Morphologic variations of the superficial palmar arc

Abstract

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.

Predictors of steal syndrome in hemodialysis patients

“…The upper arm fistulas are a widely recognized risk factor as opposed to the radiocephalic fistula for ischemic steal syndrome. This difference is explained by the superficial palmar arc that ensures the blood supply to the palm of the hand, formed by the ulnar artery and the superficial palmar branch of the radial artery …”

“…This difference is explained by the superficial palmar arc that ensures the blood supply to the palm of the hand, formed by the ulnar artery and the superficial palmar branch of the radial artery. 6 There are 3 valid options from which to choose to best accommodate each patient's antecubital anatomy with no significant differences in patency rates among them 7 -the cephalic, basilic, and median antecubital veins.…”

Palmar Type of Median Artery as a Source of Superficial Palmar Arch: A Cadaveric Study with its Clinical Significance

“…Adachi (1928; quoted by Keen) reported the median–ulnar type of SPA in 9% of subjects [18], which is relatively close to the present study (7.1%). Moraes et al reported the above occurrence in 13.3% of subjects [24]. Olave et al observed the SPA formed by the ulnar and the median artery of the forearm without anastomosis in 6.7% subjects [25].…”

A novel laboratory approach for the demonstration of hemodynamic principles: the arterial blood flow reflection

“…As arterial anatomic variations are frequent, in some people, the superficial palmar artery is near the skin surface and allows blood flow measurements through it (4,7). The position of the superficial palmar artery in all participants was also verified with ultrasound (ProSound alpha 10, Hitachi Aloka Medical).…”