High origin of a superficial ulnar artery arising from the axillary artery: anatomy, embryology, clinical significance and a review of the literature

• Autorzy: Natsis K , Papadopoulou A.L. , Paraskevas G. , Totlis T. , Tsikaras P.
• Języki publikacji: EN

Abstrakty

EN

The superficial ulnar artery (SUA) is an ulnar artery of high origin that lies superficially in the forearm. Its reported frequency ranges from 0.17% to 2%. During anatomical dissection in our department we observed a unilateral case of SUA in a 75-year-old white male human cadaver. It originated from the right axillary artery at the level of the junction of the two median nerve roots and followed a looping course, crossing over the lateral root of the median nerve and running lateral to it in the upper and middle thirds of the arm, whereas in the inferior third of the arm the SUA crossed over the median nerve and ran medially to it. In the cubital fossa, it passed superficially over the medial side of the ulnar aponeurosis and coursed subcutaneously in the ulnar side of the forearm superficially to the forearm flexor muscles. In the hand the SUA anastomosed with the superficial palmar branch of the radial artery, creating the superficial palmar arch. Additionally, it participated in the development of the deep palmar arch. The axillary artery, after the origin of the SUA, continued as the brachial artery and divided into the radial and common interosseous arteries in the cubital fossa. The normal ulnar artery was absent. No muscular or other arterial variations were observed in this cadaver. The embryological interpretation of this variation is difficult and it may arise as a result of modifications to the normal pattern of capillary vessel maintenance and regression. The existence of a SUA is undoubtedly of interest to the clinician as well as to the anatomist. This report presents a case of unilateral SUA along with a review of the literature, embryological explanation and analysis of its clinical significance.

Słowa kluczowe

EN

superficial ulnar artery; artery; anatomical variation; axillary artery; anatomy; embryology; clinical significance; upper limb; forearm flap

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2006
• Tom: 65
• Numer: 4
• Opis fizyczny: p.400-405,fig.,ref.

Twórcy

autor

Natsis K

• University of Thessaloniki, P.O. Box: 300 Postal Code, 541 24, Thessaloniki, Greece

autor

Papadopoulou A.L.

autor

Paraskevas G.

autor

Totlis T.

autor

Tsikaras P.

Bibliografia

• 1. Adachi B (1928) Das Arterien System der Japaner. Kyoto, Maruzen, 1: 285–356.
• 2. Aharinejad S, Nourani F, Hollensteiner H (1997) Rare case of high origin of the ulnar artery from the brachial artery. Clin Anat, 10: 253–258.
• 3. Anson JB, Maddock WG (1958) Callander’s surgical anatomy, 4th ed. W.B. Saunders Company, Philadelphia, London, pp. 823–824.
• 4. Arey LB (1965) Developmental anatomy. A text book and laboratory manual of embryology, 7th ed. W.B Saunders Company, Philadelphia, London, pp. 350–360.
• 5. Breme G (1899) Casuistischer Beitrag zur Kenntnis der Anomalien der Armarterien. Z Morphol Anthropol, 1: 483–494.
• 6. Collins P (1995) Embryology and development. In: Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, Ferguson MW (ed.). Gray’s anatomy. The anatomical basis of medicine and surgery. 38th ed. Churchill Livingstone, UK, pp. 318–320.
• 7. Devansh MS (1996) Superficial ulnar artery flap. Plast Reconstr Surg, 97: 420–426.
• 8. Fadel RA, Amonoo-Kuofi HS (1996) The superficial ulnar artery: development and surgical significance. Clin Anat, 9: 128–132.
• 9. Fonseka WR, Rajamantri SD, Sheriffdeen AH (2002) Ulnar basilic arteriovenous fistula: an alternative. Transplant Proc, 34: 2412.
• 10. Funk GF, Valentino J, McCulloch TM, Graham SM, Hoffman HT (1995) Anomalies of forearm vascular anatomy encountered during elevation of the radial forearm flap. Head Neck, 17: 284–292.
• 11. Fuss FK, Matula CW, Tschabitscher M (1985) Die Arteria brachialis superficialis. Anat Anz, 160: 285–294.
• 12. Gormus G, Ozcelik M, Hamdi Celik H, Cekirge S (1998) Variant origin of the ulnar artery. Clin Anat, 11: 62–64.
• 13. Gruber W (1867) Archiv fur Anatomie. Physiologie und Wissenschaftliche Medizin, pp. 668–687.
• 14. Hazlett JW (1949) The superficial ulnar artery with reference to accidental intra-arterial injection. Can Med Assoc J, 61: 289–293.
• 15. Huelke DF (1959) Variations in the origin of the branches of the axillary artery. Anat Rec, 135: 33–41.
• 16. Jacquemin G, Lemaire V, Medot M, Fissete J (2001) Bilateral case of superficial ulnar artery originating from axillary artery. Surg Radiol Anat, 23: 139–143.
• 17. Kinnaert P (1995) Relevance of the ulnaris fistula as a dialysis shunt. Nephrol Dial Transplant, 10: 2379.
• 18. Latha VP, Anuradha L, Narayana K (2002) A case of superficial ulnar artery associated with retrobrachial median nerve. Folia Anat, 30: 49–51.
• 19. Mannan A, Saricioglu L, Ghani S, Hunter A (2005) Superficial ulnar artery terminating in a normal ulnar artery. Clin Anat, 18: 602–605.
• 20. McCormack LJ, Cauldwell EW, Anson BJ (1953) Brachial and antebrachial arterial patterns. A study of 750 extremities. Surg Gynecol Obst, 96: 43–54.
• 21. McWilliams RG, Sodha I (2000) Doppler ultrasound diagnosis of a superficial ulnar artery. Eur J Ultrasound, 12: 155–157.
• 22. Miller RA (1939) Observations upon the arrangement of the axillary artery and the brachial plexus. Am J Anat, 64: 143–163.
• 23. Muller E (1903) Beitrage zur Morphologie des Gefassystems. I. Die Armarterien des Menschen. Anatomische Hefte, 22: 377–575.
• 24. Nakatani T, Tanaka S, Mizukami S, Shiraishi Y, Nakamura T (1996) The superficial ulnar artery originating from the axillary artery. Ann Anat, 178: 277–279.
• 25. Nakatani T, Tanaka S, Mizukami S (1998) Superficial ulnar artery originating from the brachial artery and its clinical importance. Surg Radio Anat, 20: 383–385.
• 26. Poteat WL (1986) Report of a rare human variation: absence of the radial artery. Anat Rec, 214: 89–95.
• 27. Quain R (1844) The anatomy of the arteries of the human body. Taylor and Walton, London.
• 28. Rodriguez-Baeza A, Nebot J, Ferreira B, Reina F, Perez J, Sanudo JR, Roig M (1995) An anatomical study and ontogenic explanation of 23 cases with variations in the main pattern of the human brachio-antebrachial arteries. J Anat, 187: 473–479.
• 29. Rodriguez-Niedenfuhr M, Burton GJ, Deu J, Sanudo JR (2001) Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations. J Anat, 199: 407–417.
• 30. Rodriguez-Niedenfuhr M, Sanudo JR, Vazquez T, Nearn L, Logan B, Parkin I (2000) Anastomosis at the level of the elbow joint connecting the deep, or normal, brachial artery with major arterial variations of the upper limb. J Anat, 196: 115–119.
• 31. Rodriguez-Niedenfuhr M, Vazquez T, Nearn L, Ferreira B, Parkin I, Sanudo JR (2001) Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature. J Anat, 199: 547–566.
• 32. Sanudo JR, Mirapeix RM, Garcia R, Rodriguez-Nidenfunr M (1998) A superficial ulnar artery anastomosing with a larger anterior interosseous artery to supply the wrist and hand. J Anat, 192: 439–441.
• 33. Uglietta JB, Kadir S (1989) Arteriographic study of variant arterial anatomy of variant arterial anatomy of the upper extremities. Cardiovasc Intervent Radiol, 12: 145–148.
• 34. Weathersby HT (1956) Unusual variation of the ulnar artery. Anat Rec, 124: 245–248.
• 35. Weathersby HT (1956) Anomalies of brachial and antebrachial arteries of surgical significance. South Med J, 49: 46–49.
• 36. Yazar F, Kirici Y, Ozan H, Aldur MM (1999) An unusual variation of the superficial ulnar artery. Surg Radiol Anat, 21: 155–157.