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Cubital Fossa - Everything You Need To Know - Dr. Nabil Ebraheim

Автор: nabil ebraheim

Загружено: 2018-07-10

Просмотров: 101903

Описание: Dr. Ebraheim’s educational animated video describe the anatomy of the cubital fossa - anterior elbow.
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https://twitter.com/#!/DrEbraheim_UTMC

Cubital Fossa
This is about understanding the arrangement of the structures in the anterior elbow. This is an anatomy video, but this can also help surgeons in knowing how to approach the insertion of the distal biceps for repair or how to approach the proximal radius fracture anteriorly. If you look at the bony structures of the anterior elbow, you need to find out where the common flexor tendon origin is, where the brachialis muscle is inserted, and where the biceps is, supinator and the pronator teres located. These structures are definitely part of the anterior elbow. The cubital fossa is a triangular depression located in front of the anterior elbow. The medial border is formed by the pronator teres, which arises from the medial epicondyle of the humerus. The lateral border of the cubital fossa is formed by the brachioradialis muscle which arises from the lateral supracondylar ridge of the humerus. The meeting of these two muscles forms the apex of the cubital fossa. The brachioradialis muscle overlaps the pronator teres, so the lateral border overlaps the medial border. The base of the cubital fossa is superior and is represented by a horizontal line connecting the two epicondyles of the humerus, the lateral and medial epicondyles.
Structures located in and around the cubital fossa
The base of the cubital fossa is seen as an imaginary line drawn between the medial epicondyle and the lateral epicondyle of the distal humerus. The pronator teres is the medial border, and the brachioradialis muscle forms the lateral border. The contents of the cubital fossa from medial to lateral are median nerve, brachial artery, biceps tendon, and radial nerve. The floor of the cubital fossa is made up of the lower part of the brachialis muscle medially and the supinator muscle laterally. The roof of the cubital fossa is made up of skin, fascia, and the bicipital aponeurosis.
The median nerve disappears by entering the forearm between the two heads of the pronator teres muscle. The brachial artery bifurcates into the ulnar artery and the radial artery. The brachial artery is over the brachialis muscle. The ulnar artery leaves the fossa by going under the deep head of the pronator teres muscle. The deep head of the pronator teres muscle separates the median nerve, which goes between two heads of the pronator teres muscle from the ulnar artery, which goes deep to the deep head of the pronator teres muscle. Another branch that is in the cubital fossa is the radial artery. The radial artery descends laterally and is overlapped by the brachioradialis muscle. The biceps tendon is lateral to the brachial artery within the cubital fossa. The biceps tendon has one main insertion laterally to the radial tuberosity and another insertion going medially to the bicipital aponeurosis. The bicipital aponeurosis covers and protects the vital structures medially to the biceps tendon (brachial artery and median nerve). The biceps tendon passes backwards (twisted) towards its insertion into the radial tuberosity. Lateral to the biceps tendon is the radial nerve and its major branch, the posterior interosseous nerve. Other important nerves in the vicinity of the cubital fossa include the superficial radial nerve which is below the brachioradialis and the lateral cutaneous nerve of the forearm which is a branch of the musculocutaneous nerve and lies below the biceps proximally and then finally lies laterally.

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