Anomalous Pattern of Median Artery in the Forearm of Indians

Srivastava, Shekhar; Pande, Benudhar

doi:10.1159/000146938

Cited by 28 publications

(24 citation statements)

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“…As observed in the dissection, the muscle belly of palmaris profundus split the median nerve in the forearm, the nerve forming a loop in the proximal third of the forearm. The median nerve forming a ring enclosing the median artery has been described by several authors (Srivastava & Pande, 1990 ;San4 udo et al 1994).…”

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confidence: 87%

Variant palmaris profundus enclosed by an unusual loop of the median nerve

Chou

Jeng

et al. 2001

Journal of Anatomy

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According to the usual description in most anatomy texts, the median nerve in the forearm passes between the 2 heads of pronator teres. It continues distally between flexor digitorum superficialis and profundus almost to the retinaculum. Muscular branches leave the nerve near the elbow and supply all superficial muscles of the anterior part of the forearm except flexor carpi ulnaris. Many variations of the median nerve in the forearm have been reported (Urban & Krosman, 1992). The palmaris profundus is also a rare anomaly of the forearm (Dyreby & Engber, 1982). It originates from the radial side of the common flexor tendon in the proximal forearm and inserts into the undersurface of the palmar aponeurosis. The origin of palmaris profundus may be close to the median nerve and its branches, and may be involved in compressive neuropathy of the anterior interosseous nerve. Its tendon crossing through the carpal canal has been implicated in the carpal tunnel syndrome (reviewed by Lahey & Aulicino, 1986). In some cases, palmaris profundus was found enclosed in a common fascial sheath with the median nerve (Stark, 1992; Sahinoglu et al. 1994). To indicate its close association with the median nerve, the palmaris profundus was also named ‘musculus comitans nervi mediani’ (Sahinoglu et al. 1994). This article reports an unusual loop of the median nerve encircling an anomalous palmaris profundus in the forearm, which, to the best of our knowledge, has not been previously described.

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confidence: 87%

Variant palmaris profundus enclosed by an unusual loop of the median nerve

Chou

Jeng

et al. 2001

Journal of Anatomy

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“…It normally regresses after the second embryonic month to become a small slender artery, the commitansnervi median [1][2][3]. However, it may persist in 1.1-27.1% of the individuals, as has reported in different studies [4][5][6][7][8][9]. In most of the cases, it simply accompanies the median nerve which is in the hand, but it may even perforate the median nerve [8,10,11].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of the Persistant Median Artery

Singla

Kaur²,

Dhiraj³

2012

JCDR

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Introduction: Neurovascular variations in the upper limb are common and they are well documented. An accurate knowledge of the normal and the variant anatomy of the median nerve and the median artery are important for clinical procedures and for vascular surgeries. The persistant median artery is one such anomaly which was seen in 6.6% (4) of the 60 upper limbs which were dissected in the present study, it being bilateral in one cadaver. Material and Methods:The present study was conducted on 60 upper limbs of 30 cadavers at the Government Medical College, Amritsar, India. The whole course of the median nerve and the persistant median artery was exposed. Results:In all the 4 variant limbs, the persistent median artery originated from the anterior interrosseous artery and terminated in the incomplete mediano-ulnar type of the superficial palmar arch. In three upper limbs, the persistant median artery simply accompanied the median nerve upto the palm. But in the left upper limb of the cadaver with the bilateral variation, the artery penetrated and divided the nerve into two halves which joined to form a neural loop around the artery. Thereafter, the nerve and the artery followed the same course upto the palm. Such a penetration of the median nerve by the persistent median artery is extremely rare. Further, its ontogeny and clinical implications have been discussed in detail.

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“…Presence of MN's loop in the forearm enclosing the abnormal persistent median artery has been detected very occasionally in the literature, 6,7 whereas an unusual MN's ring at the upper forearm enclosing the aberrant palmaris profundus muscle has also been reported. 8 In few studies the existence of MN's palmar digital nerve loops penetrated by digital arteries has also been prescribed.…”

Section: Discussionmentioning

confidence: 98%