Arterial supply to the hand

The arterial supply to the hand is comprised of a complex vascular network formed from the branches and distal continuations of the radial and ulnar arteries. This rich vascular network can be divided into palmar and dorsal components.

Palmar arterial supply

The palmar arterial supply can be divided into superficial and deep components.

Superficial component

• Superficialsuperficial palmar arch
  • superficial branch of the ulnar artery
  • distal to the flexor retinaculum
  • superficial to the deep surface of the palmar aponeurosis
  • in two-thirds of cases, the palmar arch is incomplete and forms a hockey-stick shape
  • arch lies across the centre of the palm
• Palmarpalmar digital artery
  • branches off the superficial palmar arch
  • runs on the ulnar side of the little finger
• Commoncommon palmar digital arteries
  • there are three palmar digital arteries
  • branch off the superficial palmar arch
  • run in the webs between fingers, splitting into two proper palmar digital arteries that supply adjacent fingers
• Properproper palmar digital arteries
  • branch off the common palmar digital arteries
  • runs on either side of each finger
• Superficialsuperficial palmar branch
  • branches off the radial artery
  • superficial to (or travels through) the thenar muscles
  • in one-third of cases, the superficial palmar branch joins the superficial palmar arch to form a true arcade

Deep component

• Princepsprinceps pollicis artery
  • branches off the radial artery
  • travels along the first metacarpal
  • divides into two palmar digital branches at the metacarpal head
• Radialradial indices artery
  • branches off the radial artery
  • supplies radial aspect of the index finger
• Deepdeep palmar arch
  • continuation of the radial artery that anastomoses with the deep branch of the ulnar artery; often the arch is complete (unlike the superficial arch)
  • originates between the oblique and transverse heads of adductor pollicis
  • lies 1 cm proximal to the superficial arch
• Palmarpalmar metacarpal arteries
  • there are three palmar metacarpal arteries
  • branch off the deep palmar arch
  • at the metacarpal heads, they anastomose with the common palmar digital branches of the superficial arch
  • they perforate the interosseous spaces to anastomose with the dorsal metacarpal arteries

Dorsal arterial supply

• Posteriorposterior carpal arch
  • anastomosis between the radial, ulnar, and anterior interosseous arteries
  • lies dorsal to the wrist
• Dorsaldorsal metacarpal arteries
  • branch off the posterior carpal arch
  • split at the webs to supply dorsal sides of the fingers
  • they anastomose with the deep palmar arch via the palmar metacarpal arteries