scholarly journals A study of variations in formation of superficial palmar arch in Nepalese cadavers

2021 ◽  
Vol 14 (1) ◽  
pp. 19-23
Author(s):  
Prakash Baral ◽  
Rami Shrestha ◽  
Subash Sapkota ◽  
Supana Koju ◽  
Binod Chaudhary

Introduction: The superficial palmar arch (SPA) is the main source of arterial supply to the palm. It is an arterial arcade formed mainly by the ulnar artery and is completed by the superficial palmar branch of the radial artery. The study was conducted with objective to study the variations in formation of superficial palmar arch in Nepalese cadaveric hands. Methodology: Two horizontal incisions were made, one at the wrist joint and another incision along the root of fingers. A vertical incision was made from the middle of the wrist to the 3rd metacarpo-phalangeal joint. The skin of the palm and the palmar aponeurosis was reflected. The surrounding adipose tissue was removed to view the superficial palmar arch and its branches. Result: In present study, out of 50 specimens of hands, 64% of superficial palmar arch was formed as normal pattern and in 36% cases it was formed by ulnar artery alone. Normal SPA pattern was seen 63% in male and 66.7% in female i.e. higher percentage in female than in male but it was statistically insignificant (P<0.05). SPA-ulnar artery alone pattern was seen 37% in male and 33.3% in female i.e. higher percentage in male than in female, however it was also statistically insignificant (P<0.05). Conclusion: Normal pattern of SPA observed in Sixty-four percent of Nepalese hands and in thirty-six percent cases it was formed by ulnar artery alone. There was no statistically significant difference in SPA pattern distribution between Nepalese male and female.  

2021 ◽  
pp. 14-14
Author(s):  
Milos Malis ◽  
Slobodan Kapor ◽  
Laslo Puskas ◽  
Milan Aksic ◽  
Valentina Blagojevic ◽  
...  

Backgorund / Aim. In-depth knowledge of the vascular network of hand is of great importance in modern medicine. The main vessel of hand is the superficial palmar arch. As typically described in anatomical textbooks, it arises as terminal branch of the ulnar artery which then anastomoses with the superficial palmar branch of the radial artery. However, the superficial palmar arch is characterized by remarkable variability, which was the area of interest of many researchers so far. Comprehensive examination of the anatomy of the superficial palmar arch which included two parameters - the formation of the superficial palmar arch and its localization in relation to the topographic landmarks of the hand. Methods. Research was conducted on a total number of 14 cadavers. After careful dissection, variations and distance of the superficial palmar arch from Kaplan?s cardinal line were observed on the right hands. Collected data were then analyzed statistically in SPSS 11.0 using the Mann-Whitney U test, with the accepted level of statistical significance of p < 0.05. Results. According to Coleman and Anson classification, the higher incidence of incomplete type (57.14%) of the superficial palmar arch should be in comparison to complete type (42.86%). In addition to this, a statistically significant difference discovered in distance of the superficial palmar arch from Kaplan?s cardinal line between two groups with complete and incomplete types, respectively. The parameter examined in the group with complete type took the value of 2.13 ? 0.32 cm, while in the group with incomplete type measured 3.33 ? 0.87 cm. Conclusion. The present study showed a very important complexity in the domain of anatomy of the superficial palmar arch with numerous clinical implications. For that reason, a thorough evaluation of the hand circulatory system should be considered while planning surgical procedures in order to avoid operative and postoperative complications.


2016 ◽  
Vol 203 (3) ◽  
pp. 194-202 ◽  
Author(s):  
Bettina Pretterklieber ◽  
Gerda Martschini ◽  
Michael L. Pretterklieber

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.


2014 ◽  
Vol 04 (03) ◽  
pp. 109-111
Author(s):  
Kavitha K. ◽  
Prima D'Souza ◽  
Vishal Kumar ◽  

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.


2020 ◽  
pp. 1-2
Author(s):  
Leena Raichandani ◽  
Dinesh Kumar ◽  
Sushma Kushal Kataria

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.


1999 ◽  
Vol 194 (3) ◽  
pp. 475-477
Author(s):  
TOSHIO NAKATANI ◽  
ATSUSHI IZUMI ◽  
SHIGENORI TANAKA

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.


2021 ◽  
Vol 9 (3.3) ◽  
pp. 8097-8102
Author(s):  
Suman Udupi ◽  
◽  
Pushpa Gowda ◽  

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.


2020 ◽  
Vol 8 (4.2) ◽  
pp. 7817-7822
Author(s):  
Pooja Dawani ◽  
◽  
Anita Mahajan ◽  
Sabita Mishra ◽  
Neelam Vasudeva ◽  
...  

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.


2018 ◽  
Vol 46 (02) ◽  
pp. 096-105
Author(s):  
Claudia Arroyo Berezowsky ◽  
Alejandro Gutiérrez ◽  
Jimena Fresnedo ◽  
José Montero

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.


2018 ◽  
Vol 3 (3) ◽  
pp. 951-958
Author(s):  
Agustín Algieri ◽  
Rubén Algieri ◽  
Homero Bianchi ◽  
María Ferrante ◽  
Carolina Brofman

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.


2017 ◽  
Vol 4 (1) ◽  
pp. 01-03
Author(s):  
Sonal Govindwar ◽  
◽  
Swapna Chavan ◽  

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