VESSELS OF FORE ARM AND HAND
LEARNING OBJECTIVES
AT the end of lecture the student should able to know about:
 Different kinds of vessels in forearm and hand
 Location, destination and course of radial and ulnar artery in forearm and hand
 Relations of radial and ulnar artery in forearm and hand
 Branches of radial and ulnar artery in forearm and hand
 Formation of superficial and deep palmar arch
 Superficial and deep veins of forearm and hand and their tributaries
ARTERIES OF FOREARM AND HAND


Radial artery
Ulnar artery
RADIAL ARTERY
 It arises from the brachial artery
 It is continuation of the brachial artery
 It is one of the terminal branch of the brachial artery
 It arise from the brachial artery at the level of the neck
of the radius
 It travels along the radial side of the forearm
 It winds backward around the carpus to the lateral side
 It passes below the tendons of the abductor pollicus
longus and the extensor pollicus longus and brevis
 It reaches the upper end of the space between the
metacarpal bones of the Thumb and the index finger
Termination of the radial artery
 It passes through the two heads of the First dorsal interosseous and enter into the
palm
 It crosses the metacarpal bones and reaches the ulnar side
 It joins the deep volar branch of the ulnar artery and forms the deep volar arch of
the palm
Divisions
The radial artery is divided into 3 parts:
 Radial artery in the forearm
 Radial artery on the dorsum of the wrist
 Radial artery in the hand
Radial artery in the forearm
 In the forearm it extends from the neck of the radius
 It reaches to the styloid process of the radius
 In the proximal part it is medial and in the lower part it is in front
of the radius
 The radial artery is accompanied by the venae commitantes
through out its course
Anterior relations of radial artery in forearm
 Its proximal part is covered by the brachialis
 The lower part of the radial artery is superficial and anterior to it is
skin, superficial and deep fascia
Posterior relations of the radial artery in the forearm
 Biceps brachii
 Supinator
 Pronator teres
 Radial head of the flexor digitorium sublimis
 Flexor pollicis longus
 Pronator quadratus
 Radial bone
Radial artery at the wrist

It reaches the wrist by passing between the radial
collateral ligament of wrist and the abductor pollicis
longus and extensor pollicis brevis
Radial artery in the hand
 It passes through the 1st interosseous space between the two heads of the first
dorsal interosseous muscle
 It passes transversely on the abductor pollicis obliques and the adductor pollicis
transverse
 At the base of the metacarpal bone of the little finger it anastomosis with the deep
volar branch of the ulnar artery and complete the deep volar arch
BRANCHES OF THE RADIAL ARTERY
 Branches on the forearm
1.Radial recurrent
 Arises from radial artery just below its origin and
ascend on supinator and then between brachialis
and brachioradialis
 Anastomose with radial collateral branch of
profunda brachii artery
2.Muscular
3.palmar carpal
 Joins the palmar carpal branch of ulnar to form
volar carpal arch
4.Superficial palmar branch
 Passes through the thenar muscle and anastomoses with superficial branch
of ulnar artery to complete superficial palmar arterial arch
 Branches of the radial artery at the wrist
1. Dorsal carpal
 Join the dorsal carpal branch of ulnar artery and the dorsal terminal branch
of anterior interosseous artery
2. 1st dorsal metacarpal
 Branches of the radial artery in the hand
1. Princple pollicis
 Descend along the medial border of first
metacarpal bone
 Divides into two proper digital arteries for
each side of thumb
2. Volaris indicis radilis
 Also may arise from princes pollicis or deep
palmar arch
3. Volar metacarpal
4. Perforating
5. Recurrent
ULNAR ARTERY
COURSE
 It arises from the brachial artery
 It originate at the level of the radial neck
 It travel on the ulnar side of the forearm and reach
midway between the elbow and the wrist
 It crosses the transverse carpal ligament on the
radial side of the Pisiform bone, and
immediately beyond this bone it divide into two
branches which enter into the formation of the
Superficial and deep volar arches
Relations
 It is deeply lying structure
Anterior relations in forearm:
It is covered by the
1. Pronator teres
2. Flexor carpi radialis
3. Palmaris longus
4. Flexor digitorium sublimis
Posterior relation in forearm:
It lies on the
1.Brachialis
2.Flexor digitorium profundus
 It accompanied by the venae commitantes on both the sides
through out its course
Relations in wrist

At the wrist it lies on the transverse crapal ligament and it is medial to the
pisiform bone and ulnar nerve is some what posterior to it
BRANCHES OF THE ULNAR ARTERY
The branches are arranged as under:
1. Branches in the forearm
2. At the wrist
3. In the hand
 Branches of the ulnar artery in forearm
1. Anterior recurrent
 Anastomose with inferior ulnar collateral artery
2. Posterior recurrent
 Anastomose with superior ulnar collateral artery
3. Common interosseous
 Arises from lateral side of ulnar artery and
divides into:
a) Anterior interosseous artery
 Descends with anterior interosseous
nerve in front of interosseous
membrane
 Perforate the interosseous membrane to
anastomose with posterior
interosseous and joins dorsal carpal network
b) Posterior interosseous artery
 Gives rise to interosseous recurrent artery that anastomose with
middle collateral, a branch of profunda brachii
 Descend behind the interosseous membrane
 Anastomose with anterior interosseous
4. Muscular
 Branches at the wrist
1. Volar carpal
 Joins the volar (palmar) carpal branch of radial to form palmar carpal arch
2. Dorsal carpal
 Joins the dorsal carpal branch of radial artery
Branches of the ulnar artery in the hand
1. Deep volar(palmar) branch
 Arises in front of flexor retinaculum
 Accompanies deep palmar branch of ulnar nerve through hypothenar
muscles
 Anastomose with radial artery to complete deep palmar arch
2. Superficial volar(palmar) arch
 Main termination of ulnar artery
 Completed by anastomosing with superficial palmar branch of radial
VESSELS OF HAND
 SUPERFICIAL PALMAR(VOLAR) ARTERIAL ARCH
 DEEP PALMAR (VOLAR) ARTERIAL ARCH
SUPERFICIAL PALMAR ARTERIAL ARCH:
 Direct continuation of ulnar artery
 Completed on the lateral side by superficial palmar branch of radial
 Lies immediately under the palmar aponeurosis
 Lies in front of long flexor tendons
 Curve of arch lies across the palm at the level of distal border of fully extended
thumb
 Four digital arteries arise from convexity of arch and supply fingers
DEEP PALMAR ARTERIAL ARCH:
 Direct continuation of radial artery
 Completed on medial side by deep palmar branch of ulnar
 Lies beneath the long flexor tendon
 Lies in front of metacarpal bones
 Curve of arch lies at the level of proximal border of fully extended thumb
 Gives rise to palmar metacarpal arteries that anastomose with common palmar
digital arteries
VEINS OF FOREARM AND HAND
 Veins of palm
 Dorsal venous arch
 Venae commitant in forearm
VEINS OF PALM:


Superficial and deep palmar venous arches accompanies corresponding
arterial arches
Tributaries corresponds to branches of arterial arches
VENAE COMMITANT IN FOREARM:
 Radial and ulnar arteries are accompanied by the venae commitantes on both the
sides through out their course
 These venae commitant join to form venae commitant of brachial vein
DORSAL VENOUS ARCH
 Lies on the dorsum in subcutaneous tissue
 Lies proximal to metacarpophalangeal joints
 Drains on lateral side into cephalic and medial side into basilic vein