Superficial Palmar Arch

Embryologists have shown us that the hand is vascularized as follows: the median artery develops the earliest, followed by the interosseous, and this vessel is finally (and usually) replaced by the ulnar and radial arteries. These changes during development permit a wide range of vascular variations to occur. The mature arch supplied by a comes nervi mediani (median artery) represents a persistence of the earliest embryonal blood supply of the hand.

The superficial palmar arch is subject to significant variations. The completion of the arch on the radial side is extremely variable. In a study of 200 subjects, a superficial palmar arch was absent in 32% of individuals (Jaschtschinski). It may be formed by the superficial branch of the ulnar anastomosing with the superficial palmar of the radial.

The superficial palmar branch may be larger than usual, and have a greater role than the ulnar in the formation of the arch.

In some cases, the arch is reinforced or completed by a large median artery, arising frequently from the common interosseous, or from an enlarged metacarpal artery.

The arch may be doubled, with both the superficial branch of the ulnar and the superficial palmar dividing into two branches that anastomose across the palm.

The arteries of the thumb and radial side of the index finger occasionally arise from the arch.

The arch may be incomplete, the medial digital branches arising from the ulnar and the lateral branches arising from the superficial palmar, the radial in the palm, or an enlarged median artery. When the arch is absent, the digital arteries arise from enlarged metacarpal arteries from the deep palmar arch or from enlarged dorsal metacarpal arteries.

Radialis indicis may arise from the superficial palmar arch (13% of cases) and receives contributions from both arches in 42% of individuals; in the latter case the superficial arch is the larger supply. When radialis indicis arises from the superficial arch alone, it supplies only the radial side of the index finger.

The arteria princeps pollicis my also arise from the superficial arch.

Jaschtschinski (1897) reported his observations on the palmar arches in 200 subjects and provided the following analysis: The superficial arch (primarily ulnar) was absent in 32%, and the deep arch (primarily radial) was absent only once. When both arches were present they had the following composition: radio-ulnar, 27%; ulnar, 38%; medio-ulnar, 3%; and radio-medio-ulnar, 0.5%.

See also Deep Palmar Arch .

See Image 412

Princeps Pollicis and Radialis Indicis

See Image 250

Riferimenti dell’opera originale

Elenco riportato come compare nella fonte, senza normalizzazione dei formati bibliografici.

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