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Anatomy

Upper Limb

Question 216 of 239

You are demonstrating a vascular examination on a patient to a group of medical students. Where is the radial artery pulsation best palpated:

Answer:

In the distal forearm, the radial artery lies immediately lateral to the large tendon of the flexor carpi radialis muscle and directly anterior to the pronator quadratus and the distal end of the radius; the pulse can be located by using the flexor carpi radialis muscle as a landmark.

Anterior Forearm Arteries

Anatomy / Upper Limb / Anterior Forearm

Last Updated: 10th April 2019

Radial Artery

The radial artery, branch of the brachial artery, passes along the lateral aspect of the forearm, lying deep to the brachioradialis muscle proximally, and distally being covered only by skin and fascia, making this an ideal location to palpate the pulse or to gain arterial access (palpated just lateral to the flexor carpi radialis tendon, while compressing the artery against the radius bone). The radial artery enters the hand by curving around the lateral side of the wrist, passing over the floor of the anatomical snuffbox and penetrating the dorsolateral aspect of the hand between the bases of the first and second metacarpal bones.

Ulnar Artery

The larger ulnar artery, also a branch of the brachial artery, enters the forearm by passing deep to the pronator teres muscle and passes down the medial side of the forearm between the flexor carpi ulnaris and the flexor digitorum profundus muscles. The ulnar artery enters the hand, passing lateral to the pisiform bone and superficial to the flexor retinaculum. The ulnar artery gives rise to the common interosseous artery.

Carpal Arches

The palmar and dorsal carpal arches are formed from anastomosis between the carpal branches of the radial and ulnar arteries, and supply the wrist and carpal bones.

Venae Comitantes

Deep veins of the anterior compartment generally accompany the arteries and ultimately drain into brachial veins associated with the brachial artery in the cubital fossa.

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Arteries of the Anterior Forearm. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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