Case

A 23yo playing basketball lands on their outstretched hand on the palmer side. The hand was sore for most of the day and the patient went to the emergency room for an x-ray which showed no fractures. The emergency room indicated there was no bony injury and sent the patient home. Several days later there is still considerable pain that is not getting better the patient presents to physiatrist. The physiatrist notes particularly prominent pain upon palpation of the anatomic snuffbox. There is minimal discomfort when the forearm and elbow are examined and palpated. Normal sensory responses are present in all five digits.

Question 3/3 - Several weeks later the physiatrist is palpating the anatomic snuff box to assess if there is pain and possible non-functional healing. A pulse is felt at this point. Which artery is the physiatrist detecting pulse within?

Click on your selected option(s) below  (correct = 1, possible = 2, over-thinking = 3+)

Case Complete

Correct!  The radial artery passes through the anatomic snuff box and is a location for detecting radial pulse. 

Incorrect. The ulnar artery courses along the medial (ulnar) side of the wrist. Pulse is felt on the anteromedial side just to the medial side of the tendon of the palmaris longis muscle (if present).

Incorrect. The superficial palmar arch is an arched connection of the radial and ulnar arteries in the superficial palm. Pulse cannot be detected from this arch as it is just deep to the palmar aponeurosis which is too dense to feel a pulse through.

Incorrect. The deep palmar arch is an arched connection of the radial and ulnar arteries in the deep palm. Pulse cannot be detected from this arch as it is quite deep in the palm below too many structures to detect a pulse through. 

Incorrect.  While the cephalic vein runs on the lateral (radial) side of the upper limb, veins are low pressure and pulse cannot be detected in these.

Incorrect. The brachial artery is in the arm and ends in the cubital fossa where it divides into the radial and ulnar arteries. Thus, it is not present in the forearm or hand.