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 The cubital fossa

is a triangular
hollow area that lies
in front of the
elbow joint.
 It is also called the
antecubital fossa
because it lies
anteriorly to the
elbow when in
standard anatomical
position.

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 It is bounded:

 Superiorly by an
imaginary line
connecting the medial
and lateral
epicondyles.
 Medially by the
pronator teres muscle.
 Laterally by the
brachioradialis
muscle.

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 Floor:
❑ Its floor is formed
by the brachialis
and supinator
muscles overlying
the capsule of the
elbow joint.

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 Roof:
❑ The deep fascia of
the forearm forms
its roof, which is
strengthened by
fibers of the
bicipital
aponeurosis.

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 Lying on the roof in the superficial
fascia are the anterior branches of
the medial and lateral cutaneous
nerves of the forearm and the median
cubital vein, which joins the cephalic
and basilic veins.

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▪ The cubital fossa contains four main
vertical structures (from lateral to
medial):
 The radial nerve in the cubital fossa,
located between brachioradialis and
brachialis muscles.

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 The biceps brachii
tendon The brachial
artery. The artery
usually bifurcates
near the apex
(inferior part) of the
cubital fossa into the
radial artery
(superficial) and
ulnar artery (deeper)

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 The median nerve
 The ulnar nerve 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,
cephalic vein, and basilic vein) but these
are usually considered superficial to the
cubital fossa,

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 During blood pressure measurements,
the stethoscope is placed over the
brachial artery in the cubital fossa. The
artery usually runs medial to the
bicepital tendon. The brachial pulse may
be palpated in the cubital fossa also just
medial to the tendon.

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 The area just superficial to the cubital
fossa is often used for venous access .A
number of superficial veins can cross
this region. It may also be used for the
insertion of a peripherally inserted
central catheter.

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 Historically, when
(venous) blood-letting
was practiced, the
bicipital aponeurosis
(the ceiling of the cubital
fossa) was known as
the "grace of God"
tendon because it
protected the more
important contents of
the fossa (i.e. the
brachial artery and the
median nerve).

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 Its base is formed by
the imaginary line,
which extends
across the
epicondyles of the
humerus.
 Its lateral border is
formed by the lateral
border of the
brachioradialis.

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 Its medial border is formed by the
medial border of the pronator teres. The
two muscles meet at the apex of this
triangle where they overlap.
 Its floor is formed by the following two
muscles
➢ Supinator below
➢ Brachialis above.

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❖ Its roof is formed by skin, superficial
fascia, and deep fascia and their
contained structures.

❖ Skin over cubital fossa presents no

special features except prominent
transverse collagen lines.

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❖Superficial fascia
• Superficial fascia of the cubital
fossa presents the following
structures, which cross the roof of
the fossa .

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 Medial cutaneous nerve of forearm
 Lateral cutaneous nerve of forearm
 Basilic vein
 Cephalic vein
 Median cubital vein
 Medial vein of forearm
 Radial nerve.

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 Deep fascia
▪ This presents no special feature in the
roof of the cubital fossa.

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 Axilla

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 Medial wall is Lateral wall is
formed of the narrow and formed
thoracic wall with the by the upper pert of
serratus anterior the shaft of the
muscle. humerus

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 PARTS

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 (pectoral)
axillary lymph nodes.
(subscapular)
axillary lymph nodes.
(brachial) lymph
nodes.
Central lymph nodes.
Apical lymph nodes.

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CONT….

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ANY QUESTION??

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