Human Anatomy: Part 2 - K. A. Dubenko, A. K. Kolomiytsev, Yu. B. Chaykovsky 2008

Special Part
Cardiovascular system, systema cardiovasculare - Special Part
Blood vessels of the systemic circulation - Arteries of the upper limb - Radial artery

The radial artery, a.radialis (Fig. 37, 39), is a continuation of the brachial artery. Initially, the artery lies between the pronator teres and brachioradialis Muscles, and then courses through the radial sulcus in the distal forearm between the brachioradialis, flexor carpi radialis, and flexor digitorum superficialis along with its tendons. Here, the radial artery is covered only by fascia and Skin, making it easily palpable for taking the pulse. The PROJECTION OF THE radial artery onto the skin of the forearm extends from the midpoint of the elbow crease to the pulse-taking point. At the level of the styloid process, the superficial palmar branch, ramus palmaris superficialis, arises from the radial artery. Further down, a.radialis crosses the anatomical snuffbox ("tabatiere") and reaches the palmar surface through the first interosseous space, continuing into the deep palmar arch of the hand, arcus palmaris profundus. The radial artery supplies Blood to the Muscles of the forearm, the elbow and wrist joints, and the hand.

Branches of the RADIAL ARTERY

1. A.recurrens radialis;

2. Rr.musculares;

3. R.carpalis palmaris;

4. R.palmaris superficialis;

5. R.carpalis dorsalis;

6. A.metacarpales dorsalis;

7. A.princeps policis.

1. The radial recurrent artery, a.recurrens radialis (Fig. 39), originates in the cubital fossa, runs toward the anterior surface of the lateral epicondyle, where it anastomoses with the radial collateral artery, a.collateralis radialis (a branch of the profunda brachii artery).

* The absence of the superficial palmar arch accounts for 9% of cases (M. A. Tikhomirov).

** The superficial palmar arch is formed without the participation of the superficial branch of the radial artery in 25.2% of cases (M. A. Tikhomirov, 1990).

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Fig. 39. Arteries of the forearm and hand (right upper extremity)

Fig. 39 A. Deep palmar arch, arcus palmaris profundus, and arteries of the right hand.

Fig. 40. Palmar surface of the left hand showing skin creases, the Skeletal Structure of the hand, and their relationship to the superficial and deep palmar arches (diagram based on H. K. Corning)

2. Muscular branches, rami musculares, supply the surrounding muscles.

3. The palmar carpal branch, ramus carpalis palmaris, originates from the lower part of the radial artery at the level of the lower border of the pronator quadratus Muscle, where it anastomoses with the corresponding branch of the ulnar artery, contributing to The formation of the palmar carpal network.

4. The superficial palmar branch, ramus palmaris superficialis (Fig. 37), arises from the a.radialis at the level of the radial styloid process, pierces the superficial layers of the thenar eminence, and, in the region of the index finger flexors, contributes to the Formation of the superficial palmar arch, arcus palmaris superficialis. In some cases, the superficial branch of the radial artery courses over The surface of the adductor pollicis brevis muscle.

5. The dorsal carpal branch, ramus carpalis dorsalis, originates from the a.radialis within the anatomical snuffbox, runs medially to anastomose with the corresponding branch of the ulnar artery, and together with branches of the interosseous arteries, forms the dorsal carpal network (rete carpale dorsale) on the dorsal surface of the wrist. From this carpal network, 3–4 dorsal metacarpal arteries, aa.metacarpeae dorsales, arise, which in turn give off dorsal digital arteries, aa.digitales dorsales, supplying the dorsal aspect of digits II–V.

6. The dorsal metacarpal artery, a.metacarpea dorsalis, branches off from the radial artery, extends onto the dorsum of the hand, and supplies branches to the radial side of the thumb and the adjacent sides of the First and Second fingers.

7. The principal artery of the thumb, a.princeps pollicis, originates from the radial artery at the level of the carpometacarpal joint of the thumb, where the main vessel passes through the first interosseous space to reach the PALMAR ASPECT OF the first metacarpal bone, dividing into three palmar digital branches: the palmar digital arteries, aa.digitales palmares, to both sides of the thumb, and the radial index artery, a.radialis indicis, to the radial side of the index finger.

The deep palmar arch, arcus palmaris profundus (Fig. 39 A), is formed primarily by the continuation of the main trunk of the radial artery, a.radialis, which passes from the dorsum of the hand to the palm through the first interosseous space, where it anastomoses with the deep palmar branch of the ulnar artery, r.palmaris profundus. The deep palmar arch lies on the palmar interosseous muscles at the level of the bases of the Metacarpal bones, approximately 1 cm distal to the flexor retinaculum; it is longer but has a smaller curvature than the superficial arch. The deep palmar arch is accompanied by the deep branch of the ulnar nerve. Three palmar metacarpal arteries, aa.metacarpales palmares, arise from the deep palmar arch and anastomose at the level of the metacarpal heads with the terminations of the common palmar digital arteries, aa.digitales palmares communes (branches of the superficial palmar arch). Dorsally, three perforating branches, rr.perforantes, arise from the aa.metacarpales palmares, passing through the second, third, and fourth interosseous spaces to the dorsum of the hand, where they anastomose with the dorsal metacarpal arteries, aa.metacarpeae dorsales (branches of the dorsal carpal network).

In clinical (microsurgical) practice, considerable importance is attached to the projection of the arterial arches onto the palmar surface in relation to the skin creases of the hand*, as well as The Relationship of these arches to the skeletal STRUCTURE OF THE hand (Fig. 40).

* The following skin creases are distinguished on the palmar surface of the hand: the arcuate skin crease (thenar crease), the axial crease of the palm, the proximal transverse crease, the distal transverse crease, and the palmar-digital and interdigital creases.

With the thumb abducted, the superficial palmar arterial arch is projected onto the middle third of a line drawn across the palm through the upper border of the palmar surface of the thumb, or onto the midpoint of the interval between the proximal transverse and arcuate creases of the palm, which is 4.5–5 cm distal to the distal wrist skin crease. In the case of an arcuate shape, the superficial palmar arch is most frequently projected 0.5–1 cm proximal to the proximal transverse crease of the palm.

The deep palmar arterial arch is projected in the spaces between the thenar and hypothenar muscles, 0.5–1.5 cm proximal to the superficial arterial arch. The convexity of the deep palmar arterial arch is projected onto the upper third of the third and fourth metacarpal bones.