Variant Anatomy in Termination of the Brachial Artery in a Black African Population: A Cadaveric Study | Chapter 9 | Medical Science: Recent Advances and Applications Vol. 9

 

Background: The brachial artery (BA) is the main arterial trunk of the arm, acting as the direct extension of the axillary artery (AA). As the main arterial supply of the upper limb, the BA terminates by dividing into the ulnar and radial arteries about 1cm from the neck of the radius, as documented in standard anatomy textbooks. However, due to variations in results from different studies, BA may terminate at the level of the neck of the radius, radial tuberosity, mid arm and proximal arm. Based on its clinical utility, such as blood pressure monitoring and surgical procedures, a few reported disparities in certain populations and paucity of data, especially in the black African population, exploration of variations in termination of BA is warranted.

 

Objective: This study sought to evaluate variation in the termination of the brachial artery among the black African population.

 

Methodology: This study was carried out in three human anatomy laboratories in western Kenya, namely Maseno, Masinde Muliro and Uzima universities by undergraduate medical students during their routine dissection. This was a cross-sectional descriptive study in which 77 cadavers (n=154) upper limb specimens of the black African population were sampled using a stratified sampling technique. Data on termination of BA, laterality of the upper limb and sex of the cadaver were recorded in a data entry form. The brachium region was exposed to access the brachial artery, where its course to termination was assessed. Descriptive statistics were used to assess the frequency distribution of variant termination, while the Chi-square was used to determine the difference in proportion of normal termination and the cumulative variation of termination of BA with regard to the laterality of the upper limb. Statistical analysis was done using SPSS version 26.0. (IBM, New York, USA).

 

Results: Out of 154 upper limbs studied, the majority (89.0%) had a normal termination at the radial neck, while 7.8% terminated at the radial tuberosity. A small percentage of the upper limbs (1.3% and 1.9%) had termination at midarm and proximal arm, respectively. In this study, variation in the termination of the brachial artery was more common in males as compared to females. There was no statistically significant difference in variation in the left and right limbs (p=0.333 and p= 0.564), respectively, relative to the normal termination.

 

Conclusion and Recommendations: Although variations in the termination of the brachial artery have been observed among the selected population, these deviations from the typical anatomical pattern are not statistically significant; however, they remain clinically significant. Termination at the radial tuberosity is the most common variant and is more common in men than in women. Understanding variant termination of BA among black African populations is key to all health care professionals, especially surgeons, radiologists, anatomists and medical students, as such variants may lead to misdiagnosis and postoperative complications. Thus, further population and race-specific studies need to be undertaken on such variants.

 

 

Author(s) Details

Oyale Warren Ayonga
School of Medicine, Maseno University, P.O. Box, 3275-40100, Kisumu, Kenya.

 

Paul Kosiyo
School of Medicine, Maseno University, P.O. Box, 3275-40100, Kisumu, Kenya.

 

Willis Oyieko
School of Medicine, Maseno University, P.O. Box, 3275-40100, Kisumu, Kenya.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v9/5999

Incomplete Ulnar Variant of the Superficial Palmar Arch and Its Clinical Significance: A Case Report | Chapter 8| Medical Science: Recent Advances and Applications Vol. 4

During a routine dissection session for first-year MBBS students, we observed an anatomical variation in the right upper limb of a 70-year-old embalmed male cadaver. The superficial palmar arch was found to be incomplete, formed solely by the ulnar artery on the medial side, with no contribution from the radial artery on the lateral side. The variation was carefully photographed for documentation and future reference. No associated neuromuscular anomalies were noted in the same specimen. The deep palmar arch displayed a normal formation. The arterial pattern in the left upper limb of the cadaver was entirely normal. Understanding the variations in the vascular pattern of the hand has become increasingly important in microsurgical procedures, reconstructive hand surgeries, preoperative evaluation for radial artery harvesting in myocardial revascularisation, as well as in arterial interventions such as radial artery cannulation and the radial artery forearm flap.

 

Author (s) Details

SAWANT S.P
Department of Anatomy, K.J. Somaiya Medical College, Somaiya Ayurvihar, Eastern Express Highway, Sion, Mumbai-400 022, MS, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v4/5461

 

Surgical Significance of the Variable Branching Pattern of Brachial Artery | Chapter 13 | New Visions in Biological Science Vol. 1

 The goal of this study is to look into the branching pattern of the brachial artery. Because vascular variations are widespread, differences in the branching pattern of the brachial artery were looked at at D.Y. Patil Medical College in Pune. In 50 upper limbs, the variations of the Brachial artery were studied. Many different variations have been discovered. A high origin of the radial artery was detected in 2% of instances, while a high origin of the ulnar artery was discovered in 4% of cases. Other variations included the common interosseous artery from the Radial artery, the Superior ulnar collateral artery from the Profunda brachii artery, and the shared stem for the posterior circumflex humeral artery and the Profunda brachii artery, among others. These distinctions matter in a wide range of diagnostic and surgical procedures. The embryological origins of these polymorphisms has also been investigated.

Author (S) Details

Preeti Sonje
Dr. D. Y. Patil Medical College, D. Y. Patil Vidyapeeth Pune, Maharashtra, India.

Neelesh Kanasker
Dr. D. Y. Patil Medical College, D. Y. Patil Vidyapeeth Pune, Maharashtra, India.

P. Vatsalaswamy
Dr. D. Y. Patil Medical College, D. Y. Patil Vidyapeeth Pune, Maharashtra, India.

View Book :- https://stm.bookpi.org/NVBS-V1/article/view/3181

A Brachial Artery and Its Branching Pattern - Cadaveric Study | Chapter 7 | Highlights on Medicine and Medical Science Vol. 13

 Background: Vascular radiologists and surgeons need a thorough understanding of the normal and variant arterial anatomy of the upper extremities for accurate diagnostic interpretation as well as the smooth execution of interventional and surgical treatments on the upper extremity.

Anatomical knowledge of the anomalous branching pattern of the brachial artery is essential during percutaneous arterial catheterization to avoid complications caused by accidental damage to the anomalous blood vessel, and knowledge of the variations is essential for plastic surgeons who use flaps for reconstructive surgery. All cases of traumatic amputation and revascularization procedures require knowledge of the upper division of the brachial artery. The bifurcation of the brachial artery is the most common site for embolism, and a higher bifurcation would result in a bigger area of ischemia than expected, and the higher division would seek a greater clinical importance.

Materials and Methods: Fifty upper limbs of both sexes from an embalmed adult human cadaver used for undergraduate dissection at Mandya Institute of Medical Sciences in Mandya were used in the current study.

The normal brachial artery was found in 42 specimens, accounting for 84 percent of all the samples.

Eight specimens (16%) had variations; five of these had brachial artery trifurcation into the radial, ulnar, and radial recurrent arteries (10%); one specimen had double profunda brachii artery (2%); one specimen had high origin of the radial artery (2%); and one specimen had high division of the brachial artery in the proximal third of the arm (2%) (2 percent ).

Conclusion: Physicians, cardiologists, vascular surgeons, and interventional radiologists must have a thorough understanding of the anatomy of the brachial artery and its branching pattern, as well as their variations. The study of these variations and understanding of them aids in the prevention of iatrogenic blood vessel injuries, the care of accidental/traumatic upper-limb artery injuries, and diagnostic procedures (like arteriograms).

Author (S) Details

Uma Shivanal
Department of Anatomy, JSS Medical College, JSS AHER, Mysuru, Karnataka, India.

View Book :- https://stm.bookpi.org/HMMS-V13/article/view/2726