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Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Upper Limb: Superficial Palmar Arch

Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Upper Limb

Superficial Palmar Arch

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD

Peer Review Status: Internally Peer Reviewed


Embryologists have shown us that the hand is vascularized as follows: the median artery develops the earliest, followed by the interosseous, and this vessel is finally (and usually) replaced by the ulnar and radial arteries. These changes during development permit a wide range of vascular variations to occur. The mature arch supplied by a comes nervi mediani (median artery) represents a persistence of the earliest embryonal blood supply of the hand.

The superficial palmar arch is subject to significant variations. The completion of the arch on the radial side is extremely variable. In a study of 200 subjects, a superficial palmar arch was absent in 32% of individuals (Jaschtschinski). It may be formed by the superficial branch of the ulnar anastomosing with the superficial palmar of the radial.

The superficial palmar branch may be larger than usual, and have a greater role than the ulnar in the formation of the arch.

In some cases, the arch is reinforced or completed by a large median artery, arising frequently from the common interosseous, or from an enlarged metacarpal artery.

The arch may be doubled, with both the superficial branch of the ulnar and the superficial palmar dividing into two branches that anastomose across the palm.

The arteries of the thumb and radial side of the index finger occasionally arise from the arch.

The arch may be incomplete, the medial digital branches arising from the ulnar and the lateral branches arising from the superficial palmar, the radial in the palm, or an enlarged median artery. When the arch is absent, the digital arteries arise from enlarged metacarpal arteries from the deep palmar arch or from enlarged dorsal metacarpal arteries.

Radialis indicis may arise from the superficial palmar arch (13% of cases) and receives contributions from both arches in 42% of individuals; in the latter case the superficial arch is the larger supply. When radialis indicis arises from the superficial arch alone, it supplies only the radial side of the index finger.

The arteria princeps pollicis my also arise from the superficial arch.

Jaschtschinski (1897) reported his observations on the palmar arches in 200 subjects and provided the following analysis: The superficial arch (primarily ulnar) was absent in 32%, and the deep arch (primarily radial) was absent only once. When both arches were present they had the following composition: radio-ulnar, 27%; ulnar, 38%; medio-ulnar, 3%; and radio-medio-ulnar, 0.5%.

See also Deep Palmar Arch.

Image 55A, Image 56, Image 130, Image 133, Image 137, Image 138, Image 139, Image 140, Image 141, Image 185, Image 186, Image 246, Image 249A, Image 249B, Image 249C,Image 249D, Image 250, Image 251A, Image 251B, Image 331, Image 412, Image 433

Incomplete Palmar

See Image 412

Princeps Pollicis and Radialis Indicis

See Image 250


References

Al-Turk, M. and W.K. Metcalf. (1984) A study of the superficial palmar arteries using the Doppler ultrasonic flowmeter. J. Anat. 139:27-32.

Barbosa Sueiro, M.B. (1916) Arcadas arteriais palmares. Arquivo de Anat. e Anthropol. 2:389-414.

Barbosa Sueiro, M.B. (1917) Arcadas arteriais palmares. Arquivo de Anat. e Anthropol. 3:97-124.

Bergman, R.A., Thompson, S.A., Afifi, A.K. and F. A. Saadeh. (1988) Compendium of Human Anatomic Variation: Catalog, Atlas and World Literature. Urban & Schwarzenberg. Baltimore and Munich.

Coleman, S.S. and B.J. Anson. (1961) Arterial patterns in the hand based upon a study of 650 specimens. Surg., Gynecol. Obstet. 113:409-424.

Ebner, I. und H. Hammer. (1988) Aspekte der arteriellen Gefässbeziehungen im Hohlhandbereich (Arterial connections in the palma manus). Acta Anat. 131:297-304.

Jaschtschinski, S.N. (1897) Morphologie und Topography des Arcus volaris sublimis und profundus des Menschen. Anat. Hefte 7:161-188.

Kamienski, R.W. and R.W. Barnes (1976) Critique of the Allen test for continuity of the palmar arch assessed by Doppler ultrasound. Surg., Gynecol. Obstet. 142:861-864.

Libersa, C.L., Francke, J.P., Mauppin, J.M., Bailleul, J.P. and P. Gamglin. (1982) The arterial supply to the palm of the hand (arteriae palme manus). Anat Clin. 4:33-45.

Little, J.M., Zylstra, P.L., West, J. and J. May. (1973) Circulatory patterns in the normal hand. Brit. J. Surg. 60:652-655.

Maruyama, K. (1944) Seltene Varietät der arterien der oberen Extremität bei einem Japaner (A. brachialis superficialis lateralis inferior, A. antebrachialis superficialis mediano-ulnaris, Arcus volaris superficialis vom typus mediano-ulnaris). Folia Anat. Jpn. 22:551-567.

McCormack, L.J., Cauldwell, E.W. and B.J. Anson. (1953) Porachial and antibrachial arterial patterns; a study of 750 extremities. Surg., Gynecol. and Obstet. 96:43-54.

Mozersky, D.J., Buckley, C.J., Hagord, Jr., C.O., Capps, Jr., W.F. and F.J. Dannemiller, Jr. (1973) Ultrasonic evaluation of the palmar circulation: a useful adjunct to radial artery cannulation. Am. J. Surg. 126:810-812.

Schaefer, E.A., Symington, J. and T.H. Bryce, Eds. (1915) Quain's Anatomy, 11th ed., Longmans, Green and Co., London.

Schwalbe, E. (1895) Zur vergleichenden Anatomie der Unterarmarterien, speciell des Arcus volaris sublimis. Morphologisches Jahrbuch 23:412-451.

Tandler, J. (1897) Zur Anatomie der Arterien der Hand. Anat. Hefte 7:263-282.

Weathersby, H.T. (1955) The artery of the index finger. Anat. Rec. 122:57-64.

Weathersby, H.T. (1956) Unusual variation of the ulnar artery. Anat. Rec. 124:245-248.

Weathersby, H.T. (1956) Anomalies of brachial and antebrachial arteries of surgical significance. South. Med. J. 49:46-49.

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