Second Palmar Metacarpal Artery, Anterior View

Description

Arising from the deep palmar arterial arch, the second palmar metacarpal artery courses distally in the central palm along the second intermetacarpal space, deep to the flexor tendons and lumbrical muscles and closely applied to the palmar surfaces of the metacarpals. In an anterior (palmar) view it sits medial or lateral to its companion venae comitantes, with branches that continue toward the metacarpophalangeal region to contribute to the common palmar digital arteries supplying the index and middle rays. Surrounding landmarks logically include the second and third metacarpals, the flexor digitorum superficialis and profundus tendons within their synovial sheaths, and the palmar aponeurosis superficial to the vascular plane. Small-caliber by design. Surgical relevance centers on the deep palmar arch and its metacarpal branches during approaches to the midpalm, including drainage of deep palmar space infections, excision of palmar masses, or repair after penetrating trauma between the index and middle metacarpals. This view also supports teaching the concept that most metacarpal arteries originate from the deep system (ulnar artery contribution with radial artery completion) rather than the superficial palmar arch, a distinction that matters when interpreting ischemia patterns after ulnar or radial artery injury. Close adjacency of the palmar metacarpal arteries to the deep branch of the ulnar nerve and the interosseous muscle bellies explains why neurovascular compromise can accompany crush injuries across the metacarpal bases. Hand anatomy courses, surgical atlases, and interventional radiology primers can use this plate to orient learners to the vascular layers of the palm before moving to angiography, flap planning, or operative exposure. It also suits patient education materials on laceration risk in the central palm and postoperative diagrams after deep palmar exploration. Anatomical accuracy verified by SciePro's Medical Advisory Board.