Objectives 1.3 Cubital fossa, forearm, hand

Osteology

Radius:

  • Neck
  • Radial tuberosity
  • Shaft (diaphysis)
  • Ulnar notch
  • Styloid process

Ulna:

  • Olecranon process
  • Trochlear notch
  • Coronoid process
  • Radial notch
  • Ulnar tuberosity
  • Shaft (diaphysis)
  • Styloid process

Carpals (8):

  • Scaphoid
  • Lunate
  • Triquetrum
  • Pisiform
  • Trapezium
  • Trapezoid
  • Capitate
  • Hamate
    •  Hook of hamate

Metacarpals (5)

Phalanges (28) [phalanx = singular; phalanges = plural]:

  • Proximal (10)
  • Intermediate (Middle) (8)
  • Distal (10)

 

Veins

  • Cephalic vein
  • Basilic vein
  • Median cubital vein
  • Dorsal venous plexus

 

Muscles

  • Brachioradialis
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Extensor digitorum
  • Extensor digiti minimi
  • Extensor carpi ulnaris
  • Extensor pollicis brevis
  • Extensor pollicis longus
  • Extensor indicis
  • Supinator
  • Abductor pollicis longus
  • Pronator teres
  • Pronator quadratus
  • Palmaris longus
  • Flexor carpi radialis
  • Flexor carpi ulnaris
  • Flexor digitorum superficialis
  • Flexor digitorum profundus
  • Flexor pollicis longus
  • Abductor pollicis brevis muscle
  • Flexor pollicis brevis muscle
  • Opponens pollicis muscle
  • Adductor pollicis muscle
  • Abductor digiti minimi muscle
  • Flexor digiti minimi muscle
  • Opponens digiti minimi muscle
  • Lumbricals (4)
    • Three (3) Palmar Interosseous muscles (‘PAD’= palmar are adductors)
    • Four (4) Dorsal Interosseous muscles (‘DAB’= dorsal are abductors)

 

Cubital Fossa: Boundaries and Contents

  • Lateral: Brachioradialis
  • Medial: Pronator teres
  • Roof: Bicipital aponeurosis and deep fascia of the arm
  • Floor: Brachialis and supinator
  • Superior: Between lateral and medial epicondyles
  • Contents:
    • Tendon of biceps brachii
    • Median nerve
    • Brachial artery

 

Contents of the Carpal Tunnel

  • Tendons of Flexor digitorum superficialis muscle (4)
  • Tendons of Flexor digitorum profundus muscle (4)
  • Tendon of Flexor pollicis longus muscle
  • Median nerve

 

Boundaries of the Anatomical Snuffbox

  • Extensor pollicis longus
  • Extensor pollicis brevis
  • Abductor pollicis longus

 

Nerves

  • Lateral cutaneous nerve of the forearm
  • Medial cutaneous nerve of the forearm
  • Radial nerve
    • Superficial branch of the radial nerve
    • Deep branch of the radial nerve
  • Ulnar nerve
    • Superficial branch of ulnar nerve
    • Deep branch of ulnar nerve
    • Common palmar digital branch
    • Proper palmar digital branches
  • Median nerve
    • Recurrent branch of median nerve
    • Common palmar digital branches
    • Proper palmar digital branches

 

Arteries

  • Ulnar artery
    • Superficial branch of the ulnar artery
    • Deep branch of the ulnar artery
  • Superficial palmar arch (*formed MAINLY by the continuation of the ulnar artery and some contribution from the superficial branch of the radial artery)
  • Common palmar digital arteries
  • Proper palmar digital arteries
  • Radial artery
    • Superficial branch of radial artery
  • Deep palmar arch (*formed MAINLY by the continuation of the radial artery and some contribution from the deep branch of the ulnar artery)

 

Miscellaneous Structures

  • Interosseous membrane
  • Palmar aponeurosis
  • Flexor retinaculum
  • Extensor retinaculum

Clinical Correlates

  • Dislocation of elbow joint
  • Subluxation and dislocation of radial head – Nursemaid’s elbow
  • Venipuncture
  • Tennis elbow vs. Golfer’s elbow (lateral vs. medial epicondylitis)
  • Injury of median, ulnar and radial nerves and resultant signs/deformities:
  • Claw hand
  • Hand of benediction
  • Ape hand
  • Wrist drop
  • Fractures and associated injuries
  • Distal radius fractures
  • Colles’ fracture – Dinner fork deformity
  • Smith fracture
  • Carpal fractures
  • Carpal tunnel syndrome: causes, symptoms
  • Mallet Finger, Swan neck, Boutonniere deformities
  • Trigger Finger
  • Heberden’s and Bouchard’s nodes