An unusual variation of the superficial ulnar artery

Anomalous superficial ulnar arteries were found bilaterally during routine dissection of the upper limbs of a 60-year-old male cadaver. In the left arm, the superficial ulnar artery originated from the axillary artery. It crossed the median nerve anteriorly and ran anteromedial to this nerve and the brachial artery. The superficial ulnar artery was also rudimentary and gave rise to only a narrow muscular branch to the biceps brachii. In the hand, it anastomosed with the radial artery, completing the superficial palmar arch. The radial artery was larger than usual and the deep palmar arch was formed only by the radial artery. In the right arm, the superficial ulnar artery originated from the brachial artery at the level of the inter-epicondylar line. Additionally there were “inverse palmaris longus muscles” bilaterally. This was a rare case in which the superficially ulnar artery originated from a different source on each side accompanied by anomalies of the palmar arches on one side.     

Superficial ulnar artery originating from the brachial artery and its clinical importance

Summary We found a left superficial ulnar artery in the cadaver of a Japanese woman. This anomalous vessel originated from the brachial artery at a site 55 mm distal to the inferior border of the teres major muscle and medial to the median nerve, ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. It formed superficial and deep palmar arches with the radial artery. The clinical importance of the anomalous ulnar artery is discussed.

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Artère ulnaire superficielle naissant de l'artère brachiale. Importance clinique

Résumé Nous avons trouvé une artère ulnaire superficielle gauche sur le cadavre d'une japonaise. Cette artère ulnaire anormale naissait de l'artère brachiale, 55 mm distalement au bord inférieur du m. grand rond et médialement au n. médian, se dirigeait distalement et médialement, courrait superficiellement aux mm. fléchisseurs de l'avant-bras, puis atteignait la main. Elle formait les arcades palmaires superficielle et profonde avec l'artère radiale. L'importance clinique cette artère ulnaire anormale est discutée.

     

Superficial ulnar artery originating from the brachial artery and its clinical importance

We found a left superficial ulnar artery in the cadaver of a Japanese woman. This anomalous vessel originated from the brachial artery at a site 55 mm distal to the inferior border of the teres major muscle and medial to the median nerve, ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. It formed superficial and deep palmar arches with the radial artery. The clinical importance of the anomalous ulnar artery is discussed.     

The superficial ulnar artery: incidence and calibre in 95 cadaveric specimens

The superficial ulnar artery (SUA) is an anatomical variation of the upper limb vasculature with a prevalence of 0.7-9.4% in the population. The importance of this variant is that it may be cannulated inadvertently by an unsuspecting physician, leading to possible ischemia of the hand. With the growing use of radial forearm flaps, the surgeon needs to be aware of its presence during surgery and be able to adapt the procedure accordingly. The aims of the study focus on the incidence and calibre of the SUA. Ninety-five cadaveric limbs were dissected and the calibre of the different arteries measured. Four SUAs (4.2%) were found, all in male cadavers. Two of these were from the same cadaver. Measurements of the calibre of the vessels showed that the SUA was smaller than the ulnar artery. Of the limbs dissected, 4.2% had an SUA, which is a similar prevalence to other studies in Western Europe. It is most commonly found in males, unilaterally and in the right upper limb. It is extremely rare to experience consequences from intra-arterial cannulation and the SUA may have more of a beneficial role in reconstructive fasciocutaneous forearm flaps.     

Variant origin of the ulnar artery

Axillary origin of the ulnar artery was observed during an angiographic examination of the upper extremity. The ulnar artery originated from the axillary artery at the level of the anterior and posterior circumflex humeral arteries. No additional anomalies were observed. Accurate knowledge about unusual patterns of the arteries of the upper extremities is important in order to be aware of hidden hazards during diagnostic and therapeutic preparations. Clin. Anat. 11:62–64, 1998. © 1998 Wiley-Liss, Inc.     

The superficial ulnar artery: Development and surgical significance

The upper limbs of 72 formalin-fixed human cadavers were examined by dissection for arterial anomalies. In one subject, the ulnar artery was noted to be a branch of the second part of the axillary artery on both right and left sides. It ran a superficial course in the arm, crossed the elbow immediately subjacent to the median cubital vein, and continued its course in the forearm in a subcutaneous position. In the hand it played a dominant role in the formation of the superficial palmar arch. The anomalous ulnar artery was of a smaller caliber than both the radial and common interosseous arteries. Although superficial ulnar arteries have been reported in the literature, the combination of bilateral superficial ulnar arteries originating from the axillary arteries appears to be rare. The developmental and surgical significance of the findings are discussed. © 1996 Wiley-Liss, Inc.     

Superficial ulnar artery terminating in a normal ulnar artery

Routine dissection of the left upper limb of an 86-year-old male cadaver showed a superficial ulnar artery that anastomosed with the ulnar artery. The superficial ulnar artery arose from the third part of the axillary artery, coursed distally over the flexor muscles of the forearm, and terminated by anastomosing with the ulnar artery in the distal third of the forearm. Arterial and neural variations were also observed on the contralateral side. The presence of a superficial ulnar artery is important clinically when raising forearm flaps in reconstructive surgery.     

The superficial ulnar artery originating from the left brachial artery

An anomalous superficial ulnar artery was found in the left arm of a 60-year-old man during anatomical dissection. It originated from the brachial artery approximately 6 cm distally to profound brachial artery. It crossed over the median nerve and coursed ventral to the nerve, but inferior to the bicipital aponeurosis and superficial to the flexor muscles. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The clinical importance of the anomalous ulnar artery is discussed.     

Unique case of trifurcation of the brachial artery: its clinical significance

The variability of the arteries in the upper extremity is considerable. This case is a report of a trifurcation of the brachial artery that divided into radial, ulnar, and superior ulnar collateral arteries high in the arm; the length of the brachial artery was only 4.9 cm. Because the upper extremity is a frequent site of injury, various surgical and invasive procedures are performed in this region; consequently, it is of utmost importance to be aware of arterial variations. For some medical procedures, there may be an increased risk of complications because of variant vessels; however, for other procedures, they may be beneficial. In addition to presenting a detailed anatomic study of the case, the clinical significance of the variation has been addressed.     

A morphometric study on the superficial palmar arch of the hand

The vascular anatomy of the hand is a complex and challenging area and has been the subject of many studies. Knowledge of the vascular patterns and diameters of the hand gained more importance with improvements in microsurgical techniques in reconstructive hand surgery. We evaluated 50 hands (26 left, 24 right) of 26 formalin preserved cadavers to determine the superficial palmar arch, its branches and contributing vessels with special attention to the diameters. The symmetry of the types was also evaluated in detail for the first time in the literature. Measurements were made with the help of a digital caliper. The diameters of the ulnar, radial and median arteries were taken at the level of the wrist while the common palmar digital arteries, hypothenar branches and the superficial palmar branch of the radial artery were measured at their origin. Two types of superficial palmar arch were found and defined as complete (43/50 hands) and incomplete arches (7/50 hands). The complete arches were divided into four subgroups and incomplete arches into three subgroups. Most cases were found at the complete AI group (17 hands). Comparison of the arterial diameters showed the ulnar artery was the dominant vessel of the palm. The diameters of the common palmar digital arteries were not different with regard to complete or incomplete arches and between both sides. It looks safe to sacrifice one of the radial or ulnar arteries in some arterial interventions including radial artery cannulation, radial forearm flap and radial or ulnar artery harvesting for bypass grafting if the arch is complete. But we still recommend the noninvasive tests like modified Allen test or Doppler ultrasonography, before performing an invasive arterial intervention. We propose the radiologists to incorporate the median artery into the Doppler dynamic test in particular the existence or the absence of anastomoses between radial and ulnar arteries.This study was accepted as an oral presentation in the “IX National Congress of Anatomists, 7–10 September 2005, Kusadasi, Turkey”     

Variations of the superficial brachial artery in Korean cadavers

The superficial brachial artery (SBA), a branch of the axillary artery, is one of the most common arterial variations in this area. While it is more vulnerable to accidental arterial injection or injury, it could be useful for the nourishment of a medial arm skin free flap. To analyze the relationship between the SBA of axillary origin and segmental variation of the axillary artery, we dissected 304 arms of Korean cadavers. We found an SBA of axillary origin in 12.2% of cadaveric arms. Unilateral occurrence was detected in 16 cadavers and bilateral in 10. SBAs gave rise to radial and ulnar arteries in the cubital fossa (8.9%), continued in the forearm as the radial artery (2.3%), or ended in the upper arm (1.0%). The SBA ended as ulnar artery was not found in any of the cadavers. The bifurcation of the SBA into the radial and ulnar arteries, presence of an SBA that ends in the upper arm, and the lack of continuation as the ulnar artery are characteristics of SBAs in Korean cadavers.     

尺动脉近中段肌间隙穿支皮瓣的应用解剖

目的:为尺动脉肌间隙穿支皮瓣移植提供解剖学基础。方法:在14侧红色乳胶灌注的成人上肢标本上,解剖观测尺动脉肌间隙穿支的支数、外径、走行、分支和分布。6侧上肢动脉铸型标本作对照观察。结果:尺动脉肌间隙穿支距肱骨内上髁下方(9.2±0.2)cm起自尺动脉,沿指浅屈肌与尺侧腕屈肌之间走行,穿肌间隙和深筋膜,与前臂其他皮支呈弓形吻合。干长(1.9±0.2)cm,外径(0.8±0.2)mm。结论:以尺动脉肌间隙穿支为蒂的前臂近中段皮瓣,可用于修复前臂及手部软组织缺损。     

A rare human variation a major branch of the ulnar artery found in the carpal tunnel

Abstract During a routine anatomic dissection of a 60-year-old female cadaver, a large branch of the ulnar artery in the carpal tunnel was found in the left forearm. This branch crossed the median nerve anteriorly. Guyon’s canal contained another branch of the ulnar artery and the ulnar nerve. There was no superficial palmar arch in the left hand. The right forearm was without any vascular anomalies. This anomaly has considerable consequences for surgeons considering endoscopic carpal release, because there is a significant risk of injury to the ulnar artery branch.     

Report of a rare human variation: the superficial ulnar artery arising from the axillary artery

A rare variation of the ulnar artery is presented on routine anatomical dissection in one male cadaver. The superficial ulnar artery was found to originate from the axillary artery. The free forearm flap is increasingly popular among plastic surgeons. As a result of this case, and a review of the literature to gain further knowledge of anatomical variations, it is advised that more attention should be paid clinically to this artery to prevent its injury.     

大鼠腹壁浅动脉皮瓣游离移植至腋窝模型的构建技巧

目的 推介将大鼠腹壁浅动脉皮瓣游离移植至腋窝的具体操作步骤。 方法 选取体重420 ~ 450 g的清洁级SD雄性大鼠20只,麻醉成功后备皮,设计以腹壁浅血管为蒂的4 cm × 2 cm腹股沟皮瓣,游离移植至腋窝,以胸外侧血管为受区血管,重点观察：股血管及胸外侧血管的起源、走行与分支,测量其外径和长度;大鼠生存状态;术后第7 d皮瓣存活情况。 结果 股动、静脉的管径分别为（0.72± 0.08）mm及（1.29±0.17）mm,胸外侧动、静脉的管径分别为（0.59±0.18）mm及（1.04±0.12）mm,两者适合做端端吻合。术后有2只大鼠死亡,另有3只大鼠皮瓣完全坏死,皮瓣存活率达75%。由于股动脉的破坏,患肢术后会出现跛行,1周后,随着血供的代偿,大鼠的步态逐渐恢复正常。 结论 大鼠腹壁浅动脉游离皮瓣是超级显微外科的基础研究与临床前操作练习的有效模型之一。     

A case of ectopic right renal artery: a radiologic-anatomic variant

Summary The authors report the anatomic and radiologic findings in a case of ectopic origin of the right renal artery in front of the T11–12 intervertebral disc. This seems to be an extremely rare variant, and the rarity of the reported cases is such as not to allow definition of a percentage incidence. An explanation of this variant may be found in modern concepts of the organogenesis of the renal artery.

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Une observation d'artère rénale droite ectopique

Résumé Les auteurs rapportent une observation anatomo-radiologique d'origine ectopique d'une artère rénale droite devant le disque T 11–12. Cette variation paraît extrêmement rare, sans que l'étude de la littérature et des rares cas publiés permette de fixer un pourcentage. Une explication de cette variation peut être trouvée dans les conceptions modernes de l'organogénèse de l'artère rénale.

     

低位尺浅动脉1例

在解剖一具成年男性标本时，发现其右侧低位尺浅动脉，桡动脉发骨间总动脉的异常，此种变异较为少见。现报道如下：     

Sciatic artery: a case,review of literature and attempt of systemization

Summary The authors describe a new case of persistent sciatic artery not yet described in the literature. This case is to be added to the four already existing classes of arterial vascularization of the pelvic members of certain animal species. This vascularization concerns two arteries of unequal significance according to the species. An embryological study of this vascularization is also performed. Following these studies, the authors will attempt an arterial systemization and parallel comparison of the different types of animal and embryologic vascularization and human variations of normal.

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Artère ischiatique : à propos d'un cas, revue de la littérature et essai de systématisation

Résumé Les auteurs rapportent un nouveau cas de persistance de l'artère sciatique non encore décrit dans la littérature. Ce cas vient s'ajouter aux quatre classes déjà existantes. Les auteurs font une étude anatomique comparée de la vascularisation artérielle des membres pelviens de certaines espèces animales. Cette vascularisation est le fait de deux artères d'importance inégale selon les espèces. De plus une étude embryologique de cette vascularisation est faite. A la suite de ces études, les auteurs proposent un essai de systématisation artérielle et une mise en parallèle des différents types de vascularisation animales, embryologiques et des variantes humaines de la normale.

     

Rare case of high origin of the ulnar artery from the brachial artery

Arterial variations in the arm are numerous and occur at the level of the axillary, brachial, radial, and ulnar arteries as well as in the palmar arches. We report on a high branching site of the ulnar artery. A high branching brachial artery was found in a 72-year-old white female during a dissection course. The brachial region was then dissected carefully and the preparation steps were documented. The axillary artery, after entering the arm, was located posterior to the junction of the two roots of the median nerve, just 2 cm distal to the latter, and divided into the ulnar and the radial arteries. The radial artery was located medial to the median nerve in the arm and approached the lateral side of the arm to reach the cubital fossa. Just distal to its origin, the ulnar artery ran laterally crossing ventral to the median nerve, thereafter supplying the biceps brachii muscle with three branches from a common stem. The ulnar artery then approached the medial side of the arm, crossed ventral to the median nerve again and took its course toward the cubital fossa as usual. This high bifurcation of the brachial artery and the abnormal course of the ulnar artery is of interest to clinicians; in particular vascular and plastic surgeons and radiologists. Clin. Anat. 10:253–258, 1997. © 1997 Wiley-Liss Inc.