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The hand is richly supplied by two main arteries:
Ulnar artery – forms the superficial palmar arch (main contributor).
Radial artery – forms the deep palmar arch (main contributor).
These arteries ensure a rich collateral circulation, providing constant blood flow during gripping or finger movements.
Enters the hand anterior to the flexor retinaculum, lateral to pisiform bone, within the ulnar (Guyon’s) canal.
Curves laterally across the palm, deep to palmar aponeurosis but superficial to flexor tendons, forming the superficial palmar arch.
Terminates by anastomosing with the superficial palmar branch of the radial artery.
Main terminal branch of ulnar artery.
Curves across the palm, convex toward fingers.
Gives off three common palmar digital arteries, which divide into proper digital arteries supplying adjacent sides of medial four fingers.
Each proper digital artery runs along the side of a finger to the tip.
Pierces the hypothenar muscles → joins deep palmar arch (branch of radial artery).
Supply hypothenar muscles and palmar fascia.
Supplies medial side of little finger directly.
Superficial: Palmaris brevis, palmar aponeurosis.
Deep: Flexor tendons and lumbricals.
Lateral: Hook of hamate.
Medial: Ulnar nerve (in Guyon’s canal).
In 1/3 cases, arch is incomplete → radial artery fails to join → danger in surgical procedures.
Always confirm hand circulation with Allen’s test before cannulation or grafting.
Seen in manual laborers using palm to strike objects (hammering).
Leads to ischemia of digits due to arterial trauma and thrombosis.
Felt lateral to pisiform bone in wrist region (though weaker than radial pulse).
In vascular reconstructive procedures (e.g., coronary bypass), radial artery is preferred over ulnar because ulnar is dominant in palmar circulation.
Winds around the lateral aspect of wrist → through anatomical snuffbox.
Pierces the first dorsal interosseous muscle to enter the palm.
Turns medially between the oblique and transverse heads of adductor pollicis, forming the deep palmar arch with the deep branch of the ulnar artery.
Arises before the artery passes to dorsum; joins the ulnar artery to complete the superficial palmar arch.
Contributes to dorsal carpal arch, supplying dorsum of hand.
Small artery to dorsal surface of thumb.
Major artery to the thumb; runs along its palmar aspect to the tip.
Supplies lateral side of index finger.
Continuation of radial artery → curves medially across palm.
Lies deep to long flexor tendons, resting on bases of metacarpals and interossei.
Gives palmar metacarpal arteries that join common palmar digital arteries of superficial arch.
In anatomical snuffbox: lies on scaphoid and trapezium bones.
In palm: deep to adductor pollicis; accompanied by deep branch of ulnar nerve.
Superficial branch communicates with ulnar artery.
Felt at the wrist lateral to flexor carpi radialis tendon — routine site for pulse measurement.
Common site for arterial blood gas sampling and hemodynamic monitoring.
Allen’s test performed to confirm collateral ulnar supply before cannulation.
The radial artery crosses the scaphoid bone → fracture may cause avascular necrosis of proximal fragment.
Severe bleeding in deep hand wounds; must be controlled by compressing radial artery in anatomical snuffbox.
Frequently harvested for coronary artery bypass surgery — strong and muscular wall.
Reflect the palmar aponeurosis to reveal superficial structures.
Identify ulnar artery entering the palm lateral to pisiform → trace its superficial arch across palm.
Observe common and proper digital branches.
Locate radial artery in anatomical snuffbox → follow it through first dorsal interosseous into palm.
Deeply, identify deep palmar arch and its palmar metacarpal branches.
Preserve associated ulnar and radial nerves, as they accompany the arches.
Demonstrate anastomosis between superficial and deep arches.
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