Browsing by Author "Anuradha, W.K."

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Anatomical variations of the superficial palmar arch in Sri Lankans – A cadaveric study
(Research Symposium 2009 - Faculty of Graduate Studies, University of Kelaniya, 2009) Salgado, S.; Fernando, E.D.P.S.; Anuradha, W.K.; Nishantha, M.P.
Vasculature of the hand is one of the complex areas having a high degree of anatomical variations. It is very important to have an adequate knowledge of the arterial supply to the hand in this era of modern medical technology, as a significant number of surgical procedures such as radial arterial cannulation, radial forearm flap, and radial artery conduits in coronary artery grafting are carried out. Improvement of microsurgical techniques in reconstructive hand surgery also have made a necessity for better understanding of the vasculature of the hand. The superficial palmar arch provides the major blood supply to the hand along with the deep palmar arch and represents an important anastomosis between the ulnar and radial arteries. Objective: To study the variations of the superficial palmar arch in Sri Lankans compared to the classical description given in standard text books. Methodology: Eighteen hands from formalin preserved cadavers, both males and females of the ages between 30 to 80 years were dissected. Special attention was paid to trace the blood vessels supplying the thumb. Results: The superficial palmar arch is mainly formed by ulnar artery and some contribution from the radial artery. Two types of superficial palmar arches were described, as complete and incomplete. The classic superficial palmar arch was described as the direct continuity between the ulnar artery and the superficial palmar branch of radial artery which is considered as the sub group of complete type. In the incomplete type superficial palmar arch is formed only by the ulnar artery with some communications from the deeper palmar arch . According to the previous literature, complete type ranges from 80% to 90%. In our study 16 hands (89%) were with complete type and 02 (12%) were with incomplete type. However the anastomosis between radial and ulnar arteries were seen in all the specimens of our study. Classical palmar arch having a direct continuity between the ulnar artery and the superficial palmar branch of radial artery was found in 10 (55%) hands, in contrast to the 10% in the literature. Palmar type of median artery was noticed in 2 (12%) hands contributing to form the superficial palmar arch, in contrast to the 20% in literature. Although the sole blood supply to the thumb is by the princeps pollicis according to the standard text books, in our study it was found only in 6 (33%) specimens. The classical picture of the superficial palmar arch, with the princeps pollicis supplying the thumb was not seen in any of the specimens. Conclusion: Variations in the terminations of the radial and ulnar arteries are common. Since there are anastomoses between radial and ulnar arteries it may be safe to sacrifice any of the main arteries when performing surgical and medical interventions of the hand in the absence of vascular diseases.
Variations of the Superficial Palmar Arch in a Sri Lankan Perspective: A Cadaveric Study
(Global Science and Technology Forum, 2014) Salgado, L.S.S.; Hasan, R.; Perera, A.A.M.M.S.L.; Wijesundara, W.M.R.D.; Anuradha, W.K.
INTRODUCTION: The blood supply of the hand is a complex and challenging area of study. The clinical importance of this area lies in the significant number of surgical procedures such as radial artery conduits in coronary artery bypass grafting (CABG), radial arterial cannulation and reconstructive surgery of the hand. Anatomical variations in the typical blood supply of the hand are common and are an area of extensive research. METHODOLOGY: This descriptive study was carried out in the dissecting theatres at the Department of Anatomy, Faculty of Medicine, University of Kelaniya on dissections carried out on 25 cadaveric hands. RESULTS: From the superficial palmar arches studied the following results were obtained. 88% were complete while 22% were incomplete. Specimens with contribution from both the radial and the ulnar arteries for the superficial palmar arches were 80%, while specimens with the contribution solely from the ulnar artery were 12%. 8% hands studied had contributions from the radial, ulnar and the median arteries. Three branches of the radial artery contribute to complete the superficial palmar arch. Of this 60% cadavers had the major contribution from the superficial palmar branch of the radial artery, 24% from the arteria princeps pollicis, and 16% from the first dorsal metacarpal artery. The contribution to the arterial supply of the radial side of the thumb was from the superficial palmar branch of radial artery in 80% of the cadavers while in 20% the contribution was from the arteria princeps pollicis. The contribution to the arterial supply of the ulnar side of the thumb was from the proper palmar digital artery arising from the superficial palmar arch in 44% hands and the contribution in 32% hands was from the arteria princeps pollicis while the contribution in 24% hands was from the first dorsal metacarpal artery. CONCLUSION: It is thus evident that significant anatomical variations of the superficial palmar arch exist in the Sri Lankan population. The arterial supply of the thumb also had significant changes compared to the descriptions given in standard text books.