Topographic formations of the upper limb

Topographical areas include places and openings through which important nerves, blood vessels and veins pass. For each area, it is important to know the boundaries and structures that we find there.

Structures of the shoulder girdle

Scapular notch

It is bounded caudally by the scapular notch, cranially by the superior transverse scapular ligament. Only the suprascapular nerve passes through this formation . Attention! suprascapular vessels runs above the ligament and does not belong to this topographical area.

Spinoglenoid notch

The medial boundary consists of the spine of the scapula, the lateral glenoid cavity and dorsally, inferior transverse scapular ligament.
Here we can find the suprascapular nerve a suprascapular vessels.

Omotricipital foramen

The omotricipital foramen is bordered proximally by the teres minor muscle, distally the teres major muscle and laterally the long head of the triceps brachii muscle.
The circumflex scapular artery passes through it together with circumflex scapular vein.

Humerotricipital foramen

The humerotricipital foramen is a shape lying lateral to the omotricipital foramen. It is bounded laterally by humerus, proximally by the teres minor muscle , distally by the teres major muscle and medially by the long head of the triceps brachii muscle .
There is present in the foramen the axillary nerve and the posterior circumflex humeral artery.

Clavipectoral triangle

The clavipectoral triangle is bordered laterally by the deltoid muscle, medially by the pectoralis major muscle , and cranially by the clavicle. The entire space is covered by the clavipectoral fascia. The thoracoacromial artery reaches the surface through this space and the cephalic vein passes in the opposite direction . Furthermore, the medial and lateral pectoral nerves are located here .

Infraclavicular oval fossa

Passage through the clavipectoral fascia. Passing through this to the surface is the thoracoacromial artery and to the depth is the cephalic vein .

Axillary fossa

To simplify, the axilla can be imagined as a four-sided pyramid. The axilla is bounded cranially by the shoulder joint, ventrally by the pectoral muscles , dorsally by the latissimus dorsi and teres major muscles , medially by the chest wall with the serratus anterior muscle and laterally by the humerus and its muscles.
The Axillary artery and its branches pass through it . Ventromedial to the artery is the axillary vein , into which the cephalic vein flows . Within the nerve supply there is the brachial plexus.

Structures of the free limb

Medial bicipital groove

The medial bicipital groove (sulcus bicipitalis medialis) is a superficial groove between the ventral and dorsal groups of the medial muscles of the humerus.
The nerve providing the sensitive innervation of the medial forearm, the medial antebrachial cutaneous nerve, passes through this . Furthermore, the superficial basilic vein also passes here.

Basilic hiatus

An opening in the brachial fascia approximately 3 fingers above the elbow joint . There are the same formations as in sulcus bicipitalis medialis . The basilic vein goes deep here and the medial antebrachial cutaneous nerve comes to the surface.

Lateral bicipital groove

A groove between the ventral and dorsal groups of the lateral groups of the humerus muscles. Only the superficial cephalic vein passes through it.

Cubital fossa

The cubital fossa is bordered proximally by the tendon of the biceps brachii muscle, laterally by the brachioradialis muscle , and medially by the pronator teres muscle . Its bottom is formed by the brachialis muscle .

The content is the brachial artery, which in these places divides into ulnar a radial arteries. All these arteries are accompanied by duplex veins of the same name. On the surface , the cephalic vein and the basilic vein pass , and they are connected to each other by the venous connection of the median cubital vein . Of the nerves, there are the Median nerve a Radial nerve. The radial nerve is divided here into superficial and deep branches.

Cubital canal

It is a passage between the ulnar and humeral heads of the flexor carpi ulnaris muscle and the continuation of the groove of the ulnar nerve . The ulnar nerve runs in the cubital canal.

Pronator canal

Cleft between the heads of the pronator teres muscle . It continues between the heads of the flexor digitorum superficialis muscle . The median nerve passes through it .

Supinator canal

Cleft between the superficial and deep layers of the supinator muscle . The deep branch of the radial nerve and a branch of the recurrent radial artery pass through it .

Frohse's arcade

It is a fibrous thickened band at the beginning of the supinator canal and lines the surface of the supinator muscle.

Radial foveola

Radial foveola is proximally bounded by the muscular extensor retinaculum , palmarly the tendons of the extensor pollicis brevis muscle and abductor pollicis longus muscle which are located in the common tendon sheath, and dorsally is the tendon of the extensor pollicis longus muscle.
It is covered superficially by the cephalic vein and superficial branch of the radial nerve. Located deeply is the Radial artery.
This space was formerly known as "la tabatiére" because tobacco was snuffed from the surface depression on the skin.

Carpal tunnel

Carpal tunnel is bordered dorsally by the carpal bones, medially by the ulnar carpal eminence, laterally by the radial carpal eminence and palmarly by the muscular flexor retinaculum .

It is divided into radial and ulnar parts. In the ulnar section we find the insertion parts of the tendons of the flexor pollicis longus muscle, flexor digitorum superficialis muscle and flexor digitorum profundus muscle. We also find the supplying nerve, median nerve. The flexor carpi radialis muscle passes through the radial compartment.

Paron's space

Continuation of carpal tunnel proximally. It is bordered dorsally by the pronator quadratus muscle, palmarly by the tendons of the flexor digitorum profundus muscle and the flexor pollicis longus muscle . It is made up of only thin tissue, and therefore inflammations can easily spread here.

Ulnar canal

Ulnar canal is the passage between the pisiform bone and the hamulus of the hamate bone.
Palmaris brevis muscle borders palmarly, muscular flexor retinaculum dorsally. The Ulnar nerve and ulnar vessels pass here.

Guiot's canal

The transverse head of the adductor pollicis muscle is bordering palmarly , first dorsal interosseus muscle dorsally. Deep branch of the radial artery thus enters between the muscles of the palm and subsequently forms the deep palmar arch.

Links

References

GRIM, Miloš – DRUGA, Rastislav. Základy anatomie : 5. Anatomie krajin těla. 1. edition. Galén, 2008. 119 pp. ISBN 978-80-7262-179-8.