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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: In our study we measured the location of surgically important structures with reference to palmar skin creases.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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Related in: MedlinePlus

Dissected palm of the left hand: 1 superficial palmar arch, cut, 2 Berrettini’s communicating branch 3 distal palmar crease
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Fig6: Dissected palm of the left hand: 1 superficial palmar arch, cut, 2 Berrettini’s communicating branch 3 distal palmar crease

Mentions: The communicating branch between the median and ulnar nerve, known as the Berrettini’s communicating branch (Fig. 6), was also examined. This branch courses from the common digital nerve in the fourth interosseous space (ulnar nerve origin) to the common digital nerve in the third interosseous space (median nerve origin). Its course often parallels the superficial palmar arterial arch. In two cases this nerve was present in a plexiform nature. This communicating branch was perforated by the superficial palmar arch (Fig. 7). In the other specimens the Berrettini’s communicating branch of ulnar nerve was located deep to the superficial palmar arch.Fig. 6


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

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

Dissected palm of the left hand: 1 superficial palmar arch, cut, 2 Berrettini’s communicating branch 3 distal palmar crease
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig6: Dissected palm of the left hand: 1 superficial palmar arch, cut, 2 Berrettini’s communicating branch 3 distal palmar crease
Mentions: The communicating branch between the median and ulnar nerve, known as the Berrettini’s communicating branch (Fig. 6), was also examined. This branch courses from the common digital nerve in the fourth interosseous space (ulnar nerve origin) to the common digital nerve in the third interosseous space (median nerve origin). Its course often parallels the superficial palmar arterial arch. In two cases this nerve was present in a plexiform nature. This communicating branch was perforated by the superficial palmar arch (Fig. 7). In the other specimens the Berrettini’s communicating branch of ulnar nerve was located deep to the superficial palmar arch.Fig. 6

Bottom Line: In our study we measured the location of surgically important structures with reference to palmar skin creases.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