Cubital Fossa
A triangular shaped depression over the anterior aspect of the elbow joint
Cubital Fossa: lateral border
medial border of the brachioradialis
Cubital Fossa: medial border
lateral border of pronator teres
Cubital Fossa: superior border
Horizontal line drawn between the epicondyles of the humerus
Cubital Fossa: Roof
bicipital aponeurosis aka lacertus fibrosis. An aponeurosis from the tendon of biceps brachii muscle in the cubital fossa. It gets attached to the deep fascia of the medial side of forearm
Cubital Fossa: Floor
brachialis proximally and supinator distally
Transverse Retinacular Ligament: Function
function
with PIP flexion, pull lateral bands volarly over PIP
with PIP extension, prevents excessive dorsal translation of lateral bands
Transverse Retinacular Ligament: Anatomy
origin: from edge of flexor tendon sheath at PIP
insertion: lateral border of conjointed lateral bands
Transverse Retinacular Ligament: Pathology
attenuation leads to dorsal translation of lateral bands and a resulting swan neck deformity
contracture (with attenuation of triangular ligament) leads to volar translation of lateral bands and resulting boutonniere deformity
Landsmeer’s Ligament
Links motion of DIP and PIP.
Origin: lateral volar aspect of P1
Insertions: lateral terminal extensor tendon dorsally
With PIP flexion, ligament relaxes to allow for DIP flexion. With PIP extension, ligaments tighten to facilitate DIP extension
If tight: resting finger position is DIP extended, PIP flexed. Unable to flex DIP if PIP is extended
Cleland’s ligaments
Digital cutaneous ligaments. Tether skin to deeper layers of fascia and bone to prevent excessive mobility of skin.
Dorsal to digital nerves. Think C for ceiling. Not invovled in Dupuytren’s.
Grayson’s ligament
Digital cutaneous ligament. Tether skin to deeper layers of fascia and bone to prevent excessive skin mobility. Volar to digital nerves.
Quadrangular Space
Anatomical space in the posterior scapula with four boundaries. Passageway that allows structures to travel between the axilla and posterior compartment of the upper arm.
Superior: Inferior margin of teres minor
Lateral: Surgical neck of the humerus
Medial: long head of triceps brachii
Inferior: Superior aspect of the teres major
Arcade of Froshe
The superficial head of the supinator muscle forms a fibrous arch called the arcade of froshe
Arcade of Struthers
a muscular or tendinous structure in the arm that can compress the ulnar nerve. It’s located on the medial side of the lower and middle thirds of the arm, 3–10 cm above the medial epicondyle. The arcade is formed by the triceps muscle’s medial head and aponeurotic expansion, and the internal brachial ligament.
Cubital Tunnel Anatomy
The walls creating the tunnel include the olecranon and the medial epicondyle, while the joint capsule of the elbow and the transverse and posterior bands of the medial ulnar collateral ligament form the floor, and finally the roof is comprised of the fascia of the flexor carpi ulnaris muscle and Osborne’s band, and referred to as Osborne’s fascia.
Radial Tunnel Anatomy
Lateral: brachioradialis, ECRL, ECRB
Medial: biceps tendon, brachialis
Floor: capsule of the radiocapitellar joint
Osborne’s Ligament
Uniting the triangular muscular interval between the humeral and ulnar heads of the FCU, Osborne’s ligament forms the roof of the cubital tunnel
Deltoid and Supraspinatus act synergistically then the remaining rotator cuff muscles provides humeral head depression to prevent superior migration. Force vector of deltoid is nearly vertical
Active Arm Elevation: force couple
Ratio of GH to scapulothoracic motion, scapulohumeral rhythm
First 30 degrees is mostly GH wheres the last 60 degrees near equal contribution. There is a predominance of GH with high speed
As the humerus is elevated, the scapula must upward rotate, posterior tilt.
Active Arm Elevation: force couple serratus anterior and traps. Upper fibers and SA upward rotates. Lower fibers and SA posterior tilts
Depressed fracture of the lunate fossa of the articular surface of the distal radius
Die Punch fx
Fracture dislocation of radiocarpal joint with intra-articular fx involving volar lip
volar barton fx
fracture dislocation of radiocarpal joint with intraarticular fracture of drosal lip
dorsal barton
