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Can palmar creases serve as landmarks for the deeper neuro-vascular structures?

Kwiatkowska M, Jakutowicz T, Ciszek B, Czubak J - Surg Radiol Anat (2013)

Bottom Line: Four creases: distal wrist flexion crease, thenar crease, proximal palmar crease and distal palmar crease were evaluated with reference to the following structures: palmar cutaneous branch of median nerve, palmar cutaneous branch of ulnar nerve, the nerve of Henle, transverse palmar branches from ulnar nerve, recurrent motor branch of median nerve, radial proper palmar digital nerve to the index and the ulnar proper palmar digital nerve to the thumb, Berrettini's communicating branch, ulnar nerve and artery, superficial palmar arch.Among the other observations we noticed that the palmar cutaneous branches of the median and ulnar nerves were located at least 0.5 cm away from the thenar crease.The superficial palmar arch was found between the thenar and proximal palmar crease and never crossed the proximal or distal palmar creases.

View Article: PubMed Central - PubMed

Affiliation: Department of Descriptive and Clinical Anatomy, Centre of Biostructure, Research Medical University of Warsaw, Chalubinskiego 5, 02-004, Warsaw, Poland, magdkwiat@gmail.com.

ABSTRACT

Purpose: The aim of this study was the examination of the superficial anatomy of palmar creases and their relation to deeper neuro-vascular structures.

Methods: Four creases: distal wrist flexion crease, thenar crease, proximal palmar crease and distal palmar crease were evaluated with reference to the following structures: palmar cutaneous branch of median nerve, palmar cutaneous branch of ulnar nerve, the nerve of Henle, transverse palmar branches from ulnar nerve, recurrent motor branch of median nerve, radial proper palmar digital nerve to the index and the ulnar proper palmar digital nerve to the thumb, Berrettini's communicating branch, ulnar nerve and artery, superficial palmar arch. We performed dissections of 20 cadaveric upper limbs derived from a homogenous Caucasian group. In our study we measured the location of surgically important structures with reference to palmar skin creases.

Results: Among the other observations we noticed that the palmar cutaneous branches of the median and ulnar nerves were located at least 0.5 cm away from the thenar crease. The superficial palmar arch was found between the thenar and proximal palmar crease and never crossed the proximal or distal palmar creases.

Conclusions: These anatomical dissections will provide reference material for further ultrasound studies on the arrangements of neuro-vascular structures in reference to superficial palmar creases.

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Distances between creases, nerves, and arteries: 1 radial proper palmar digital nerve to the index, 2 ulnar proper palmar digital nerve to the thumb, 3 recurrent motor branch of the median nerve, 4 carpal tunnel, 5 ulnar nerve, artery and nerve of Henle, 6 palmar cutaneous branch of the median nerve (PCBMN), 7 palmar cutaneous branch of the ulnar nerve (PCBUN)
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Fig3: Distances between creases, nerves, and arteries: 1 radial proper palmar digital nerve to the index, 2 ulnar proper palmar digital nerve to the thumb, 3 recurrent motor branch of the median nerve, 4 carpal tunnel, 5 ulnar nerve, artery and nerve of Henle, 6 palmar cutaneous branch of the median nerve (PCBMN), 7 palmar cutaneous branch of the ulnar nerve (PCBUN)

Mentions: The thenar crease, in our dissections, was never crossed by any cutaneous or motor branches of nerves. These structures were always located a few millimetres away from the thenar creases (at least 5 mm). The only structure to be found within the course of the thenar crease is the carpal tunnel (Table 1; Figs. 1, 3).Table 1


Can palmar creases serve as landmarks for the deeper neuro-vascular structures?

Kwiatkowska M, Jakutowicz T, Ciszek B, Czubak J - Surg Radiol Anat (2013)

Distances between creases, nerves, and arteries: 1 radial proper palmar digital nerve to the index, 2 ulnar proper palmar digital nerve to the thumb, 3 recurrent motor branch of the median nerve, 4 carpal tunnel, 5 ulnar nerve, artery and nerve of Henle, 6 palmar cutaneous branch of the median nerve (PCBMN), 7 palmar cutaneous branch of the ulnar nerve (PCBUN)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4061464&req=5

Fig3: Distances between creases, nerves, and arteries: 1 radial proper palmar digital nerve to the index, 2 ulnar proper palmar digital nerve to the thumb, 3 recurrent motor branch of the median nerve, 4 carpal tunnel, 5 ulnar nerve, artery and nerve of Henle, 6 palmar cutaneous branch of the median nerve (PCBMN), 7 palmar cutaneous branch of the ulnar nerve (PCBUN)
Mentions: The thenar crease, in our dissections, was never crossed by any cutaneous or motor branches of nerves. These structures were always located a few millimetres away from the thenar creases (at least 5 mm). The only structure to be found within the course of the thenar crease is the carpal tunnel (Table 1; Figs. 1, 3).Table 1

Bottom Line: Four creases: distal wrist flexion crease, thenar crease, proximal palmar crease and distal palmar crease were evaluated with reference to the following structures: palmar cutaneous branch of median nerve, palmar cutaneous branch of ulnar nerve, the nerve of Henle, transverse palmar branches from ulnar nerve, recurrent motor branch of median nerve, radial proper palmar digital nerve to the index and the ulnar proper palmar digital nerve to the thumb, Berrettini's communicating branch, ulnar nerve and artery, superficial palmar arch.Among the other observations we noticed that the palmar cutaneous branches of the median and ulnar nerves were located at least 0.5 cm away from the thenar crease.The superficial palmar arch was found between the thenar and proximal palmar crease and never crossed the proximal or distal palmar creases.

View Article: PubMed Central - PubMed

Affiliation: Department of Descriptive and Clinical Anatomy, Centre of Biostructure, Research Medical University of Warsaw, Chalubinskiego 5, 02-004, Warsaw, Poland, magdkwiat@gmail.com.

ABSTRACT

Purpose: The aim of this study was the examination of the superficial anatomy of palmar creases and their relation to deeper neuro-vascular structures.

Methods: Four creases: distal wrist flexion crease, thenar crease, proximal palmar crease and distal palmar crease were evaluated with reference to the following structures: palmar cutaneous branch of median nerve, palmar cutaneous branch of ulnar nerve, the nerve of Henle, transverse palmar branches from ulnar nerve, recurrent motor branch of median nerve, radial proper palmar digital nerve to the index and the ulnar proper palmar digital nerve to the thumb, Berrettini's communicating branch, ulnar nerve and artery, superficial palmar arch. We performed dissections of 20 cadaveric upper limbs derived from a homogenous Caucasian group. In our study we measured the location of surgically important structures with reference to palmar skin creases.

Results: Among the other observations we noticed that the palmar cutaneous branches of the median and ulnar nerves were located at least 0.5 cm away from the thenar crease. The superficial palmar arch was found between the thenar and proximal palmar crease and never crossed the proximal or distal palmar creases.

Conclusions: These anatomical dissections will provide reference material for further ultrasound studies on the arrangements of neuro-vascular structures in reference to superficial palmar creases.

Show MeSH
Related in: MedlinePlus