Type of Article : Original Research
Year: 2015 | Volume 3 | Issue 3 | Page No. 1267-1272
Date of Publication: 31-08-2015
STUDY OF PALMAR TYPE OF MEDIAN ARTERY AND ITS FATE
Bhagya Shree *1, Meenakshi Khullar 2, Ashwini Kumar 3, Zora Singh 4.
*1 Senior Resident, Dept. of Anatomy, Guru Gobind Singh Medical College, Faridkot, Punjab, India.
2 Assistant Professor, Dept. of Anatomy, Guru Gobind Singh Medical College, Faridkot, Punjab, India.
3 Assistant Professor, Dep. of Forensic Medicine, Guru Gobind Singh Medical College, Faridkot, Punjab, India.
4 Professor & Head, Dept. of Anatomy, Dashmesh institute of research and Dental sciences, Faridkot, Punjab, India.
Address: Dr. Bhagya Shree, Senior Resident, Dept. of Anatomy, Guru Gobind Singh Medical College, Faridkot-151203, Punjab, India. Mob: 91-9463364664.
Background: The median artery is a transitory vessel that represents the arterial axis of the forearm during early embryonic life. When present, it appears mainly as two types: antebrachial and palmar.
Context and purpose of the study: In the present study the objective was to investigate the occurrence and fate of palmar type of median artery. The study was conducted on 40 cadaveric upper extremities dissected in the department of Anatomy, Guru Gobind Singh Medical College, Faridkot, India.
Results: In the present study, persistent median artery (palmar type) was seen in 2.5% of the limbs dissected. It was originating from the posterior aspect of the ulnar artery approximately 3.2 cm distal to the elbow joint. It pierced the median nerve (traversing from its medial to its lateral aspect) in the proximal third of the forearm. The artery then travelled lateral to the median nerve in rest of the forearm. Subsequently, it accompanied the median nerve into the palm passing deep to the flexor retinaculum. Finally, the artery terminated by completing the superficial palmar arch. In addition to the above described variant blood vessel, we also observed high division of median nerve into its medial and lateral branches.
Clinical implications: When median artery is patent and reaches the hand, it forms the only arterial supply to the median nerve and damage to this artery could have serious effects. The aim of our study was to provide additional information about anomalous palmar type of median artery and its clinical implications.
KEY WORDS: Palmar type of median artery, Median nerve, Superficial palmar arch.
- Rodriguez- Niedenfuhr M, Sanudo JR, Vazquez T, Nearn L, Logan B, Parkin I. Median artery revisited. J Anat 1999; 195: 57-63.
- George BJ, Henneberg M. High frequency of the median artery of the forearm in South African newborns and infants. South African Medical Journal 1986; 86: 175-176.
- Srivastava SK, Pande BS. Anomalous pattern of median artery in the forearm of Indians. Acta Anatomica 1990; 138: 193-194.
- Dickinson JC, Kleinbert JM. Acute carpal tunnel syndrome caused by a calcified median artery. A case report. J Bone Joint Surg 1991; 73(4): 610-611.
- Romanes GJ. The forearm and hand. In Cunningham’s manual of practical anatomy. Volume 1. 15th edition. Oxford: Oxford University Press; 1986: 73-81.
- Singer E. Embryological patterns persisting in arteries of the arm. Anat Rec 1933; 55: 403-409.
- Quain R. The anatomy of the arteries of the human body. London: Taylor and Walton; 1884.
- Jorge- Barreiro FJ, Valdecaseas- Huelin JMG. Etude a l’aide de la radio- anatomie de la vascularisation de l’avant- bras et de la main: acquisitions recentes. In Traite de Chirurgie de la Main. Volume1. Edited by Toubiana R. 1991; 329-346.
- D’Costa S, Narayana K, Narayan P, Jiji, Nayak SR, Madhan SJ. Occurence and fate of palmar type of median artery. ANZ J Surg 2006; 76: 484-487.
- Durgesh V, Ramana Rao R. Persistent median artery. International Journal of Basic and Applied Medical Sciences 2013; 3(1): 284-286.
- Kumar P, Kulkarni R. Persistent palmar pattern of median artery bilaterally. Int J Anat Res 2013; 1(2): 43-45.
- Joshi SB, Vatsalaswamy P, Bhahetee BH. Median artery in formation of superficial palmar arch: A cadaveric study. Int J Med Res health sci 2013; 2(3): 545-550.
- Raviprasanna KH, Dakshayani KR. Persistent median artery in the carpal tunnel. Int J Anat Res 2014; 2(3): 589-593.
- Coleman SS, Anson BJ. Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynecol Obstet 1961; 113: 409-424.
- Tsuruo Y, Ueyama T, Ito T, Nanjo S, Gyobu H, Satoh K et al. Persistent median artery in the hand: A report with a brief review of literature. Anatomical Science International 2006; 81: 242-252.
- Vollala VR, Nagabhooshana S, Bhat SM, Potu BK, Rodrigues V, Pamidi N. Multiple arterial, neural and muscular variations in upper limb of a single cadaver. Romanian Journal of Morphology and Embryology 2009; 50(1): 129-135.
- Singla RK, Kaur N, Dhiraj GS. Prevalance of the persistent median artery. JCDR 2012; 6(9): 1454-1457.
- Sanudo JR, Chikwe J, Evans SE. Anomalous median nerve associated with persistent median artery. J Anat 1994;185: 447-451.
- Agarwal P, Gupta S, Yadav P, Sharma D. Cadaveric study of anatomical variations of the median nerve and persistent median artery at wrist. Indian J Plast Surg 2014; 47: 95-101.
- Manners ST. The limb artery of primates. J Anat Physiol 1910; 45: 23-64.
- Arey LB. Developmental Anatomy. In Development of the Arteries. 6th edition. Philadelphia: W.B. Saunders Co; 1957: 375-377.
- Keibel F, Mall FP. Manual of Human Embryology. In Development of blood vascular system- The arteries. Volume 2. 1st edition. Edited by Minot CS, Evans HM, Tandler J and Sabin FR. Phildelphia & London: J.B. Lippincot Co; 1912: 659- 667.
- Neyert JP. Sur l’ anatomie compare des arteres de l’ avnatbras chez les mammiferes domestiques. I. Le systeme des arteres radials. Zentralblatt fur Veterinarmedizin C. Anatomia, Histologia, Embryologia 1979; 8: 340-359.
- O’Donaghue CH. The blood vascular system of the Tautara, Sphenodon punctatus. Volume 210. Philosophical Transactions of the Royal Society 1920; 175-252.
- Williams PL, Bannister LH, Berry MM, Standring S, Collins P, Dyson M, Dussek JE et al. Embryology and development, The nervous system. In Gray’s Anatomy. 38th edition. Edinburgh, London: Churchill Livingstone; 1995: 230-237, 1266-1274.
- Huber GC. The vascular system. In Piersol’s Human Anatomy. 9th edition. Philadelphia, Montreal, London: J.B. Lippincott Co.; 1930: 767-791.
Bhagya Shree, Meenakshi Khullar, Ashwini Kumar, Zora Singh. STUDY OF PALMAR TYPE OF MEDIAN ARTERY AND ITS FATE. Int J Anat Res 2015;3(3):1267-1272. DOI: 10.16965/ijar.2015.207