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In human anatomy, the radial artery is the main blood vessel, with oxygenated blood, of the lateral aspect of the forearm. It arises from the brachial artery and terminates in the deep palmar arch, which joins with the deep branch of the ulnar artery. Its pulse is palpable in the anatomical snuff box and on the anterior aspect of the arm over the carpal bones (where it is commonly used to assess the heart rate and cardiac rhythm).
Along its course, it is accompanied by a similarly named vein, the radial vein.
Use in coronary artery bypass grafting
The radial artery is used for coronary artery bypass grafting and is growing in popularity among cardiac surgeons. Recently, it has been shown to have a superior peri-operative and post-operative course when compared to saphenous vein grafts.
Branches
The 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
- The radial recurrent artery (a. recurrens radialis) arises immediately below the elbow. It ascends between the branches of the radial nerve, lying on the Supinator and then between the Brachioradialis and Brachialis, supplying these muscles and the elbow-joint, and anastomosing with the terminal part of the profunda brachii.
- The muscular branches (rami musculares) are distributed to the muscles on the radial side of the forearm.
- The volar carpal branch (ramus carpeus volaris; anterior radial carpal artery) is a small vessel which arises near the lower border of the Pronator quadratus, and, running across the front of the carpus, anastomoses with the volar carpal branch of the ulnar artery. This anastomosis is joined by a branch from the volar interosseous above, and by recurrent branches from the deep volar arch below, thus forming a volar carpal net-work which supplies the articulations of the wrist and carpus.
- The superficial volar branch (ramus volaris superficialis; superficialis volœ artery) arises from the radial artery, just where this vessel is about to wind around the lateral side of the wrist. Running forward, it passes through, occasionally over, the muscles of the ball of the thumb, which it supplies, and sometimes anastomoses with the terminal portion of the ulnar artery, completing the superficial volar arch. This vessel varies considerably in size: usually it is very small, and ends in the muscles of the thumb; sometimes it is as large as the continuation of the radial
At the Wrist
- The dorsal carpal branch (ramus carpeus dorsalis; posterior radial carpal artery) is a small vessel which arises beneath the Extensor tendons of the thumb; crossing the carpus transversely toward the medial border of the hand, it anastomoses with the dorsal carpal branch of the ulnar and with the volar and dorsal interosseous arteries to form a dorsal carpal network. From this network are given off three slender dorsal metacarpal arteries, which run downward on the second, third, and fourth Interossei dorsales and bifurcate into the dorsal digital branches for the supply of the adjacent sides of the middle, ring, and little fingers respectively, communicating with the proper volar digital branches of the superficial volar arch. Near their origins they anastomose with the deep volar arch by the superior perforating arteries, and near their points of bifurcation with the common volar digital vessels of the superficial volar arch by the inferior perforating arteries.
- The first dorsal metacarpal arises just before the radial artery passes between the two heads of the first Interosseous dorsalis and divides almost immediately into two branches which supply the adjacent sides of the thumb and index finger; the radial side of the thumb receives a branch directly from the radial artery.
In the Hand
- The arteria princeps pollicis arises from the radial just as it turns medialward to the deep part of the hand; it descends between the first Interosseous dorsalis and Adductor pollicis obliquus, along the ulnar side of the metacarpal bone of the thumb to the base of the first phalanx, where it lies beneath the tendon of the Flexor pollicis longus and divides into two branches. These make their appearance between the medial and lateral insertions of the Adductor pollicis obliquus, and run along the sides of the thumb, forming on the volar surface of the last phalanx an arch, from which branches are distributed to the integument and subcutaneous tissue of the thumb.
- The arteria volaris indicis radialis (radialis indicis artery) arises close to the preceding, descends between the first Interosseus dorsalis and Adductor pollicis transversus, and runs along the radial side of the index finger to its extremity, where it anastomoses with the proper digital artery, supplying the ulnar side of the finger. At the lower border of the Adductor pollicis transversus this vessel anastomoses with the princeps pollicis, and gives a communicating branch to the superficial volar arch. The a. princeps pollicis and a. volaris indicis radialis may spring from a common trunk termed the first volar metacarpal artery.
- The deep volar arch (arcus volaris profundus; deep palmar arch) is formed by the anastomosis of the terminal part of the radial artery with the deep volar branch of the ulnar. It lies upon the carpal extremities of the metacarpal bones and on the Interossei, being covered by the Adductor pollicis obliquus, the Flexor tendons of the fingers, and the Lumbricales. Alongside of it, but running in the opposite direction—that is to say, toward the radial side of the hand—is the deep branch of the ulnar nerve.
- The volar metacarpal arteries (aa. metacarpeæ volares; palmar interosseous arteries), three or four in number, arise from the convexity of the deep volar arch; they run distally upon the Interossei, and anastomose at the clefts of the fingers with the common digital branches of the superficial volar arch.
- The perforating branches (rami perforantes), three in number, pass backward from the deep volar arch, through the second, third, and fourth interosseous spaces and between the heads of the corresponding Interossei dorsalis, to anastomose with the dorsal metacarpal arteries.
- The recurrent branches arise from the concavity of the deep volar arch. They ascend in front of the wrist, supply the intercarpal articulations, and end in the volar carpal network.
See also
References
- Sajja LR, Mannam G, Pantula NR, Sompalli S. Role of radial artery graft in coronary artery bypass grafting. Ann Thorac Surg. 2005 Jun;79(6):2180-8. PMID 15919345
- Cohen G, Tamariz MG, Sever JY, Liaghati N, Guru V, Christakis GT, Bhatnagar G, Cutrara C, Abouzahr L, Goldman BS, Fremes SE. The radial artery versus the saphenous vein graft in contemporary CABG: a case-matched study. Ann Thorac Surg. 2001 Jan;71(1):180-5; discussion 185-6. PMID 11216742
External links
- Radial artery puncture - medicalstudents.com
"Radial artery"