So if we
look at the boundaries of the cubital fossa,
these are made up of those muscular and bony
boundaries. We've got superficial view here and
we've got a slightly deeper view here.
This is the anterior aspect of the right arm,
elbow and then we have got the forearm here.
We can see the muscle belly of biceps brachii.
We can see brachialis. We can see running
across the elbow joint we have got the bicipital
aponeurosis and running down in this direction
we will find those parts that run in the cubital fossa. If we just look at
the boundaries to start off with the cubital
fossa is the shallow triangular depression
directly anterior to the elbow joint.
The boundaries superiorly is a horizontal line
indicated here in green. Its really an imaginary
line that is running between the two medial
and lateral epicondyles. So it is
running here. We then got the apex of the triangle
being formed. Laterally by brachioradialis
muscle we can see here and medially by pronator
teres muscle we can see here. So if we continue
these boundaries up to the superior boundary we
can find a triangle and this is a cubital fossa.
The flow of the cubital fossa we can see in
this deeper dissection we have brachialis
muscle here and we also have another muscle
known as supinator and this form the floor
of the cubital fossa. So now brachioradialis here
has been reflected, we can still make out pronator
teres running in this direction. But because
the bicipital aponeurosis has been reflected,
we can see into the space of the cubital fossa.
The contents of the cubital fossa: Well there
is a nerve. There is an artery and there is
a tendon. So here we can see on the right elbow
joint the cubital fossa and from lateral
to medial we find we have a tendon. We find
we have an artery. We find we have a nerve.
In a deeper dissection we can see the cut
tendon, we can see the artery and we can see
the nerve. So from lateral to medial we have
tendon, artery and nerve. If we look the bicipital
tendon we then have the brachial artery.
We then have the median nerve. We can see that
in this deeper dissection the bicipital tendon
has been cut. Bicipital tendon, brachial
artery and median nerve. Running over the
cubital fossa, we have the median cubital
vein. Remember the median cubital vein was
formed when the cephalic and the basilic veins
were sending out for the upper limb and at
the elbow there was this union between the two
which is the median cubital vein. We can see
the cut cephalic here and the basilic here and running
across would have the median cubital vein.
We also have various cutaneous nerves following
the basilic and the cephalic veins and these
are supplying the forearm. So the contents to
recap within the cubital fossa: We have the
termination of the brachial artery, we can
see here. If we follow the brachial artery
deep through the cubital fossa we find we
have it dividing into the radial and the
ulnar arteries. With them we can see we have
the median nerve. We can see we have the
biceps tendon. If you were just to move brachioradialis
to one side as reflected. We will see that
we also have the radial nerve positioned here.
Not really in the cubital fossa when its
all intact, but by removing the brachioradialis we can expose the
radial nerve. so the contents of the cubital fossa bearing in
mind that for venupuncture the median cubital nerve is approached,
then caution has to be taken by the medical practitioner
that they don't pass the needle too far and start
rupturing these structures.