Location
Philadelphia, PA
Start Date
9-5-2018 1:00 PM
Description
Introduction: Development of vascular abnormalities throughout the body are not uncommon. Little insight can be found regarding the clinical manifestations and development of these irregularities in the current data, indicating that further research needs to be done in order to gain full understanding of their implications. In the current case presentation, a persistent median artery (PMA) was identified in the left forearm of a cadaver. Normal vasculature of the forearm proceeds as follows; the brachial artery splits into the radial and ulnar arteries. The common interosseous artery branches off of the ulnar artery and then splits into an anterior and posterior portion. The anterior interosseous artery pierces the interosseous membrane and anastomoses with the posterior interosseous artery on the dorsum of the hand to form the dorsal carpal arch. On the ventral aspect of the hand the radial and ulnar arteries form the superficial and deep palmar arches along the metacarpals. Little is known on the developmental regulation of the branching of these arteries.
Methods: The forearm of an 84-year-old female was dissected as part of a gross anatomy course at Philadelphia College of Osteopathic Medicine.
Results: A PMA followed the course of the median nerve in the cadaver’s left forearm, splitting the nerve immediately distal to the elbow. The median nerve then rejoins and both the nerve and artery follow the nerve’s standard path through the carpal tunnel. This anomaly was found in only the left arm. The radial and ulnar artery were unremarkable, following their conventional pathways with no additional abnormal branching.
Discussion: Clinical applications for the abnormality concern both carpal tunnel syndrome and neuropathy. A PMA has been noted as a cause for carpal tunnel because of its ability to compress the median nerve. With the unusual splitting of the median nerve, the implications are unknown, but neuropathy seem possible if not likely.
Embargo Period
5-31-2018
A Case of Persistent Median Artery Splitting the Median Nerve
Philadelphia, PA
Introduction: Development of vascular abnormalities throughout the body are not uncommon. Little insight can be found regarding the clinical manifestations and development of these irregularities in the current data, indicating that further research needs to be done in order to gain full understanding of their implications. In the current case presentation, a persistent median artery (PMA) was identified in the left forearm of a cadaver. Normal vasculature of the forearm proceeds as follows; the brachial artery splits into the radial and ulnar arteries. The common interosseous artery branches off of the ulnar artery and then splits into an anterior and posterior portion. The anterior interosseous artery pierces the interosseous membrane and anastomoses with the posterior interosseous artery on the dorsum of the hand to form the dorsal carpal arch. On the ventral aspect of the hand the radial and ulnar arteries form the superficial and deep palmar arches along the metacarpals. Little is known on the developmental regulation of the branching of these arteries.
Methods: The forearm of an 84-year-old female was dissected as part of a gross anatomy course at Philadelphia College of Osteopathic Medicine.
Results: A PMA followed the course of the median nerve in the cadaver’s left forearm, splitting the nerve immediately distal to the elbow. The median nerve then rejoins and both the nerve and artery follow the nerve’s standard path through the carpal tunnel. This anomaly was found in only the left arm. The radial and ulnar artery were unremarkable, following their conventional pathways with no additional abnormal branching.
Discussion: Clinical applications for the abnormality concern both carpal tunnel syndrome and neuropathy. A PMA has been noted as a cause for carpal tunnel because of its ability to compress the median nerve. With the unusual splitting of the median nerve, the implications are unknown, but neuropathy seem possible if not likely.