IJAR.2021.156
Type of Article: Original Research
Volume 9; Issue 3.3 (September 2021)
Page No.: 8097-8102
DOI: https://dx.doi.org/10.16965/ijar.2021.156
Patterns of Arterial Arcades of the Superficial Palmar Arch: A Study In Embalmed Cadaver Palms
Suman Udupi *1, Pushpa Gowda 2.
*1 Associate Professor, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India.
2 Associate Professor, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India.
Corresponding Author: Dr Suman U, Associate professor, Department of Anatomy, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India. Phone numbers: 9980013352 E-Mail: sumanvadhiraj@gmail.com
ABSTRACT
Background: The complex and variable pattern of the arterial arcades of the palm form an interesting area of study anatomically and surgically. In the present study arches were classified into complete and incomplete types, the complete type being the most prominent in 88.6% of the palms. Among the complete type, arch formed by ulnar artery alone supplying the thumb and index finger was found in majority of the specimens (50%). The classical or standard superficial palmar arch formed by the superficial palmar branch of radial and ulnar arteries was found in only 28.5%. Different patterns of the arterial arcades of the superficial palmar arch are normally encountered during routine anatomical dissections of the palm which needs to be emphasized and highlighted for a desired surgical out come during microvascular reconstructive surgeries of the palm and during radial artery cannulation.
Context: With technological advancements in microsurgical procedures of the hand, fields of anatomical interest like the classification of arterial arcades of the palm, now becomes essential for operating vascular surgeons for a desired surgical outcome
Purpose of the study: The present study was taken up to analyze and document varying patterns of the arterial arcades of the superficial palmar arch.
Methods and Material: the study was conducted by dissecting 70 randomly obtained formalin fixed cadaver palms.
Results: In the present study arches were classified into complete and incomplete types, the complete type being the most prominent in 88.6% of the palms. Among the complete type, arch formed by ulnar artery alone supplying the thumb and index finger was found in majority of the specimens (50%). The classical or standard superficial palmar arch formed by the superficial palmar branch of radial and ulnar arteries was found in only 28.5%. Out of the 70 hands, incomplete arches were found only in 8 hands with an incidence of 11.4%.
Conclusion: Knowledge of arterial pattern of the hand is very important to vascular and reconstructive surgeons for effective treatment of injuries of the hand. Such a knowledge of the disposition of the arterial arcades of the palm also enables cardio-vascular surgeons to plan and modify surgical procedures such as radial artery harvesting, cannulation and in preventing the ischemia of hands in such procedures.
Key words: Superficial palmar arch, Arterial arcades, Complete arch, Incomplete arch.
REFERENCES
[1]. Sinnatamby CS. Last’s Anatomy Regional and Applied.10th ed. Edinburgh: Churchill Livinstone;1999.
[2]. Chhatrapati DN. Absence of radial artery. Indian J Med Sci 1964; 18:462-465.
[3]. Coleman S, Anson BJ. Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynecol Obstet 1961; 113:409-424.
[4]. Romanes G J. Cunningham’s Manual of Practical Anatomy. 15th ed. Oxford university press 2005; vol 1: 174-179.
[5]. Jaschtschinski S N. Morphologie and topographie des arcus volaris sublimis and profundus. Anat Hefte:1897; 7:163-188.
[6]. Adachi B. Des arterien- system des Japaner, Kyoto, 1928; 1:365-389.
[7]. Al -Turk M, Metcalf W K. A study of the superficial arteries using the doppler ultrasonic flowmeter. J Anat 1984; 139:27-32.
[8]. Gellman H, Botte M J, Shankwiler J, Gelberman R H. Arterial patterns of the deep and superficial palmar arches. Clin Orthop and Related research 2001; 383:41-46.
[9]. Reungsakularch P, Eizenberg N, Fahrer C, Fahrer M, Buxton B Surgical implications of variations in hand collateral circulation: Anatomy revisited. The J Thoracic Cardiovasc surg 2001:122(4):682-686.
[10]. Patnaik V V G, Kalsey G, Singla R K. Palmar arterial arches -a morphological study. Journal of Anatomical society of India 2002;51(2): 187-193.
[11]. Loucas M, Holdman D, Holdman S. Anatomical variations of the superficial and deep palmar arches. Folia Morphol (warsz) 2005;64(2) :78-83.
[12]. Singh S, Lazarus L, De Gama B. Satyapal K S. An anatomical investigation of the superficial and deep palmar arches. Folia Morphol 2017 ;76(2) :219-225.
[13]. Koman L A, Urbanaik J R. Ulnar artery insufficiency: A guide to treatment. J Hand Surg 1981;6(1) :16-24.
[14]. Maj Mozersky D J, Lt Col Capps W F Jr, Col Danne Miller F J.Jr. Ultrasonic evaluation of palmar circulation. A useful adjunct to radial artery cannulation. The Am J of surgery 1973; 126:810-812.
[15]. Kaplanoglu H, Beton O. Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with C T angiography. Surg Radiol Anat 2017;39(4):419-426.
[16]. Conn J, Bergann JJ, Bell JL. Hypothenar hammer syndrome post traumatic digital ischemia. Surgery 1970;68(6):1122-1128.
[17]. Little J M, Zylestra P L, West J, May J. Circulatory patterns in normal hand. Brit J Surg 1973; 60:652-655.
[18]. Starnes S l, Wolk S W, Lamprman R M, Shanley C J, Prager R L, Kang B K et a l. Noninvasive evaluation of hand circulation before radial artery harvest for coronary artery bypass grafting. The J Thorac Cardiovasc Surg 1999; 117:261-266.