00:01
We’ll see this later on. So now let’s move to the
hand and the blood supply to the hand, which
is really formed from the radial and the ulnar
artery forming deep and superficial palmar
arches, which we can just make out on this
diagram here. So we’ll talk about the palmar
arches. So, all the arterial blood to the
hand, like I said, is supplied via the radial
and ulnar arteries. And they form two palmar
arches that run across the central compartment
of the hand, superficial and deep. If we just
look at the ulnar artery, first of all, then
the ulnar artery we can see enters anterior
to the flexor retinaculum. Remember, it’s
running in Guyon’s or the ulnar canal. It’s
running between pisiform and the hook of hamate.
00:51
It’s running into the hand. We can see its
giving rise to its palmar and dorsal carpal
branches here. And then as it progresses towards
the central compartment of the hand, it gives
rise to the deep palmar branch. So we can
see that the ulnar artery is then giving rise
to the deep palmar branch that goes around
here. But the main trunk of the artery carries
on and it passes superficial to the long flexor
tendons and it forms the superficial palmar
arch which we can see here. So it enters,
it gives rise to those carpal branches.
01:31
It then gives rise to a deep palmar branch we'll
come back to in a moment. But the main trunk
of the artery carries on and it forms this
loop, the superficial palmar arch. The superficial
palmar arch will ultimately become the superficial
palmar branch which is coming from the radial
artery. And here, we can see we have a complete
anastomosis. Superficial palmar branch here
coming from the radial is uniting with the
superficial palmar arch. And we can see that
running superficially within the hand. This
artery gives off three common palmar digital
arteries. So we can see one, two, three.
Coming from the superficial palmar arch, we
have three common palmar digital arteries.
And these are going to anastomos with palmar
metacarpal arteries arising from the deep
palmar arch, and they go on to supply the
digits via proper palmar digital arteries.
So we can see this here. We’ve got our common
palmar digital arteries and they are going
to give rise to these palmar digital arteries
as we can see here. And these are going to
supply the tendons and the distal digits.
02:53
The superficial palmar arch unites with the
radial artery to complete the arch.
02:58
Remember, that’s done via this superficial palmar
branch here. If we look at the radial artery,
the radial artery wraps around the lateral
aspect of the wrist, and it runs along the
floor of the anatomical snuff box. So we can
see the radial artery here is then going laterally
and it’s going within the anatomical snuff
box, and then it’s passing between the heads
of the first dorsal interosseous muscle. It
then passes into the palm of the hand by going
through the heads of the first dorsal interosseous
muscle. It continues medially across the base
of the metacarpals, we can see the base of
the metacarpals here. And it unites with the
deep palmar branch. So here we can see we’ve
got the deep palmar branch again coming off
the ulnar and this is uniting with that continuation
of the radial artery. And this forms the deep
palmar arch that’s running all the way around
here. We now have two complete circuits.
04:03
We have two complete palmar arches. We have
the superficial palmar arch which is coming
primarily from the ulnar artery but connects
to the radial, and we have the deep palmar
arch that is coming primarily from the radial
artery and is in connection with the ulnar artery.
04:23
The deep palmar arch gives rise to three palmar
metacarpal arteries. I’ve mentioned these
arteries in the last slide. And this anastomose
we can see here or palmar metacarpal arteries,
we can see this anastomosing with our common
palmar digital arteries. So again, as these
common palmar digital arteries are supplying
the digits, they’re having an input from
both the superficial via the common palmar
digital arteries, and they’re also having
a contribution from the palmar metacarpal
arteries. So these digits are then supplied
by both the superficial and the deep palmar
arch. The deep palmar arch, which we can see
here, also gives off the princeps pollicis
artery and that passes towards the thumb,
and then it also gives off the radialis indices
artery that specifically goes to the
index finger. So we can see we’ve now got all of
the digits and the thumb covered by these
digital branches that are coming from either
the superficial or the deep palmar arch.
05:33
So in this lecture, we have reviewed the blood
supply to the upper limb, looking at the blood
supply to the axilla, the arm, the forearm,
and the hand. We looked at the axillary artery,
its three divisions and branches, and anastomosis
around the scapula. We then looked at the
branches coming from the brachial artery,
specifically the profunda brachii and some
collateral branches that supplied the elbow.
We then looked at the ulnar and radial arteries,
the recurrent and collateral branches forming
anastomosis around the elbow. We looked at
the blood supply to the deep musculature via
interosseous branches, and then the two carpal
arches, very briefly, the palmar and dorsal
coming from the radial and ulnar arteries.
06:15
We finished by looking at the superficial
and the deep palmar arches. These are supplied
by the ulnar and the radial arteries
to supply the digits of the hand.