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 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 Morphologic variations of the superficial palmar arc

2003 ◽  
Vol 18 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Sílvia Regina Arruda de Moraes ◽  
Tâmara Nunes de Araújo ◽  
Alexandre Roque da Silva ◽  
Amanda Rodrigues de Paula ◽  
Juliana Larocerie Salgado
Keyword(s):  
Radial Artery ◽  
Ulnar Artery ◽  
Superficial Branch ◽  
Flexor Muscles ◽  
Different Types ◽  
Classic Pattern ◽  
Palmar Aponeurosis ◽  
Median Artery ◽  
Lumbrical Muscles ◽  
Palm Of The Hand

The superficial palmar arc ensures the blood supply to the palm of the hand. It is formed by the ulnar artery and the superficial palmar branch of the radial artery (classic pattern), shows a distal convexity, from where three ordinary digital palmar arteries go out. It is located over the flexor muscles of the fingers, the lumbrical muscles, and the branches of the median and the ulnar nerves, under the protection of the palmar aponeurosis. PURPOSE: The fact of frequent anatomic variations attracted the interest in checking its incidence, improving the knowledge of the territory of the hand aiming clinical and surgical applications. The aim of this study is the observation of the morphology of the superficial palmar arc and the frequency of the variations regarding the contribution of the other arteries to its formation. METHODS: To carry out this work, 30 pieces of corpse, fixed in a watery solution of formaldehyde, were studied by the method of macroscopic dissection. The analyzed pieces were designed and photographs were taken, and the obtained results, statistically, applying the test of equality of proportions, had a level of trust of 95%. RESULTS: An amount of 100% showed the superficial palmar arc. From these, 18 cases (60%) showed anastomosis among the arteries that form the arc and 12 cases (40%) did not. Concerning about the arterial contribution for the arc formation, the following results were obtained: 11 cases (36,67%) were formed by the anastomosis of the ulnar artery with the superficial branch of the radial artery; 7 cases (23%) were formed by the ulnar artery only; 4 cases (13,33%) were formed by the ulnar artery and the superficial branch of the radial artery without anastomosis; 4 cases (13,33%) were formed by the anastomosis of the ulnar artery with the main artery of the thumb; 3 cases (10%) were formed by the anastomosis of the ulnar artery with the median artery of the forearm; 1 case (3,33%) was formed by the ulnar artery and the median artery without anastomosis. CONCLUSION: These results show the incidence of the classic pattern and variations of morphology and different types of contribution for the formation of the superficial palmar arc.

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 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.

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 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.

Endovascular management of critical hand ischemia by ‘palmar arch loop’ technique

Vascular ◽  
2020 ◽  
pp. 170853812096693
Author(s):  
Amit Singh ◽  
Neeraj Kumar ◽  
Ajitesh P Jain ◽  
Rakesh Verma ◽  
Vinay Krishna
Keyword(s):  
Radial Artery ◽  
Ulnar Artery ◽  
Transluminal Angioplasty ◽  
Primary Patency ◽  
Endovascular Management ◽  
Technical Success ◽  
Palmar Arch ◽  
Technical Success Rate ◽  
Hand Ischemia ◽  
Loop Technique

Introduction Critical hand ischemia with advancing gangrene of digits requires urgent intervention to salvage as much tissue as possible. The purpose of this study was to evaluate the efficacy of “palmar arch loop” technique for endovascular management of critical hand ischemia by establishing inline flow to the palmar arch via both radial artery and ulnar artery, in patients with failed antegrade recanalization. To the best of our knowledge, this is the first case series evaluating the efficacy of “palmar arch loop” technique, with retrograde percutaneous transluminal angioplasty of the involved radial artery and/or ulnar artery. Material and methods We retrospectively investigated 10 patients (60% female; mean age 42 ± 18 years; mean time of presentation post-acute event 24 ± 11 days) with critical hand ischemia undergoing endovascular intervention using “palmar arch loop” technique at a single center in northern India between April 2017 and March 2019. All patients were followed up at regular intervals (weekly for a month, fortnightly for 3 months, and then at 6 and 12 months) with clinical assessment and SpO2 measurement. Study end points were technical success rate, hand healing, and primary patency rate at one year. Results Causes for critical hand ischemia were iatrogenic injuries due to inadvertent intra-arterial injection in 50% ( n = 5) and thromboembolic events in 50% patients ( n = 5). Vessels involved were: both radial artery and ulnar artery along with the PA in 50%; radial artery and palmar arch in 30%; ulnar artery and palmar arch in 20%. All of them had total occlusion of the involved vessel (>2/3rd of total length) with occlusion/diffuse disease of palmar arch as well; 70% technical success rate was achieved ensuring inflow to palmar arch via both the arteries with improved flow distally to the common and proper digital arteries. Retrograde percutaneous transluminal angioplasty of radial artery in 50% ( n = 5) and ulnar artery in 20% ( n = 2) was done successfully by looping the guidewire across the palmar arch; 90% showed subjective improvement in pain with healing of the lesions and/or formation of clear line of demarcation with reversal of pregangrenous changes proximally. Out of the eight patients with gangrene of fingers, three underwent minor amputation of the gangrenous digits and five underwent auto-amputation of the gangrenous tissue with complete healing of the stump. Primary patency rate was 85.7% at one year. There was no access site-related complication or mortality in the follow-up period. Conclusions Endovascular management of critical hand ischemia by “palmar arch loop” technique is an efficient technique to deal with occluded forearm vessels, particularly when antegrade recanalization fails. This technique, with good technical success and patency rates, is potentially a unique tool in the endovascular armamentarium for salvaging hand.

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
Keyword(s):  
Wrist Joint ◽  
Ulnar Artery ◽  
Superficial Palmar Arch ◽  
Normal Pattern ◽  
Palmar Arch ◽  
Male And Female ◽  
Vertical Incision ◽  
Significant Difference ◽  
Palmar Aponeurosis ◽  
Pattern Distribution

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.  

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