A Cadaveric Study of Superficial Palmar Arch with Surgical Importance (original) (raw)

Analysis of the vascular pattern in the superficial palmar arch formation

innovative publication

Background: 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 or princeps pollicis artery or radialis indicis artery or median artery. The knowledge about the variations in the formation of SPA is important in reconstructive hand surgery and in radial artery grafts. Objective: The objective of the present study is to identify the arterial patterns in the formation of superficial palmar arch and classify according to its formative tributaries. Material and Methods: The study conducted on 69 formalin fixed hands at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. The vascular pattern of superficial palmar arch was recorded and classified according to the variations. Results: It was found that 96% of SPA were complete and 4% incomplete. Based on Coleman and Anson classification, type A arch was identified in 39%, type B in 17%, type C in 9%, type E in 31% and type G in 4%. Another finding was in 35% cases, the ulnar artery was highly tortuous in its course in the palm. A thin collateral or additional branch was found in 31% of the SPA. Conclusion: These findings on the variations of SPA is essential in microvascular surgery and radial artery harvesting in coronary artery bypass graft procedure.

Cadveric Study of Superficial Palmar Arch

IOSR Journals , 2019

Awareness of the anatomical variations of the blood supply of the hand is necessary for the anatomist but also for surgeons when considering hand surgeries. The objective of this study was to find the incidence of anatomical variations of the superficial palmar arch and describe any anatomical variation. 18 cadavers were observed for this during routine dissections of MBBS graduates in Andhra Medical College, Visakhapatnam. In one of the cadavers there is no superficial palmar arch but the ulnar artery alone is seen suplying the medial 3 digits. And the superficial palmar branch of radial artery never joined the ulnar or niether of its branches joined to complete the arch. But in turn the superficial palmar branch of Radial artery supplied the thumb and index finger. Knowledge of vascular anamolies of the hand should be borne in mind to avoid iatrogenic injuries during surgery of the hand.

A morphometric study on the superficial palmar arch of the hand

Surgical and Radiologic Anatomy, 2006

The vascular anatomy of the hand is a complex and challenging area and has been the subject of many studies. Knowledge of the vascular patterns and diameters of the hand gained more importance with improvements in microsurgical techniques in reconstructive hand surgery. We evaluated 50 hands (26 left, 24 right) of 26 formalin preserved cadavers to determine the superficial palmar arch, its branches and contributing vessels with special attention to the diameters. The symmetry of the types was also evaluated in detail for the first time in the literature. Measurements were made with the help of a digital caliper. The diameters of the ulnar, radial and median arteries were taken at the level of the wrist while the common palmar digital arteries, hypothenar branches and the superficial palmar branch of the radial artery were measured at their origin. Two types of superficial palmar arch were found and defined as complete (43/50 hands) and incomplete arches (7/50 hands). The complete arches were divided into four subgroups and incomplete arches into three subgroups. Most cases were found at the complete AI group (17 hands). Comparison of the arterial diameters showed the ulnar artery was the dominant vessel of the palm. The diameters of the common palmar digital arteries were not different with regard to complete or incomplete arches and between both sides. It looks safe to sacrifice one of the radial or ulnar arteries in some arterial interventions including radial artery cannulation, radial forearm flap and radial or ulnar artery harvesting for bypass grafting if the arch is complete. But we still recommend the noninvasive tests like modified Allen test or Doppler ultrasonography, before performing an invasive arterial intervention. We propose the radiologists to incorporate the median artery into the Doppler dynamic test in particular the existence or the absence of anastomoses between radial and ulnar arteries.

Variations of the Superficial Palmar Arch: A Clinico-Anatomical Consideration

International Journal of Anatomy and Research, 2020

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 co...

Cadaveric study on the variant pattern of superficial palmar arch and its clinical relevance

IP Innovative Publication Pvt. Ltd., 2017

Introduction: Superficial palmar arch is one of the important arterial arcade supplying the human hand. Vascular supply to human hand is one of the challenging areas showing many morphological variations. Presently the modern medical technology has shown vast improvement, it is better to have a detailed knowledge of arterial supply to the hand because significant number of surgical procedures such as canulation of radial artery, radial artery auto grafting in coronary bypass surgeries are carried out. Knowledge of vascular pattern is more important in reconstructive hand surgery. Materials and Method: 40 human hands procured from 20 embalmed cadavers of A.J. Institute of Medical science, Mangalore used for the study. Dissection of arch was carried out and variations of superficial palmar arch with regards to formative arteries and branching pattern are studied in detail. Results: Out of 40 hands studied 31 (77.5%) hands showed complete and 9(22.5%) hands showed incomplete superficial palmar arches. In majority of hands (26) complete arch were formed by the direct continuity between ulnar artery and superficial palmar branch of radial artery. In 2 hands arch was formed by ulnar artery and median artery. Out of 9 incomplete arches, 7 hands showed arch formed mainly by ulnar artery and in 2 hands ulnar artery and superficial palmar branch of radial artery without anastomosis. Conclusion: The results of this study will be helpful for surgeons, intervention radiologist and orthopaedicians for the successful outcome of any hand surgeries.

The Superficial Palmar Arch: A Morphological Study

International Journal of Anatomy and Research, 2019

Background: The functional importance of hand is revealed by its rich vascularity contributed by superficial and deep palmar arches (SPA and DPA). The efficiency of collateral circulation in hand by SPA and DPA is essential in certain peripheral vascular diseases like Raynaud's disease and in harvesting radial artery for coronary artery bypass graft (CABG). Knowledge of variations in the arterial supply of hand is important while performing microsurgical procedures like arterial repair, vascular graft and flap application. Objective: To study the morphology of the Superficial Palmar Arch and variation in its formation.

Anatomical variations of the superficial palmar arch and its clinical relevance

Vojnosanitetski pregled, 2021

Background/Aim. In-depth knowledge of the vascular net-work of the hand is of great importance in modern medicine. The main vessel of the hand is the superficial palmar arch (SPA). As typically described in anatomical textbooks, it arises as a terminal branch of the ulnar artery, which then anastomoses with the superficial palmar branch of the radial artery. However, the SPA is characterized by remarkable variability, which has been the area of interest of many researchers so far. The aim of this study was to exert a comprehensive examination of the anatomy of the SPA. Methods. The research was conducted at the Institute of Anatomy ?Niko Miljanic? on a total number of 14 cadavers. After careful dissection, variations of the modality of formation of the SPA and its distance of the SPA 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 significa...

Variations of the superficial palmar arch in a Sri Lankan perspective: A Cadaveric Study

1st Annual International Conference on Microscopic and Macroscopic Anatomy (CMMA 2014), 2014

Introduction The blood supply of the hand is a complex and challenging area of study. The clinical importance of this area lies in the significant number of surgical procedures such as radial artery conduits in coronary artery bypass grafting (CABG), radial arterial cannulation and reconstructive surgery of the hand. Anatomical variations in the typical blood supply of the hand are common and are an area of extensive research. Methodology-This descriptive study was carried out in the dissecting theatres at the Department of Anatomy, Faculty of Medicine, University of Kelaniya on dissections carried out on 25 cadaveric hands. Results-From the superficial palmar arches studied the following results were obtained. 88% were complete while 22% were incomplete. Specimens with contribution from both the radial and the ulnar arteries for the superficial palmar arches were 80%, while specimens with the contribution solely from the ulnar artery were 12%. 8% hands studied had contributions from the radial, ulnar and the median arteries. Three branches of the radial artery contribute to complete the superficial palmar arch. Of this 60% cadavers had the major contribution from the superficial palmar branch of the radial artery, 24% from the arteria princeps pollicis, and 16% from the first dorsal metacarpal artery. The contribution to the arterial supply of the radial side of the thumb was from the superficial palmar branch of radial artery in 80% of the cadavers while in 20% the contribution was from the arteria princeps pollicis. The contribution to the arterial supply of the ulnar side of the thumb was from the proper palmar digital artery arising from the superficial palmar arch in 44% hands and the contribution in 32% hands was from the arteria princeps pollicis while the contribution in 24% hands was from the first dorsal metacarpal artery. Conclusion It is thus evident that significant anatomical variations of the superficial palmar arch exist in the Sri Lankan population. The arterial supply of the thumb also had significant changes compared to the descriptions given in standard text books.

Anatomical Variations of the Superficial Palmar Arch- a Cadaveric Study

Journal of Evidence Based Medicine and Healthcare, 2017

BACKGROUND There is lot of variability in the formation of the superficial palmar arch and its contributing arteries. The superficial palmar arch is usually formed by the superficial branch of ulnar artery and completed by one of the branch of radial artery, i.e. superficial palmar branch, arteria radialis indices or arteria princeps pollicis. It is rarely completed by the axis artery of the upper limb, i.e. median artery, which accompanies the median nerve type. In some cases, it is of incomplete nature where digital branches are arising separately from the superficial branch of ulnar artery on one side and from one of the branches of radial artery on the other side. A study of the variations of the palmar arch will not only help anatomists, but also vascular surgeons while doing reconstructive surgeries of the hand to avoid possible complications.