origin from proximal brachial artery

AbstractDuring routine dissection of a cadaver alloted to the undergraduate students in the department of anatomy in SN Medical College, Bagalkot, the authors found multiple variations in the branching pattern of brachial, ulnar and radial arteries. There was high division of brachial artery into ulnar and radial arteries. The profunda brachii originated from brachial artery as usual while superior and inferior ulnar collateral arteries originated from ulnar artery. The radial artery gave origin to common interosseous artery which further divided into anterior and posterior interosseous arteries. All the three arteries i.e. brachial, ulnar and radial were considered as superficial arteries as they were superficial throughout the course. These observations of vascular anomalies are of clinical significance to vascular and plastic surgeons.

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Observation of modes of brachial artery termination in south Indian cadavers

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175452 ◽

2017 ◽

Vol 5 (12) ◽

pp. 5347

Author(s):

R. S. Jnanesh

Keyword(s):

Radial Artery ◽

Upper Limb ◽

Brachial Artery ◽

Elbow Joint ◽

Ulnar Artery ◽

Anatomical Variations ◽

Accurate Knowledge ◽

South Indian ◽

Anatomical Knowledge ◽

Relationship Of

Background: Variations in upper limb arteries have been frequently observed. Accurate knowledge of muscular and neurovascular variations is important for both surgeons and radiologists, which may prevent diagnostic errors.Methods: A study was done to note the variations in the termination of brachial artery in relation to the level of termination and the terminal branches. A total of 60 upper limbs (33 Right, 27 Left) were studied. The level of termination of brachial artery was identified based on the distance between the intercondylar line and the point of termination. The classic textbook description of brachial artery bifurcating into radial and ulnar arteries, 1 cm distal to elbow joint (ICL) was taken as normal.Results: A high origin of radial artery was noted in 11.67% of cases. Variations in the origin and relationship of median nerve to brachial artery, radial artery and ulnar artery was seen in 4 cases.Conclusions: Due to higher incidence of anatomical variations of arteries of the upper limb, prior anatomical knowledge of anomalies is of great clinical significance to vascular surgeons, orthopaedicians and radiologists performing angiographic studies.

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Trauma to arteries of the forearm

Sao Paulo Medical Journal ◽

10.1590/s1516-31801994000100002 ◽

1994 ◽

Vol 112 (1) ◽

pp. 485-488 ◽

Cited By ~ 1

Author(s):

Nelson Wolosker ◽

Paulo Celso Motta Guimarães ◽

Alvaro Gaudëncio ◽

Sérgio Kuzniec ◽

Marcel Scheinman ◽

...

Keyword(s):

Radial Artery ◽

Postoperative Period ◽

Soft Tissues ◽

Severe Infection ◽

Ulnar Artery ◽

Multiple Organ ◽

Iatrogenic Trauma ◽

Arterial Trauma ◽

Interosseous Artery ◽

Allen Test

Trauma to arteries of the forearm corresponds to 20% of total arterial trauma. The authors analyzed 24 patients with non iatrogenic trauma of the forearm arteries, cared for from January 1987 to December 1990. All patients were male, trauma by penetrating instrument was the most frequent, with 21 cases (87.5%), absence of pulses was the most frequent clinical manifestation (62.5%), fifteen patients did not present ischemic manifestations (54.2%) and half of the patients did not exhibit neurological symptoms. Injury to only one artery was found in 11 cases, five of them in the radial artery (20.8%), five in the ulnar artery (20.8%) and one in the interosseous artery (4.2%). Concurrent injury to the radial and ulnar arteries was found in 13 cases (54.1%). Regarding nervous impairment, injury to the radial nerve was found in four cases (16.6%) and of the median and ulnar nerves, one case in each (4.1%). All patients with concurrent injury to the ulnar and radial arteries (13) were submitted to arterial restoration. The 11 patients with injury to a sole artery of the forearm were managed as follows: ligature of the interosseous artery in one case, ligature of the radial artery in four cases, raphe of the radial artery in one case, ligature of the ulnar artery in three cases, restoration of the ulnar artery using a segment of the v. saphena in the two cases in which the Allen test had been positive. One patient died in the immediate postoperative period as a result of multiple organ failure due to polytraumatism. Preservation of the member was attained in 23 patients (95.8%) and the sole amputation, was due to extensive traumatism of the soft tissues with severe infection and systemic impairment.

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A cadaveric study of brachial artery and its variations with its ontogenic basis: An Anatomical Perspective

International Journal of Anatomy and Research ◽

10.16965/ijar.2020.233 ◽

2021 ◽

Vol 9 (9) ◽

pp. 7844-7850

Author(s):

Monika Lalit ◽

◽

Sanjay Piplani ◽

Keyword(s):

Upper Limb ◽

Brachial Artery ◽

Ulnar Artery ◽

Branching Pattern ◽

Age Group ◽

Upper Limbs ◽

Morphological Pattern ◽

Superficial Brachial Artery ◽

Interosseous Artery ◽

Cubital Fossa

Introduction: Conventional knowledge of the brachial artery, the principal artery of the upper limb & its branches has played a major role in vascular surgeries. Literature along with various cadaveric & clinical studies suggest that brachial artery vary widely in origin, course and branching pattern. The great variability of this arterial pattern may be attributed to the failure of regression of some paths of embryonic arterial trunks. Anatomical knowledge of this principal artery and its variations has many clinical implications especially in surgeries related to orthopedic and vascular re-constructive procedures. MATERIALS AND METHODS: The present study was conducted on 56 upper limbs of different age group and sex (19 Male and 9 Female) The brachial arteries were identified and branching pattern and relations of the brachial artery with brachial plexus in arm was observed and presence or absence of variations were documented. Results: Out of 56 upper limbs studies, 53 (94.64%) limbs showed normal morphological pattern of brachial artery, 3 (5.35%) limbs showed superficial brachial artery, 1 limb (1.78%) showed tortuous and SBA with trifurcation into radial artery, ulnar artery and common interosseous artery in the cubital fossa. Conclusion: The study of Brachial artery and variation in its course and branching pattern is clinically important for surgeons, ortho-paedicians operating on the supracondylar fracture of humerus and radiologists performing angiographic studies on the upper limb. KEY WORDS: Common Interosseous Artery, Median Nerve, Superficial Brachial Artery, Trifurcation, Ulnar Artery.

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Anomalies of radial and ulnar arteries

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.011716 ◽

2017 ◽

Vol 16 (1) ◽

pp. 56-59 ◽

Cited By ~ 1

Author(s):

Rajani Singh ◽

Rashmi Malhotra ◽

Munish Wadhawan

Keyword(s):

Median Nerve ◽

Radial Artery ◽

Brachial Artery ◽

Ulnar Artery ◽

Medial Epicondyle ◽

Lateral Side ◽

Flexor Muscles ◽

Teres Major ◽

The Right ◽

Anomalous Formation

Abstract During dissection conducted in an anatomy department of the right upper limb of the cadaver of a 70-year-old male, both origin and course of the radial and ulnar arteries were found to be anomalous. After descending 5.5 cm from the lower border of the teres major, the brachial artery anomalously bifurcated into a radial artery medially and an ulnar artery laterally. In the arm, the ulnar artery lay lateral to the median nerve. It followed a normal course in the forearm. The radial artery was medial to the median nerve in the arm and then, at the level of the medial epicondyle, it crossed from the medial to the lateral side of the forearm, superficial to the flexor muscles. The course of the radial artery was superficial and tortuous throughout the arm and forearm. The variations of radial and ulnar arteries described above were associated with anomalous formation and course of the median nerve in the arm. Knowledge of neurovascular anomalies are important for vascular surgeons and radiologists.

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Multiple arterial anomalies in upper limb

Kathmandu University Medical Journal ◽

10.3126/kumj.v7i3.2740 ◽

1970 ◽

Vol 7 (3) ◽

pp. 293-297 ◽

Cited By ~ 2

Author(s):

P Baral ◽

P Vijayabhaskar ◽

S Roy ◽

S Kumar ◽

S Ghimire ◽

...

Keyword(s):

Radial Artery ◽

Upper Limb ◽

Axillary Artery ◽

Ulnar Artery ◽

Common Trunk ◽

Palmar Arch ◽

Thoracoacromial Artery ◽

The Third ◽

Flexor Muscles ◽

Interosseous Artery

An isolated neurovascular variation is common but multiple vascular anomalies on same upper limb is a very rare case. We observed an unusual variations in right upper limb during routine dissection of a Nepali cadaver. The variations were observed in Axilla, Forearm and Palm. In axilla, first part of axillary artery did not give any branch, the second part of axillary artery gave off only two branches - (a) thoracoacromial artery and (b) a large common trunk which later gave off lateral thoracic, thoracodorsal, subscapular, posterior circumflex scapular and then continued as posterior circumfl ex humeral artery. The third part of axillary artery gave off only anterior circumflex humeral artery. In forearm, the ulnar artery runs downward superficial to flexor muscles. Here, radial artery gave off common interosseous artery. In palm radial artery did not give any contribution to superficial palmar arch which is solely formed by the continuation of ulnar artery. This type of anomalies are very rare and is not reported in Nepalese cadaver at all. These anomalies are described in detail and their clinical relevance is highlighted. Key words: Axillary artery; Brachial artery; Radial artery; Ulnar artery; Palmar arch; Variations DOI: 10.3126/kumj.v7i3.2740 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 293-297

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Bilateral Tortuous Upper Limb Arterial Tree and Their Clinical Significance

10.47363/jnrrr/2020(2)124 ◽

2020 ◽

pp. 1-3

Author(s):

Alka Bhingardeo ◽

Keyword(s):

Radial Artery ◽

Upper Limb ◽

Brachial Artery ◽

Axillary Artery ◽

Ulnar Artery ◽

Arterial System ◽

Detailed Knowledge ◽

Arterial Tree ◽

Palmar Arch ◽

First Case

The detailed knowledge about the possible anatomical variations of upper limb arteries is vital for the reparative surgery of the region. Brachial artery is the main artery of upper limb; it is a continuation of axillary artery from the lower border of teres major muscle. During routine cadaveric dissection, we found bilateral tortuous brachial artery which was superficial as well as tortuous throughout its course. It is called superficial as it was superficial to the median nerve. At the neck of radius, it was divided into two terminal branches radial and ulnar arteries which were also tortuous. Tortuosity of the radial artery was more near the flexor retinaculum. When observed, the continuation of ulnar artery as superficial palmar arch also showed tortuosity throughout, including its branches. Being superficial such brachial artery can be more prone to trauma. Tortuous radial artery is one of the causes of access failure in trans-radial approach of coronary interventions. To the best of our knowledge, this is the first case where entire post axillary upper limb arterial system is tortuous bilaterally. So knowledge of such tortuous upper limb arterial tree is important for cardiologist, radiologist, plastic surgeons and orthopedic surgeons

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THE ARTERY BLOOD SUPPLY VARIANT OF THE UPPER LIMB

Medicine and Pharmacy Reports ◽

10.15386/cjmed-549 ◽

2015 ◽

Vol 88 (4) ◽

pp. 545-549

Author(s):

Ivan Maslarski

Keyword(s):

Radial Artery ◽

Upper Limb ◽

Brachial Artery ◽

Vascular Anatomy ◽

Ulnar Artery ◽

Lateral Side ◽

Palmar Arch ◽

Male Cadaver ◽

Hand Region ◽

The Right

Variations of arterial patterns in the upper limb have represented the most common subject of vascular anatomy. Different types of artery branching pattern of the upper limb are very important for orthopedists in angiographic and microvascular surgical practice.The brachial artery (BA) is the most important vessel in the normal vascular anatomy of the upper limb. The classical pattern of the palmar hand region distribution shows the superficial palmar arch. Normally this arch is formed by the superficial branch of the ulnar artery and completed on the lateral side by one of these arteries: the superficial palmar branch of the radial artery, the princeps pollicis artery, the superficial palmar branch of the radial artery or the median artery.After the routine dissection of the right upper limb of an adult male cadaver, we found a very rare variant of the superficial arch artery – a division in a higher level brachial artery. We found this division at 10.4 cm from the beginning of the brachial artery. This superficial brachial artery became a radial artery and was not involved in the formation of the palm arch. In the forearm region, the artery variant was present with the median artery and the ulnar artery, which form the superficial palm arch.

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Estimation of culprit lesion using brachial artery RI and radial artery RI by ultrasound-guided vascular access

Choonpa Igaku ◽

10.3179/jjmu.jjmu.a.118 ◽

2018 ◽

Vol 45 (6) ◽

pp. 605-610

Author(s):

Masahito MINAMI ◽

Mayu TUJIMOTO ◽

Ayako NISHIMOTO ◽

Mika SAKAGUCHI ◽

Yasuhiro OONO ◽

...

Keyword(s):

Radial Artery ◽

Vascular Access ◽

Brachial Artery ◽

Culprit Lesion ◽

Ultrasound Guided

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Variant origin of Common Interosseous Artery from Brachial Artery

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i3.8245 ◽

2017 ◽

Vol 2 (3) ◽

Author(s):

Pralhad D. Subbannavar

Keyword(s):

Brachial Artery ◽

The Body ◽

Dead Body ◽

Invasive Procedures ◽

Arterial Variations ◽

Statistical Inferences ◽

Individual Variations ◽

Interosseous Artery ◽

Cubital Fossa ◽

Dissection Techniques

Acharya Sushruta has emphasized the method and importance of dissection to study anatomy practically. Perfect knowledge of anatomy is vital for practicing surgeons and hence the training of dissecting the dead body was considered as mandatory for surgeons. Though dissection techniques may give the perception of the structure of organs, the pervading and subtle consciousness in the body can be experienced with the eyes of knowledge and penance only. Though the standard anatomy is defined based on statistical inferences on comparing large number of subjects, individual variations and exceptional structural specialties tend to occur quite frequently. Proper recording and publication of such instances would strengthen the knowledge base of the science. Knowledge regarding arterial variations of upper limb is important for surgeons and orthopedicians as they are commonly involved in invasive procedures. We report a case ofvariant origin of right common interosseous artery from brachial artery in cubital fossa. It followed a normal course after the origin.

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