Ulnar Artery

A 27-year-old man injected a 2 mg suspension of crushed oral buprenorphine into his left ulnar artery, leading to acute ischemia of the hand he was successfully treated with iloprost and dextran-40 (3). 

Damage to the blood supply about the elbow, either as result of injury or following surgery may affect its subsequent growth and function. It is supplied proximally by branches of the brachial artery and distally by branches from the radial and ulnar arteries. The distal humerus is supplied by vessels running posteriorly. There is no anastomosis between the blood supply to the metaphyseal region and the ossific nuclei. 

The blood supply to the trochlea is via two terminal interosseous branches of the recurrent ulnar artery, the lateral trochlea and medial trochlea arteries. The medial artery maybe damaged in fractures of the medial condyle, leading to avascular necrosis. 

Fig. 24.12a-c. Vascular malformation ofthe wrist. The MIP (a) and VRT (b) images from multidetector CT angiography and MR angiography (c) show a dilated serpentine ulnar artery that, along with the medial palmar branch and the superficial palmar arch, feeds a high-flow vascular malformation (a,b reprinted with permission from Blum et al. 2006)... 

Allen test evaluates functioning of the medial and ulnar arteries. Occlude the two arteries and have the patient open and close his fist. The palm should be pale. Release one artery and the hand should flush. Repeat with the other artery. 

Based on their histologic architecture, the arteries can be divided into four different groups elastic arteries, medium-sized muscular arteries, small arteries, and arterioles (i.e. the radial and ulnar arteries belong to the medium-sized muscular group). Elastic arteries are the largest in the body they expand when the heart contracts and return to a normal caliber in diastole. Muscular arteries are small and middle-sized vessels with a relatively narrow lumen and thick walls consisting of circumferentially arranged smooth muscle fibers which restrict the lumen when they contract. The... 

Veiling TE, Brennan FJ, Hall LD et al (2001) Sonographic diagnosis of ulnar artery aneurysm in hypothenar Hammer syndrome report of 2 cases. J Ultrasound Med 20 921-924 Verhagen WIM, Gabreels-Festen AA, van Wensen PJ et al (1993) Hereditary neuropathy with liability to pressure palsies a clinical, electroneurophysiological and morphological study. J Neurol Sci 116 176-184 Wilson D (2004) Ultrasound assessment of carpal tunnel syndrome. Clin Radiol 59 909... 

At the elbow, the brachial artery is superficial and courses along the medial border of the biceps muscle and tendon overlying the brachialis (Figs. 8.4b,c,8.5). Then, it passes between the median nerve (medial) and the biceps tendon (lateral) beneath the bicipital aponeurosis to divide, at the proximal forearm, into the radial and ulnar arteries. 

The major nerves and vessels of the forearm are located within or traverse the volar compartment (Fig. 9.3). The median nerve enters the volar compartment passing between the superficial and deep heads of the pronator teres muscle. It then crosses the ulnar artery and proceeds toward depth to pass... 

The two main arteries in the forearm are the radial and the ulnar arteries, which are terminal divisions of the brachial artery (Fig. 9.3). The ulnar artery travels through the volar compartment with the ulnar nerve. It arises at the level of the neck of the radius, just medial to the distal biceps tendon, and courses deep to the sublimis bridge accompanied by the median nerve. At the middle third of the forearm, the ulnar artery traverses posterior to the median... 

Fig. 103 a,b. a Photograph of the anterior aspect of the wrist with b cadaveric correlation shows the flexor carpi radialis tendon (black arrow) which serves as a guide to the radial artery (a) which lies just lateral to it. The long lean tendon of the pahnaris longus (arrowhead) is a landmark for the median nerve (MN) which is deep and frequently lateral to it. More medially, the flexor carpi ulna-ris tendon (open arrow) is seen moving down to the pisiform (P). This tendon may be used as a key reference for the ulnar artery and nerve which lie lateral to it... 

The wrist is crossed by the median nerve, the ulnar nerve and the superficial cutaneous branch of the radial nerve. In the wrist area, the ulnar nerve is accompanied by the ulnar artery and the median nerve gives off a sensory branch, the palmar cutaneous branch. 

The brachial artery has two terminal branches the radial artery and the ulnar artery. At the distal forearm, the radial artery courses superficially over the ventral aspect of the distal radius where its pulse can readily be felt Then, it curves dorsally over the radial aspect of the wrist, passes deep to the extensor tendons of the first compartment and crosses the floor of the anatomic... 

On gray-scale US images, the ulnar and radial arteries are readily visible because of their pulsatil-ity. The main landmark for the radial artery is the lateral aspect of the flexor carpi radialis while the ulnar artery passes medial to the flexor carpi ulnaris (Fig. 10.23). More distally, the radial artery moves in a lateral position within the subcutaneous tissue, between the skin and the superficial aspect of the pronator quadratus (Fig. 10.24a). As it approaches the distal radius, this artery deepens to pass on the dorsal aspect of the wrist, within the anatomic snuff-box. Its palmar branch can be imaged in the subcutaneous tissue as a small hypoechoic pulsatile structure. Variations in size of the palmar branch are common and this vessel may also appear as large as the radial artery. The ulnar artery can be found in... 

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