July 18, 2024

Blood supply of the hand is supplied by two main arteries either radial artery and the ulnar artery and their tributaries

Blood Supply of hand
Blood supply of hand

Passes between brachioradialis and Flexor Carpi Radialis

Radial Artery

Gives superficial palmar arch (communicates with superficial arch)

Finally passes between two heads of 1st dorsal interosseous to form a deep palmar arch

Ulnar Artery

Passes beneath Flexor Carpi Ulnaris

Lateral to the Ulnar nerve at the wrist

Enters the hand through Guyon’s canal

Lies in transverse carpal ligaments

Volar section of artery and nerve anatomy
Volar section of artery and nerve anatomy

Superficial arch

Deep to the palmar fascia

Blood supply predominantly Ulnar Artery

Branches of the superficial arch

From ulnar to radial

  • 1st deep branches that supply minor supply to deep palmar arch
  • 2nd ulnar digital artery of the little finger
  • 3,4,5,6: Common palmar digital arteries

In the palm: Digital arteries are volar to the digital nerve

In the digit: Digital arteries are dorsal to the digital nerve

Deep arch

Deep to flexor tendons (FDS, FDP)

Proximal to superficial arch

Blood supply:

Predominantly is the deep branch of the Radial

Minor supply: Deep branches of ulnar artery

The complete arch is present in 80% of cases where if radial and ulnar artery is injured, sufficient digital perfusion is provided by the uninjured artery however incomplete arch in 20% may have significant perfusion if the dominant artery is injured

Branches

  • Principle pollices: Between 1st dorsal interosseous and adductor pollices
  • Branch to the radial side of the index finger: The proper digital artery to the radial side of IF arises directly from a deep arch
  • Branches to the 3rd common digital arteries in 2,3 and 4 web spaces

Digital Arteries

Arises from superficial palmar arch where following arteries are dominant as per fingers

  • Index: Ulnar artery dominant
  • Middle: Ulnar artery dominant
  • Ring finger: Radial artery dominant
  • Little finger: Radial artery dominant

Dorsal arteries

  • By Posterior interosseous artery
  • Dorsal perforating branch of the anterior interosseous artery

Presence of an incomplete arch is detected by Allen’s test

Veins

Deep veins and Superficial veins

Anastomosis of elbow joint

Anastomosis of elbow joint picture is summarized below in a figure

Anastomosis of elbow joint

See also: Nerve supply of forearm and hand

See also: Martin-Gruber anastamosis

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