4.8
9
Radial and ulnar arteries and superficial and deep palmar arches
The radial and ulnar arteries are the terminal branches of the brachial artery. The radial artery supplies the lateral part of the forearm and hand and the ulnar artery supplies the medial part of the forearm and hand. Both arteries continue to the palm, but neither of them pass in the carpal tunnel. They form vascular arches within the palm. The superficial palmar arch is supplied mainly by the ulnar artery and the deep palmar arch is supplied mainly by the radial artery. Radial artery (arteria radialis) Course
1. its initial segment is located between the pronator teres and the brachioradialis 2. passes between the brachioradialis and flexor carpi radialis and then continues between the radial styloid process and scaphoid 3. then it runs on the lateral surface of the wrist to the radial foveola and passes through the first interdigital space to reach the palm
• 1 Radial artery 1.1 Radial recurrent artery (arteria recurrens radialis) – heads proximally to the cubital articular anastomosis 1.2 Palmar carpal branch (ramus carpalis palmaris) – terminates in the palmar carpal articular anastomosis • 1.3 Superficial palmar branch (ramus palmaris superficialis)
– runs between the thenar muscles and participates in the formation of the superficial palmar arch 1.4 Dorsal carpal branch (ramus carpalis dorsalis) – arises at the radial foveola and gives branches supplying the dorsum of the hand 1.5 First dorsal metacarpal artery (arteria metacarpalis dorsalis prima) – divides into the dorsal digital arteries supplying the thumb and lateral side of the forefinger 1.6 First palmar metacarpal artery (arteria metacarpalis palmaris prima) – arises where the radial artery enters the palm and divides into the palmar digital arteries, which supply both margins of the thumb and the lateral margin of the forefinger
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Ulnar artery (arteria ulnaris) Course
1. after its origin in the cubital fossa it passes along the ulnar side of the forearm 2. lies between the flexor digitorum superficialis and flexor digitorum profundus 3. distally it runs between the flexor carpi ulnaris and the flexor digitorum superficialis 4. enters the palm through the ulnar canal (Guyon’s canal) with the ulnar nerve
1
2 2.2
• 2 Ulnar artery 2.1 Ulnar recurrent artery (arteria recurrens ulnaris) – heads proximally to the cubital articular anastomosis • 2.2 Common interosseous artery (arteria interossea communis) – heads to the interosseous membrane of the forearm • 2.2.1 Anterior interosseous artery (arteria interossea anterior)
– runs on the anterior surface of the interosseous membrane of the forearm, perforates the membrane proximally to the pronator teres and terminates in the palmar carpal articular anastomosis 2.2.2 Posterior interosseous artery (arteria interossea posterior) – perforates the interosseous membrane of the forearm (distally to the oblique cord) and runs on the posterior surface of the forearm between the superficial and deep layers of the extensors 2.3 Palmar carpal branch (ramus carpalis palmaris) – heads to the palmar carpal articular anastomosis 2.4 Dorsal carpal branch (ramus carpalis dorsalis) – heads to the dorsal carpal articular anastomosis 2.5 Deep palmar branch (ramus palmaris profundus) – anastomoses with the radial artery and forms the deep palmar arch
2.2.1 2.2.2
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1.3 2.5
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4 1.6
Superficial and deep palmar arches (arcus palmaris superficialis et profundus)
• 3 Superficial palmar arch (arcus palmaris superficialis) – is formed by an anastomosis between the larger trunk of the ulnar artery and the smaller superficial palmar branch of the radial artery • 3.1 Common palmar digital arteries (arteriae digitales palmares communes) – descend distally between the metacarpals • 3.2 Proper palmar digital arteries (arteriae digitales palmares propriae) – paired branches arising at the level of the metacarpal heads that run along the sides of the fingers • 4 Deep palmar arch (arcus palmaris profundus) – is formed by an anastomosis between the larger terminal branch of the radial artery and the smaller deep palmar branch of the ulnar artery 4.1 Palmar metacarpal arteries (arteriae metacarpales palmares)
3 3.1 3.2
– supply the fingers, head distally and anastomose with the common digital arteries
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