Anatomoclinical and surgical correlation of the radial artery with the surface branch of the radial nerve

International Journal of Development Research ◽

10.37118/ijdr.18573.05.2020 ◽

2020 ◽

pp. 35937-35941

Keyword(s):

Radial Artery ◽

Surgical Procedures ◽

Radial Nerve ◽

Anatomical Variation ◽

Surgical Anatomy ◽

Human Anatomy ◽

Vascular Events ◽

Descriptive Research ◽

Superficial Branch ◽

Anatomy Laboratory

The present study aimed to correlate the clinical and surgical anatomy of the radial artery with the superficial branch of the radial nerve, looking for injuries to this nerve in the literature through surgery of the mentioned vessel. Thus, the present study consisted of observational and descriptive research. Eleven upper limbs and a digital caliper were used to measure the distance between the radial artery and the superficial branch of the radial nerve (vasculonervous bundle). Dissections of the anterior, posterior, lateral and medial sides of the arm, forearm, and hand were performed. The 11 cadaverous pieces belong to the Human Anatomy Laboratory of Universidade Brasil. For the development of the study, cadaveric pieces were used as a reference to measure the distance between the radial artery and the superficial branch of the radial nerve and, thus, analyzing in the literature the findings for anatomical and surgical correlation of the vasculonervous bundle. It is concluded that the middle and distal third of the forearm and the wrist are frequent sites of surgical procedures, whether percutaneous or open, where injury to the superficial branch of the radial nerve can occur and, generally, with undesirable and even disastrous results, therefore, the surgeon must be extremely careful in surgical procedures in the studied region, mainly vascular and in those so called percutaneous that expose to SBRN injuries. More work is suggested related to vascular events associated with SBRN injuries. Therefore, one must be aware of the possibility of occurrence, especially when these situations occur anatomical variation or even the lack of anatomical knowledge, which can be a determining factor for nerve damage.

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SUPERFICIAL BRANCH OF THE RADIAL NERVE PIERCING THE BRACHIORADIALIS TENDON TO BECOME SUBCUTANEOUS: AN ANATOMICAL VARIATION WITH CLINICAL RELEVANCE

Hand Surgery ◽

10.1142/s0218810404002224 ◽

2004 ◽

Vol 09 (02) ◽

pp. 191-195 ◽

Cited By ~ 7

Author(s):

M. Tryfonidis ◽

G. K. Jass ◽

C. P. Charalambous ◽

S. Jacob

Keyword(s):

Radial Nerve ◽

Anatomical Variation ◽

Sensory Loss ◽

Compression Neuropathy ◽

Anatomical Anomaly ◽

Superficial Branch ◽

Lateral Cutaneous Nerve ◽

Gliding Movement ◽

Minimal Area ◽

Wartenberg’S Syndrome

We dissected 20 preserved Caucasian cadaveric upper limbs looking at the relation of the superficial branch of the radial nerve (SBRN) to the brachioradialis tendon. SBRN emerged from deep to superficial position by piercing the brachioradialis tendon near its dorsal border in four limbs. The resulting dorsal tendinous band compressed the nerve and prevented longitudinal gliding movement during ulnar flexion. This is likely to increase the risk of chronic compression neuropathy (Wartenberg's syndrome). In two of these four limbs, there was a communication between the SBRN and lateral cutaneous nerve of the forearm. No such communication was found in the remaining 16 forearms. This communication could contribute to the minimal area of sensory loss observed in Wartenberg's syndrome. We recommend that this anatomical anomaly is looked for and if present dealt with during surgical treatment of Wartenberg's syndrome, as it is likely to predispose to chronic compression neuropathy.

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The cadaveric anatomy of the distal radius: implications for the use of volar plates

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221501186 ◽

2012 ◽

Vol 94 (2) ◽

pp. 116-120 ◽

Cited By ~ 16

Author(s):

PA McCann ◽

D Clarke ◽

R Amirfeyz ◽

R Bhatia

Keyword(s):

At Risk ◽

Median Nerve ◽

Radial Artery ◽

Distal Radius ◽

Surgical Anatomy ◽

Operative Intervention ◽

Distal Radial Fractures ◽

Palmar Cutaneous Branch ◽

Superficial Branch ◽

Cutaneous Branch

INTRODUCTION Fractures of the distal radius are common upper limb injuries, representing a substantial proportion of the trauma workload in orthopaedic units. With ever increasing advancements in implant technology, operative intervention is becoming more frequent. As growing numbers of surgeons are performing operative fixation of distal radial fractures, an accurate understanding of the relevant surgical anatomy is paramount. The flexor carpi radialis (FCR) tendon forms the cornerstone of the Henry approach to the volar cortex of the distal radius. A number of key neurovascular structures around the wrist are potentially at risk during this approach, especially when the FCR is mobilised and placed under retractors. METHODS In order to clarify the safe margins of the FCR approach, ten fresh frozen human cadaver limbs were dissected. The location of the radial artery, the median nerve, the palmar cutaneous branch of the median nerve and the superficial branch nerve were measured with respect to the FCR tendon. Measurements were taken on a centre-to-centre basis in the coronal plane at the watershed level. In addition, the distances between the tendons of brachioradialis, abductor pollicis longus and flexor pollicis longus, and the radial artery and median nerve were measured to create a complete picture of the anatomy of the FCR approach to the distal radius. RESULTS The structure most at risk was the palmar cutaneous branch of the median nerve. It was located on average 3.4mm from the FCR tendon. The radial artery and the main trunk of the median nerve were located 7.8mm and 8.9mm from the tendon. The superficial branch of the radial nerve was 24.4mm from the FCR tendon and 11.1mm from the brachioradialis tendon. CONCLUSIONS Operative intervention is not without complication. We believe a more accurate understanding of the surgical anatomy is key to the prevention of neurovascular damage arising from the surgical management of distal radial fractures.

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CORRIGENDUM: Superficial Branch of the Radial Nerve Piercing the Brachioradialis Tendon to Become Subcutaneous: An Anatomical Variation with Clinical Relevance

Hand Surgery ◽

10.1142/s0218810405002668 ◽

2005 ◽

Vol 10 (01) ◽

pp. 141-141 ◽

Cited By ~ 1

Author(s):

M. Tryfonidis ◽

G. K. Jass ◽

P. Charalambous ◽

S. Jacob

Keyword(s):

Clinical Relevance ◽

Radial Nerve ◽

Anatomical Variation ◽

Superficial Branch

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Anatomical Variation of Superficial Branch of Radial Nerve in Gujrat Region

Indian Journal of Forensic Medicine & Toxicology ◽

10.37506/ijfmt.v15i2.14260 ◽

2021 ◽

Keyword(s):

Radial Nerve ◽

Anatomical Variation ◽

Superficial Branch

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High Brachial Artery Bifurcation Clinical finding in Cadaveric Specimen by Medical Students During Internship

International Journal for Innovation Education and Research ◽

10.31686/ijier.vol9.iss2.2946 ◽

2021 ◽

Vol 9 (2) ◽

pp. 57-63

Author(s):

Giulia Garcia Pedrão ◽

Thales Vinicius Candido da Silva ◽

Paulo Eduardo Novelini ◽

Beatriz Ferratone Magalhães ◽

Danilo Anderson Pereira ◽

...

Keyword(s):

Brachial Artery ◽

Anatomical Variation ◽

Anatomical Variations ◽

Human Anatomy ◽

Vascular Lesions ◽

Upper Limbs ◽

Surgical Interventions ◽

Cadaveric Specimen ◽

Arterial Blood ◽

Anatomy Laboratory

The high brachial artery bifurcation is an anatomical variation found in the arm segment. Although it does not present any alteration in the arterial blood functionality, it is considered a common spot for vascular lesions during surgical interventions that consist of the absence of anatomical knowledge. The research objective was to describe the high brachial artery bifurcation found in a cadaveric specimen from the anatomy laboratory as well as its main anatomoclinical aspects. Twenty-six upper limbs were investigated and dissected from the Universidade Brasil's Human Anatomy Laboratory, SP. These were formolized cadaveric specimens from both sexes. During upper limb dissection, arterial anatomical variations were observed in a single-arm segment. The variation was unilateral in the left hemisphere. The clinical findings were high brachial artery bifurcation and a rare case of the radial artery in the medial path, as well as an ulnar artery with a lateral path in the arm median third. It is clear that the understanding of anatomy and anatomical variations patterns is of utmost importance and a requirement for surgery, so surgeons need to be aware of clinical, anatomical, and arterial variations data, avoiding vascular lesions during the surgical interventions. Dissection is an important learning tool for students and resident doctors. It is suggested the use of dissection as a pedagogical resource to acquire skills in surgeries during internship and also to improve the anatomical variation cognition of upper limbs.

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Acupuncture Point “Hegu” (LI4) Is Close to the Vascular Branch from the Superficial Branch of the Radial Nerve

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/6879076 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Kanae Umemoto ◽

Munekazu Naito ◽

Kaori Tano ◽

Hayato Terayama ◽

Taro Koike ◽

...

Keyword(s):

Radial Artery ◽

Radial Nerve ◽

Acupuncture Point ◽

Nerve Fibers ◽

Circulatory Failure ◽

Acupuncture Points ◽

Superficial Branch ◽

Dorsal Metacarpal Artery ◽

Hematoxylin And Eosin ◽

Arterial Constriction

The acupuncture point “Hegu” (LI4) has been used for treating peripheral circulatory failure, which is located in the area covered by the superficial branch of the radial nerve (SBRN). SBRN has branches reaching arteries, so-called vascular branches (VBs), which are thought to be involved in the arterial constriction. The distribution areas of the VBs from the SBRN have been reported, but the positional relationship between these distribution areas and the acupuncture points are not known. To examine the positional relationship between LI4 and VBs from the SBRN, forty hands were examined to assess the positional relationship between the acupuncture points “Erjian” (LI2), “Sanjian” (LI3), LI4, and “Yangxi” (LI5) in the Yangming Large Intestine Meridian of Hand, which are located in the area covered by SBRN, and the VBs from the SBRN. After the VBs were identified, the distances from the acupuncture points (LI2, LI3, LI4, and LI5) to the point where the VBs reached the radial artery or the first dorsal metacarpal artery were measured. VBs reaching the radial arteries were observed in all specimens. The mean distances from LI2, LI3, LI4, and LI5 to the point where the VBs reached the radial artery were 64.2 ± 8.2 mm, 42.0 ± 7.5 mm, 4.3 ± 4.3 mm, and 33.0 ± 4.8 mm, respectively. LI4 was significantly closer than the other acupuncture points (P<0.01). The nerve fibers of the VBs adjacent to the radial artery were confirmed using hematoxylin and eosin staining. Our findings provide anatomical evidence that stimulation at LI4 is used for treating peripheral circulatory failure such as Raynaud’s disease. LI4 is significant because it is located at a source point, making it clinically important.

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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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