Radial artery

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Radial artery
Gray1237.svg
Palm of left hand, showing position of skin creases and bones, and surface markings for the volar arches.
Gray528.png
Ulnar and radial arteries. Deep view.
Details
Source brachial artery
Branches
Vein radial vein
Identifiers
Latin arteria radialis
MeSH D017534
TA98 A12.2.09.027
TA2 4641
FMA 22730
Anatomical terminology

In human anatomy, the radial artery is the main artery of the lateral aspect of the forearm.

Contents

Structure

The radial artery arises from the bifurcation of the brachial artery in the antecubital fossa. It runs distally on the anterior part of the forearm. There, it serves as a landmark for the division between the anterior and posterior compartments of the forearm, with the posterior compartment beginning just lateral to the artery. The artery winds laterally around the wrist, passing through the anatomical snuff box and between the heads of the first dorsal interosseous muscle. It passes anteriorly between the heads of the adductor pollicis, and becomes the deep palmar arch, which joins with the deep branch of the ulnar artery.

Along its course, it is accompanied by a similarly named vein, the radial vein.

Branches

The named branches of the radial artery may be divided into three groups, corresponding with the three regions in which the vessel is situated.

In the forearm

At the wrist

  • Dorsal carpal branch of radial artery - a small vessel which arises beneath the extensor tendons of the thumb
  • First dorsal metacarpal artery - arises just before the radial artery passes between the two heads of the first dorsal interosseous muscle and divides almost immediately into two branches which supply the adjacent sides of the thumb and index finger; the lateral side of the thumb receives a branch directly from the radial artery.

In the hand

  • Princeps pollicis artery - arises from the radial artery just as it turns medially to the deep part of the hand.
  • Radialis indicis - arises close to the princeps pollicis. The two arteries may arise from a common trunk, the first palmar metacarpal artery.
  • Deep palmar arch - terminal part of radial artery.

Variations

In less than 1% of the population, the radial artery takes a superficial course in the anatomical snuff box. [1] This arterial variation can be mistaken for the cephalic vein as accidental injection of this variant radial artery has been reported. [2] Identifying arterial pulsation in the anatomical snuff box is therefore recommended.

Clinical significance

The radial artery lies superficially in front of the distal end of the radius, between the tendons of the brachioradialis and flexor carpi radialis; it is here that clinician takes the radial pulse. (where it is commonly used to assess the heart rate and cardiac rhythm). Presence of radial pulse was thought to indicate a systolic blood pressure of at least 70 mmHg, as estimated from the 50% percentile, although this was found to generally be an overestimation of a patient's true blood pressure. [3] The radial artery can be less easily felt as it crosses the anatomical snuff box. The radial artery is used for coronary artery bypass grafting and is growing in popularity among cardiac surgeons. [4] Recently, it has been shown to have a superior peri-operative and post-operative course when compared to saphenous vein grafts. [5]

The radial artery is often punctured in a common procedure to obtain an arterial blood gas. Such a procedure may first involve an Allen's test.

The radial artery is also used to evaluate the collateral circulation of blood through the hands; applying pressure through palpating the palmar arches results in paleness over the area being compressed; adequate collateral circulation can be ascertained by how quickly normal colour returns after the pressure is removed. [6]

The radial artery is a common site for the insertion of an arterial line, such as for blood pressure monitoring in an intensive care unit. It is also commonly used for cerebral angiograms for the treatment of cerebral pathologies, such as strokes, [7] cerebral aneurysms [8] It is selected because it is accessible, and because of the low incidence of complications such as thrombosis. [9]

Additional images

Related Research Articles

<span class="mw-page-title-main">Radial nerve</span> Nerve in the human body that supplies the posterior portion of the upper limb

The radial nerve is a nerve in the human body that supplies the posterior portion of the upper limb. It innervates the medial and lateral heads of the triceps brachii muscle of the arm, as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin.

<span class="mw-page-title-main">Median nerve</span> Nerve of the upper limb

The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus.

<span class="mw-page-title-main">Anatomical snuffbox</span> Indent on back of hand between tendons

The anatomical snuff box or snuffbox or foveola radialis is a triangular deepening on the radial, dorsal aspect of the hand—at the level of the carpal bones, specifically, the scaphoid and trapezium bones forming the floor. The name originates from the use of this surface for placing and then sniffing powdered tobacco, or "snuff." It is sometimes referred to by its French name tabatière.

<span class="mw-page-title-main">Femoral artery</span> Large artery in the thigh

The femoral artery is a large artery in the thigh and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery and descends along the anteromedial part of the thigh in the femoral triangle. It enters and passes through the adductor canal, and becomes the popliteal artery as it passes through the adductor hiatus in the adductor magnus near the junction of the middle and distal thirds of the thigh.

<span class="mw-page-title-main">Ulnar nerve</span> Nerve which runs near the ulna bone

In human anatomy, the ulnar nerve is a nerve that runs near the ulna bone. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest in the human body unprotected by muscle or bone, so injury is common. This nerve is directly connected to the little finger, and the adjacent half of the ring finger, innervating the palmar aspect of these fingers, including both front and back of the tips, perhaps as far back as the fingernail beds.

<span class="mw-page-title-main">Scaphoid bone</span> Bone of the carpus

The scaphoid bone is one of the carpal bones of the wrist. It is situated between the hand and forearm on the thumb side of the wrist. It forms the radial border of the carpal tunnel. The scaphoid bone is the largest bone of the proximal row of wrist bones, its long axis being from above downward, lateralward, and forward. It is approximately the size and shape of a medium cashew nut.

<span class="mw-page-title-main">Upper limb</span> Consists of the arm, forearm, and hand

The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the arm, forearm and hand, and is primarily used for climbing, lifting and manipulating objects.

<span class="mw-page-title-main">Ulnar artery</span> Artery of the forearm

The ulnar artery is the main blood vessel, with oxygenated blood, of the medial aspects of the forearm. It arises from the brachial artery and terminates in the superficial palmar arch, which joins with the superficial branch of the radial artery. It is palpable on the anterior and medial aspect of the wrist.

In human anatomy, the extensor pollicis longus muscle (EPL) is a skeletal muscle located dorsally on the forearm. It is much larger than the extensor pollicis brevis, the origin of which it partly covers and acts to stretch the thumb together with this muscle.

<span class="mw-page-title-main">Flexor pollicis brevis muscle</span> Muscle in the thenar compartment

The flexor pollicis brevis is a muscle in the hand that flexes the thumb. It is one of three thenar muscles. It has both a superficial part and a deep part.

<span class="mw-page-title-main">Supinator muscle</span> Muscle of the forearm in humans

In human anatomy, the supinator is a broad muscle in the posterior compartment of the forearm, curved around the upper third of the radius. Its function is to supinate the forearm.

<span class="mw-page-title-main">Extensor pollicis brevis muscle</span>

In human anatomy, the extensor pollicis brevis is a skeletal muscle on the dorsal side of the forearm. It lies on the medial side of, and is closely connected with, the abductor pollicis longus. The extensor pollicis brevis (EPB) belongs to the deep group of the posterior fascial compartment of the forearm. It is a part of the lateral border of the anatomical snuffbox.

<span class="mw-page-title-main">Superficial palmar arch</span>

The superficial palmar arch is formed predominantly by the ulnar artery, with a contribution from the superficial palmar branch of the radial artery. However, in some individuals the contribution from the radial artery might be absent, and instead anastomoses with either the princeps pollicis artery, the radialis indicis artery, or the median artery, the former two of which are branches from the radial artery.

<span class="mw-page-title-main">Deep palmar arch</span>

The deep palmar arch is an arterial network found in the palm. It is usually primarily formed from the terminal part of the radial artery. The ulnar artery also contributes through an anastomosis. This is in contrast to the superficial palmar arch, which is formed predominantly by the ulnar artery.

<span class="mw-page-title-main">Radial artery of index finger</span>

The radialis indicis artery is a branch of the radial artery that provides blood to the index finger.

In anatomy, arterial tree is used to refer to all arteries and/or the branching pattern of the arteries. This article regards the human arterial tree. Starting from the aorta:

The posterior compartment of the forearm contains twelve muscles which primarily extend the wrist and digits. It is separated from the anterior compartment by the interosseous membrane between the radius and ulna.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Extrinsic extensor muscles of the hand</span>

The extrinsic extensor muscles of the hand are located in the back of the forearm and have long tendons connecting them to bones in the hand, where they exert their action. Extrinsic denotes their location outside the hand. Extensor denotes their action which is to extend, or open flat, joints in the hand. They include the extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor digitorum (ED), extensor digiti minimi (EDM), extensor carpi ulnaris (ECU), abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and extensor indicis (EI).

<span class="mw-page-title-main">Muscles of the thumb</span>

The muscles of the thumb are nine skeletal muscles located in the hand and forearm. The muscles allow for flexion, extension, adduction, abduction and opposition of the thumb. The muscles acting on the thumb can be divided into two groups: The extrinsic hand muscles, with their muscle bellies located in the forearm, and the intrinsic hand muscles, with their muscles bellies located in the hand proper.

References

PD-icon.svgThis article incorporates text in the public domain from page 592 of the 20th edition of Gray's Anatomy (1918)

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  2. Beale, Evan W.; Behnam, Amir (June 2012). "Injection Injury of an Aberrant Superficial Radial Artery Requiring Surgical Intervention". Journal of Hand and Microsurgery. 4 (1): 39–42. doi:10.1007/s12593-011-0053-8. ISSN   0974-3227. PMC   3371123 . PMID   23730089.
  3. Deakin CD, Low JL (September 2000). "Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study". BMJ. 321 (7262): 673–674. doi:10.1136/bmj.321.7262.673. PMC   27481 . PMID   10987771.
  4. Sajja, Lokeswara Rao; Mannam, Gopichand; Pantula, Narasinga Rao; Sompalli, Sriramulu (June 1, 2005). "Role of Radial Artery Graft in Coronary Artery Bypass Grafting". The Annals of Thoracic Surgery. 79 (6): 2180–2188. doi: 10.1016/j.athoracsur.2004.07.049 . ISSN   0003-4975. PMID   15919345.
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  6. Fuhrman, Thomas M.; Pippin, William D.; Talmage, Lance A.; Reilley, Thomas E. (January 1, 1992). "Evaluation of collateral circulation of the hand". Journal of Clinical Monitoring. 8 (1): 28–32. doi:10.1007/BF01618084. ISSN   1573-2614. PMID   1538249. S2CID   31956149.
  7. Khanna, Omaditya; Mouchtouris, Nikolaos; Sweid, Ahmad; Chalouhi, Nohra; Ghosh, Ritam; Al Saiegh, Fadi; Gooch, Michael R; Tjoumakaris, Stavropoula; Rosenwasser, Robert H; Romo, Victor; Jabbour, Pascal (March 2020). "Transradial approach for acute stroke intervention: technical procedure and clinical outcomes". Stroke and Vascular Neurology. 5 (1): 103–106. doi:10.1136/svn-2019-000263. PMC   7213497 .
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  9. Bersten, Andrew D (2013). Oh's Intensive Care Manual. p. 123. ISBN   9780702047626.