Arterial supply to the hand

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The arterial supply to the hand is comprised of a complex vascular network formed from the branches and distal continuations of the radial and ulnar arteries. This rich vascular network can be divided into palmar and dorsal components.

Palmar arterial supply

The palmar arterial supply can be divided into superficial and deep components.

Superficial component
  • superficial palmar arch
    • the superficial branch of the ulnar artery
    • distal to the flexor retinaculum
    • superficial to the long flexor tendons of the digits and deep to the palmar aponeurosis
    • in two-thirds of cases, the palmar arch is incomplete and forms a hockey-stick shape
    • arch lies across the center of the palm at the level of the distal border of the extended thumb
  • palmar digital artery
    • branches off the superficial palmar arch
    • runs on the ulnar side of the little finger
  • common palmar digital arteries
    • there are three palmar digital arteries
    • branch off the superficial palmar arch
    • run in the webs between fingers, splitting into two proper palmar digital arteries that supply adjacent fingers
  • proper palmar digital arteries
    • branch off the common palmar digital arteries
    • runs on either side of palmar aspect of each finger
    • occasionally gives off dorsal branch distally at distal interphalangeal joint
  • superficial palmar branch
    • branches off the radial artery
    • superficial to (or travels through) the thenar muscles
    • in one-third of cases, the superficial palmar branch joins the superficial palmar arch to form a true arcade
Deep component
  • radial artery
    • passes into the wrist/hand along the roof of the anatomical snuffbox and then dorsally around the scaphoid and trapezium before passing between the two heads of the first dorsal interosseous muscle and then between the two heads of the adductor pollicis to enter into the deep plane of the palm and form the deep palmar arch
  • princeps pollicis artery
    • branches off the radial artery
    • travels along the first metacarpal
    • divides into two palmar digital branches at the metacarpal head
  • radialis indicis artery
    • branches off the radial artery
    • supplies radial aspect of the index finger
  • deep palmar arch
    • continuation of the radial artery that anastomoses with the deep branch of the ulnar artery; often the arch is complete (unlike the superficial arch)
    • originates between the oblique and transverse heads of adductor pollicis
    • lies 1 cm proximal to the superficial arch
  • palmar metacarpal arteries
    • there are three palmar metacarpal arteries
    • branch off the deep palmar arch
    • at the metacarpal heads, they anastomose with the common palmar digital branches of the superficial arch
    • they perforate the interosseous spaces to anastomose with the dorsal metacarpal arteries

Dorsal arterial supply

  • posterior carpal arch
    • anastomosis between the dorsal carpal branches of the radial and ulnar artery, and the dorsal branch of the anterior interosseous artery
    • lies dorsal to the wrist
  • dorsal metacarpal arteries
    • branch off the posterior carpal arch
    • split at the webs to supply dorsal sides of the fingers via the dorsal digital arteries
    • they anastomose with the deep palmar arch via the palmar metacarpal arteries