Cubital Fossa

Overview

1. Features- Shape, Location & Homologous
2. Boundaries- Lateral, Medial, Apex, Floor, Roof & Floor
3. Content- M B T R
4. Clinicals- Blood Pressure Measure, Brachial Pulse, Intra Venous Injection, Collection of Blood Sample, Fracture, Volkmann’s Ischemic Contracture,

1. FEATURES

  • This is triangular in shape- So it has three border- Lateral, Medial, Lower ( Base ), and an apex ( Medial & Lateral Border meet here )
  • Present in front of the elbow joint ( between the lower part of Humorous Bone & upper part of Radius and Ulna Bone )
  • It is Homologous with Popliteal Fossa ( present behind the Knee Joint )

2. BOUNDARIES

  • Lateral Boundaries– formed by the Medial Border of Brachioradialis muscle / BR ( Not Brachialis Muscle- Muscle of Arm ) – Extensor Compartment muscles of the forearm
  • Medial Boundaries– formed by the lateral border of Pronator Teres Muscle ( PT )  – Flexor Compartment Muscle of the forearm
  • Base
    • Directed Upward
    • It is formed by an imaginary line that is passed through the front of two epicondyles ( Lateral and Medial ) of Humorous Bone ( present in the lower end of the Humerus bone )
  • Apex ( means pointed or narrowed end ) – another example- Heart Apex, Lung Apex 
    • Directed Downward
    • This is the meeting point of Brachio Radialis (BR) / Lateral Boundaries of cubital fossa and Pronator Teres (PT) / Medial Boundaries of cubital Fossa
  • Roof– It is made up of four main structures from superficial to deep.
    • Skin- Most Superficial present
    • Superficial Fascia- this fascia contains Veins ( Median Cubital Vein: connect Cephalic Vein and Basilic Vein ) and Nerve ( Medial and Lateral cutaneous nerve of forearm )
    • Deep Fascia
    • Bicipital Aponeurosis ( flat tendon of Biceps Brachii Muscle )
  • Floor- It is formed by two muscles:
    • The upper part of the floor- It is formed by Brachialis Muscle  ( not Brachio Radialis / BR )
    • The lower part of the floor- It is formed by Supinator Muscle ( Extensor Compartment Muscle of Forearm )

3. CONTENT

Total four main structures are present in the cubital fossa (  M B T R – from Medial to Lateral )

M– Median Nerve

B– Brachial Artery ( terminal part )

T– Tendon of Biceps Brachii Muscle

R– Radial Nerve ( Supply to Extensor Compartment Muscles of Forearm )

Median Nerve and Brachial Artery are separated by the Biceps brachii Aponeurosis

4. CLINICALS

  • Blood Pressure Measurement– use Brachial Artery
  • Palpate Brachial Pulse ( use Brachial Artery ) in Cubital Fossa, medial to the Biceps Brachii Tendon
  • Intra Venous Injection– in Median Cubital Vein
  • Collection of Blood Sample: for Collection blood sample blood from Median Cubital vein ( present in Roof of cubital fossa ): Venepuncture or Venipuncture
  • Fracture- Important in the Fracture of Humerus ( Supra Condylar Fracture )
  • Volkmann’s Ischemic Contracture– due to tearing of Brachial Artery in Supra Condylar Fracture of Humerous and that leads to Ischemia ( Blood Supply to the Muscle are decrease ), as result Muscles are Paralyse.