Skip to main content
Top
Published in: Surgical and Radiologic Anatomy 7/2019

01-07-2019 | Original Article

Newer insights in the anatomy of superficial palmar arch

Authors: Dhivyalakshmi Gnanasekaran, Raveendranath Veeramani

Published in: Surgical and Radiologic Anatomy | Issue 7/2019

Login to get access

Abstract

Purpose

The purpose of the study is to study and classify the superficial palmar arch and its variation based upon the gross dissection and to check the bilateral symmetry of the arches. Specifically, we checked for the presence of the superficial palmar arch as described in the standard textbooks.

Methods

We dissected 55 hands from 28 cadavers of both sexes that include 18 males and 10 females. The superficial palmar arch was carefully dissected and the arteries contributing its formation were traced. It was classified into complete, incomplete arches. Bilateral symmetry of the arches was also studied.

Results

The most common pattern of superficial palmar arch observed is complete. And it is further classified into radio-ulnar and predominantly ulnar types. A consistent proportion of radio-ulnar type arch is completed around first web space. None of the dissected hand meets the definition of the classical superficial palmar arch as described in the standard anatomical textbooks. We also encountered few rare variants of the incomplete superficial palmar arch.

Conclusions

Type 1–4 superficial palmar arch is complete and can be utilized for radial artery or ulnar artery cannulation and radial artery harvesting procedure. In type 5 arch, ulnar artery occlusion could lead to severe hand ischemia and at the same time the radial artery in this type can be harvested without ischemic complication. We suggest that the definition of the complete superficial palmar arch should be rechecked and modified as complete superficial palmar or complete superficial first web space arch.
Literature
1.
go back to reference Al-Turk M, Metcalf WK (1984) A study of the superficial palmar arteries using the Doppler ultrasonic flowmeter. J Anat 138:27–32PubMedPubMedCentral Al-Turk M, Metcalf WK (1984) A study of the superficial palmar arteries using the Doppler ultrasonic flowmeter. J Anat 138:27–32PubMedPubMedCentral
2.
go back to reference Arey LB (1957) Developmental anatomy. A text book and laboratory manual of embryology, 6th edn. W B Saunders Co, Philadelphia Arey LB (1957) Developmental anatomy. A text book and laboratory manual of embryology, 6th edn. W B Saunders Co, Philadelphia
3.
go back to reference Bilge O, Pinar Y, Ozer MA, Govsa F (2006) A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat 28:343–350CrossRefPubMed Bilge O, Pinar Y, Ozer MA, Govsa F (2006) A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat 28:343–350CrossRefPubMed
4.
go back to reference Birch R (2005) Pectoral girdle and upper limb. In: Standring S (ed) Gray’s Anatomy. The anatomical basis of clinical practice, 39th edn. Elsevier Churchill Livingstone, Edinburgh, pp 776–894 Birch R (2005) Pectoral girdle and upper limb. In: Standring S (ed) Gray’s Anatomy. The anatomical basis of clinical practice, 39th edn. Elsevier Churchill Livingstone, Edinburgh, pp 776–894
5.
go back to reference Coleman SS, Anson BJ (1961) Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynaecol Obstet 113:409–424 Coleman SS, Anson BJ (1961) Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynaecol Obstet 113:409–424
6.
go back to reference Doyle JR, Botte MJ (2003) Surgical anatomy of hand and upper extremity, 1st edn. Lippincott, Williams & Wilkins, Philadelphia Doyle JR, Botte MJ (2003) Surgical anatomy of hand and upper extremity, 1st edn. Lippincott, Williams & Wilkins, Philadelphia
7.
go back to reference Gokhroo R, Bisht D, Saja G, Kishor K, Ranwa B (2016) Palmar arch anatomy: Ajmer Working Group classification. Vascular 24:31–36CrossRefPubMed Gokhroo R, Bisht D, Saja G, Kishor K, Ranwa B (2016) Palmar arch anatomy: Ajmer Working Group classification. Vascular 24:31–36CrossRefPubMed
8.
go back to reference Ikeda A, Ugawa A, Kazihara Y, Hamada N (1988) Arterial patterns in the hand based on a three-dimensional analysis of 220 cadaver hands. J Hand Surg Am 13:501–509CrossRefPubMed Ikeda A, Ugawa A, Kazihara Y, Hamada N (1988) Arterial patterns in the hand based on a three-dimensional analysis of 220 cadaver hands. J Hand Surg Am 13:501–509CrossRefPubMed
9.
go back to reference Jaschtschinski SN (1896) Morphologie und topographie des arcus volaris sublimis uno profundus des Menschen. Anatomische Hefte 7:161–188CrossRef Jaschtschinski SN (1896) Morphologie und topographie des arcus volaris sublimis uno profundus des Menschen. Anatomische Hefte 7:161–188CrossRef
10.
go back to reference Joshi SB, Vatsalaswamy P, Bahetee BH (2014) Variation in formation of superficial palmar arches with clinical implications. J Clin Diagn Res 8:AC06–AC09PubMedPubMedCentral Joshi SB, Vatsalaswamy P, Bahetee BH (2014) Variation in formation of superficial palmar arches with clinical implications. J Clin Diagn Res 8:AC06–AC09PubMedPubMedCentral
11.
go back to reference Kaplanoglu H, Beton O (2017) Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography. Surg Radiol Anat 39:419–426CrossRefPubMed Kaplanoglu H, Beton O (2017) Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography. Surg Radiol Anat 39:419–426CrossRefPubMed
12.
go back to reference Keen JA (1961) Study of the arterial variations in the limbs, with special reference to symmetry of vascular patterns. Am J Anat 108:245–261CrossRefPubMed Keen JA (1961) Study of the arterial variations in the limbs, with special reference to symmetry of vascular patterns. Am J Anat 108:245–261CrossRefPubMed
14.
go back to reference Lippert H, Pabst R (1985) Arterial variations in man: classification and frequency. Bergmann, MunchenCrossRef Lippert H, Pabst R (1985) Arterial variations in man: classification and frequency. Bergmann, MunchenCrossRef
15.
go back to reference Loukas M, Holdman D, Holdman S (2005) Anatomical variations of the superficial and deep palmar arches. Folia Morphol (Warsz) 64:78–83 Loukas M, Holdman D, Holdman S (2005) Anatomical variations of the superficial and deep palmar arches. Folia Morphol (Warsz) 64:78–83
16.
go back to reference Moore KL, Dalley AF (1999) Clinically oriented anatomy, 4th edn. Lippincott, Williams & Wilkins, Philadelphia Moore KL, Dalley AF (1999) Clinically oriented anatomy, 4th edn. Lippincott, Williams & Wilkins, Philadelphia
17.
go back to reference Mozersky DJ, Buckley CJ, Hagood CO Jr, Capps WF Jr, Dannemiller FJ Jr (1973) Ultrasonic evaluation of palmar circulation: a useful adjunct to radial artery cannulation. Am J Surg 126:810–812CrossRefPubMed Mozersky DJ, Buckley CJ, Hagood CO Jr, Capps WF Jr, Dannemiller FJ Jr (1973) Ultrasonic evaluation of palmar circulation: a useful adjunct to radial artery cannulation. Am J Surg 126:810–812CrossRefPubMed
18.
go back to reference Nayak SR, Krishnamurthy A, kumar SM, Prabhu LV, Potu BK, D’costa S, Ranade AV (2010) Palmar type of median artery as a source of superficial palmar arch: a cadaveric study with its clinical significance. Hand (NY) 5:31–36CrossRef Nayak SR, Krishnamurthy A, kumar SM, Prabhu LV, Potu BK, D’costa S, Ranade AV (2010) Palmar type of median artery as a source of superficial palmar arch: a cadaveric study with its clinical significance. Hand (NY) 5:31–36CrossRef
19.
go back to reference Olave E, Prates JC, Gabrielli C, Pardi P (1997) Median artery and superficial palmar branch of the radial artery in the carpal tunnel. Scand J Plast Reconstr Surg Hand Surg 31:13–16CrossRefPubMed Olave E, Prates JC, Gabrielli C, Pardi P (1997) Median artery and superficial palmar branch of the radial artery in the carpal tunnel. Scand J Plast Reconstr Surg Hand Surg 31:13–16CrossRefPubMed
20.
go back to reference Ottone NE, Prum N, Dominguez M, Blasi E, Medan C, Shinzato S, Finkelstein D, Bertone VH (2010) Analysis and clinical importance of superficial arterial palmar irrigation and its variants over 86 cases. Int J Morphol 28:157–164CrossRef Ottone NE, Prum N, Dominguez M, Blasi E, Medan C, Shinzato S, Finkelstein D, Bertone VH (2010) Analysis and clinical importance of superficial arterial palmar irrigation and its variants over 86 cases. Int J Morphol 28:157–164CrossRef
21.
go back to reference Patnaik VVG, Kalsey G, Singla Rajan K (2002) Palmar arterial arches—a morphological study. J Anat Soc India 51:187–193 Patnaik VVG, Kalsey G, Singla Rajan K (2002) Palmar arterial arches—a morphological study. J Anat Soc India 51:187–193
22.
go back to reference Pola P, Serricchio M, Flore R, Manasse E, Favuzzi A, Possati GF (1996) Safe removal of the radial artery for myocardial revascularization: a doppler study to prevent ischemic complications to the hand. J Thorac Cardiovasc Surg 112:737–744CrossRefPubMed Pola P, Serricchio M, Flore R, Manasse E, Favuzzi A, Possati GF (1996) Safe removal of the radial artery for myocardial revascularization: a doppler study to prevent ischemic complications to the hand. J Thorac Cardiovasc Surg 112:737–744CrossRefPubMed
23.
go back to reference Romanes GJ (2005) Cunnigham’s manual of practical anatomy, vol. 1, 15th edn. Oxford University Press, Oxford, pp 74–104 Romanes GJ (2005) Cunnigham’s manual of practical anatomy, vol. 1, 15th edn. Oxford University Press, Oxford, pp 74–104
24.
go back to reference Sawant SP (2013) The anatomical study of variant superficial palmar arch. Int J Curr Sci 6:E 101–106 Sawant SP (2013) The anatomical study of variant superficial palmar arch. Int J Curr Sci 6:E 101–106
25.
go back to reference Sherif MM (1994) First dorsal metacarpal artery flap in hand reconstruction. II. Clinical application. J Hand Surg Am 19:32–38CrossRefPubMed Sherif MM (1994) First dorsal metacarpal artery flap in hand reconstruction. II. Clinical application. J Hand Surg Am 19:32–38CrossRefPubMed
26.
go back to reference Wagener JF, Rao SV (2015) Radial artery occlusion after transradial approach to cardiac catheterization. Curr Atheroscler Rep 17:489CrossRefPubMed Wagener JF, Rao SV (2015) Radial artery occlusion after transradial approach to cardiac catheterization. Curr Atheroscler Rep 17:489CrossRefPubMed
27.
go back to reference Zarzecki MP, Popieluszko P, Zayachkowski A, Pekala PA, Henry BM, Tomaszewski KA (2018) The surgical anatomy of the superficial and deep palmar arches: a meta-analysis. J Plast Reconstr Aesthet Surg 71:1577–1592CrossRefPubMed Zarzecki MP, Popieluszko P, Zayachkowski A, Pekala PA, Henry BM, Tomaszewski KA (2018) The surgical anatomy of the superficial and deep palmar arches: a meta-analysis. J Plast Reconstr Aesthet Surg 71:1577–1592CrossRefPubMed
Metadata
Title
Newer insights in the anatomy of superficial palmar arch
Authors
Dhivyalakshmi Gnanasekaran
Raveendranath Veeramani
Publication date
01-07-2019
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 7/2019
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-019-02223-w

Other articles of this Issue 7/2019

Surgical and Radiologic Anatomy 7/2019 Go to the issue