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The cubital fossa, antecubital fossa, chelidon, inside of elbow, or, humorously, wagina, is the area on the anterior side of the upper part between the arm and forearm of a human or other hominid animals. It lies to the (antecubital) (Latin cubitus) when in standard anatomical position. The cubital fossa is a triangular area having three borders.


Boundaries
  • superior (proximal) boundary – an imaginary horizontal line connecting the medial epicondyle of the humerus to the lateral epicondyle of the humerus
  • medial (ulnar) boundary – lateral border of muscle originating from the medial epicondyle of the humerus.
  • lateral (radial) boundary – medial border of muscle originating from the lateral supraepicondylar ridge of the humerus.
  • apex – it is directed inferiorly, and is formed by the meeting point of the lateral and medial boundaries
  • superficial boundary (roof) – skin, superficial fascia containing the median cubital vein, the lateral cutaneous nerve of the forearm and the medial cutaneous nerve of the forearm, reinforced by the bicipital aponeurosis (a sheet of tendon-like material that arises from the tendon of the biceps brachii)
  • deep boundary (floor) – and muscles


Contents
The cubital fossa contains four main vertical structures (from lateral to medial):

The is also in the area, but is not in the cubital fossa; it occupies a groove on the posterior aspect of the medial epicondyle of the humerus.

Several veins are also in the area (for example, the median cubital vein, , and ) but these are usually considered superficial to the cubital fossa, and not part of its contents.

From lateral to medial, the order of the contents within the cubital fossa can be described by the acronym TAN: tendon, artery, nerve


Clinical aspects
Like other flexion surfaces of large joints (, , and essentially the anterior part of the ), it is an area where blood vessels and nerves pass relatively superficially, and with an increased amount of .

During measurements, the is placed over the brachial artery in the cubital fossa. The artery runs medial to the biceps tendon. The brachial pulse may be palpated in the cubital fossa just medial to the tendon.

The area just superficial to the cubital fossa is often used for access () in procedures such as injections and obtaining samples for . A number of superficial veins can cross this region. It may also be used for the insertion of a peripherally inserted central catheter.

Historically, during , the bicipital aponeurosis (the ceiling of the cubital fossa) was known as the "grace of God tendon" because it separated and protected the more important contents of the fossa such as the and the .

Statistically, the antecubital fossa is the least tender region for peripheral intravenous access, although it provides a greater risk for venous thrombosis.


Additional images

See also
  • Median cubital vein
  • Peripherally inserted central catheter


External links

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