Blood Supply of the Hand – Overview of Arterial Supply to Upper Limb

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.