Type of Article:  Original Research

Volume 7; Issue 3.3 (September 2019)

Page No.: 6918-6923

DOI: https://dx.doi.org/10.16965/ijar.2019.256


Ankita Saha 1, Nidhi Lal *2, Sharmila Pal 3.

1 Post-graduate Student, Department of Anatomy, Medical College and Hospital, Kolkata, West Bengal, India.

*2 Assistant Professor, Department of Anatomy, Medical College and Hospital, Kolkata, West Bengal, India.

3 Professor & HOD, Department of Anatomy, Medical College and Hospital, Kolkata, West Bengal, India.

Address for Correspondence: Dr. Nidhi Lal, Assistant Professor, Department of Anatomy, Medical College and Hospital, Kolkata, West Bengal, India. E-Mail: nidhi25_lal@rediffmail.com


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.

Materials and methods: We have dissected 30 cadaveric hands at Department of Anatomy of Medical College and Hospital, Kolkata.

Result and conclusion: Out of 30 specimens, variations were observed in 14 specimens. Out of 14 specimens in 11 specimens SPA was formed alone by Ulnar Artery, in two specimens SPA was incomplete formed by superficial palmar branches of Ulnar and Radial Artery, in one specimen there was presence of Persistent Median Artery with incomplete SPA. All the variations found were present unilaterally. In rest 16 specimens SPA was complete classical radio-ulnar type.

KEY WORDS: Superficial palmar arch (SPA), Ulnar artery (UA), Radial artery (RA), Persistent Median artery (PMA).


  1. Standring Susan. Gray’s anatomy : the anatomical basis of clinical practice (41 st ed.) Elsevier 2016; p.889-890.
  2. Gellman H, Botte MJ, Shankwiler j, Gelberman RH. Arterial patterns of the deep and superficial palmar arches. ClinOrthopRelat Res 2001;383E:41-46.
  3. Coleman SS, Anson BJ. Arterial patterns in the hand based upon a study of 650 specimens. SurgGynecolObstet 1961;113:409-24.
  4. Adachi B. Das Arteriensystem der Japaner; Kyoto, Maruzen. 1928; vol.1 ,pp. 285-356.
  5. Singer E.Embryological patterns persisting in the arteries of the arm.Anatomical record.1933;55:406-13.
  6. Jones NF, Ming NL. Persistent median artery as a cause of pronator syndrome. J Hand Surg Am 1988;13:728-32.
  7. Henneberg M, George BJ. High incidence of the median artery of the forearm in a sample of recent southern African cadavers. J Anat 1992;180:185-8.
  8. Rodriguez-Niedenführ M, Sanudo J.R, Vázquez T, Nearn L, LoganB, ParkinI; Median artery revisited. J. Anat. (1999) 195, pp. 57–63.
  9. Claassen H, Schmitt O, Wree A. Large patent median arteries and their relation to the superficial palmar arch with respect to history, size consideration and clinical consequences, SurgRadiol Anat. 2008;30:57-63.
  10. BalakrishnanC, Smith MF, Puri P. Acute carpal tunnel syndrome from thrombosed persistent median artery.JEmerg Med. 1999 May-Jun;17(3):437-9.
  11. Gassner EM, Schocke M, Peer S, Schwabegger A, Jaschke W, BodnerG.Persistent median artery in the carpal tunnel: Color Doppler ultrasonographic findings. J Ultrasound Med 2002;21:455-61.
  12. Natsis K., Jordache G., Gigis I., Kyriazidou,A., Lazaridis N., Nourrsions G., Paraskevas G. Persistent median artery in the carpal tunnel: anatomy, embryology, clinical significance and review of the literature. Folia Morphol. (2009) vol 68: no 4,193-200.
  13. Proudman T. W., Menz P. J. An anomaly of the median artery associated with the anterior interosseous nerve syndrome. J. Hand Surg. Br. (1992) vol17: 507-509.
  14. D’Costa S., Narayana K., Narayan,P., Nayak S. R., Madhan S. J. Occurrence of and fate of palmar type of median artery. ANZ J. Surg. (2006) Vol 76: 484-487.
  15. Romanes G.J. Cunningham’s Manual of Practical Anatomy, Upper & Lower Limbs, 15th Edition, Oxford Medical Publications 2010; p77-7.
  16. Singh S, Lazarus L, De Gama B.Z , Satyapal K.S. An anatomical investigation of the superficial and deep palmar arches. Folia Morphol., 2017, Vol. 76, No. 2 ,pp. 219–225.
  17. Al-Turk M, Metcalf WK. A study of the superficial palmar arteries using the doppler ultrasonic flowmeter. J Anat 1984;138:27-32.
  18. Patnaik VVG, Kalsey G, Singla RK. Palmar Arterial Arches- A Morphological Study. J Anat Soc India 2002;51(2):187-193.
  19. Ikeda A, Ugawa A, Kazihara Y, Hamada N. Arterial patterns in the hand based on a three-dimensional analysis of 220 cadaver hands. J Hand Surg. 1988;13:501-509.
  20. Nayak S.R, Krishnamurthy A, Kumar S.J, Prabhu L, Kumar B, D’Costa S, Ranade A.V; Palmar Type of Median Artery as a Source of Superficial Palmar Arch: A Cadaveric Study with Its Clinical Significance,American Association for Hand Surgery (2010) 5:31–36.
  21. Ruengsakulrach P, Eizenberg N, Fahrer C, Fahrer M, Buxton BF; Surgical implications of variations in hand collateral circulation: anatomy revisited,JThoracCardiovasc Surg. 2001 Oct;122(4):682-6.
  22. Sílvia Regina Arruda de Moraes, TâmaraNunes de Araújo, AlexandreRoque da Silva, Amanda Rodrigues de Paula, Juliana Larocerie Salgado. Morphologic variations of the superficial palmar arc. ActaCirurgicaBrasileira São Paulo. 2003;18(3).
  23. Joshi SB,VatsalaswamyP, BaheteeB.H,Variation in Formation of Superficial Palmar Arches with Clinical Implications. Journal of Clinical and Diagnostic Research. 2014 Apr, Vol-8(4): AC06-AC09.
  24. Loukas M, Holdman D, Holdman S. Anatomical variations of the superficial and deep palmar arches. Folia Morphol (Warsz) 2005;64:78-83.

Cite this article: Ankita Saha, Nidhi Lal, Sharmila Pal. THE SUPERFICIAL PALMAR ARCH: A MORPHOLOGICAL STUDY. Int J Anat Res 2019;7(3.3):6918-6923. DOI: 10.16965/ijar.2019.256