Bicipital aponeurosis

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Bicipital aponeurosis
Gray410.png
Superficial muscles of the chest and front of the arm. (Lacertus fibrosus visible as white band at lower right.)
Details
Identifiers
Latin aponeurosis musculi bicipitis brachii
TA98 A04.6.02.016
TA2 2467
FMA 39085
Anatomical terminology

The bicipital aponeurosis (also known as lacertus fibrosus) is a broad aponeurosis of the biceps brachii, which is located in the cubital fossa of the elbow. It separates superficial from deep structures in much of the fossa.

Contents

Structure

The bicipital aponeurosis originates from the distal insertion of the biceps brachii, and inserts into the deep fascia of the forearm. [1] The biceps tendon inserts on the radial tuberosity, and the bicipital aponeurosis lies medially to it. [2] It reinforces the cubital fossa, helping to protect the brachial artery and the median nerve running underneath. [1] [3] [4]

Variations

Some individuals (about 3% of the population) have a superficial ulnar artery that runs superficially to the bicipital aponeurosis instead of underneath it. These individuals are at risk for accidental injury to the ulnar artery during venipuncture. [5]

Clinical significance

The bicipital aponeurosis is superficial to the brachial artery and the median nerve, but deep to the median cubital vein. This protection is important during venipuncture (taking blood).

It is one structure that has to be incised during fasciotomy in the treatment of acute compartment syndrome of the forearm and elbow region.

Related Research Articles

<span class="mw-page-title-main">Arm</span> Proximal part of the free upper limb between the shoulder and the elbow

In human anatomy, the arm refers to the upper limb in common usage, although academically the term specifically means the upper arm between the glenohumeral joint and the elbow joint. The distal part of the upper limb between the elbow and the radiocarpal joint is known as the forearm or "lower" arm, and the extremity beyond the wrist is the hand.

<span class="mw-page-title-main">Brachioradialis</span> Muscle of the upper limb

The brachioradialis is a muscle of the forearm that flexes the forearm at the elbow. It is also capable of both pronation and supination, depending on the position of the forearm. It is attached to the distal styloid process of the radius by way of the brachioradialis tendon, and to the lateral supracondylar ridge of the humerus.

<span class="mw-page-title-main">Radial nerve</span> Nerve in the human body that supplies the posterior portion of the upper limb

The radial nerve is a nerve in the human body that supplies the posterior portion of the upper limb. It innervates the medial and lateral heads of the triceps brachii muscle of the arm, as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin.

<span class="mw-page-title-main">Brachial artery</span> Large blood vessel

The brachial artery is the major blood vessel of the (upper) arm. It is the continuation of the axillary artery beyond the lower margin of teres major muscle. It continues down the ventral surface of the arm until it reaches the cubital fossa at the elbow. It then divides into the radial and ulnar arteries which run down the forearm. In some individuals, the bifurcation occurs much earlier and the ulnar and radial arteries extend through the upper arm. The pulse of the brachial artery is palpable on the anterior aspect of the elbow, medial to the tendon of the biceps, and, with the use of a stethoscope and sphygmomanometer, often used to measure the blood pressure.

<span class="mw-page-title-main">Median nerve</span> Nerve of the upper limb

The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus.

Pronator quadratus is a square-shaped muscle on the distal forearm that acts to pronate the hand.

The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is used to describe the entire appendage of the upper limb, but which in anatomy, technically, means only the region of the upper arm, whereas the lower "arm" is called the forearm. It is homologous to the region of the leg that lies between the knee and the ankle joints, the crus.

<span class="mw-page-title-main">Axillary nerve</span> Nerve of the human body near the armpit

The axillary nerve or the circumflex nerve is a nerve of the human body, that originates from the brachial plexus at the level of the axilla (armpit) and carries nerve fibers from C5 and C6. The axillary nerve travels through the quadrangular space with the posterior circumflex humeral artery and vein to innervate the deltoid and teres minor.

<span class="mw-page-title-main">Ulnar nerve</span> Nerve which runs near the ulna bone

In human anatomy, the ulnar nerve is a nerve that runs near the ulna bone. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest in the human body unprotected by muscle or bone, so injury is common. This nerve is directly connected to the little finger, and the adjacent half of the ring finger, innervating the palmar aspect of these fingers, including both front and back of the tips, perhaps as far back as the fingernail beds.

<span class="mw-page-title-main">Musculocutaneous nerve</span> Nerve in the arm

The musculocutaneous nerve is a mixed branch of the lateral cord of the brachial plexus derived from cervical spinal nerves C5-C7. It arises opposite the lower border of the pectoralis major. It provides motor innervation to the muscles of the anterior compartment of the arm: the coracobrachialis, biceps brachii, and brachialis. It provides sensory innervation to the lateral forearm. It courses through the anterior part of the arm, terminating 2 cm above elbow; after passing the lateral edge of the tendon of biceps brachii it is becomes known as the lateral cutaneous nerve of the forearm.

<span class="mw-page-title-main">Cubital fossa</span> The human elbow pit

The cubital fossa,chelidon, grivet or inside of elbow, is the area on the anterior side of the upper part between the arm and forearm of a human or other hormid animals. It lies anteriorly to the elbow when in standard anatomical position.

In human anatomy, the median cubital vein is a superficial vein of the arm on the anterior asepct of the elbow. It classically connects the cephalic vein and the basilic vein.

<span class="mw-page-title-main">Coracobrachialis muscle</span> Muscle of the upper arm

The coracobrachialis muscle is a muscle in the upper medial part of the arm. It is located within the anterior compartment of the arm. It originates from the coracoid process of the scapula; it inserts onto the middle of the medial aspect of the body of the humerus. It is innervated by the musculocutaneous nerve. It acts to adduct and flex the arm.

The pronator teres is a muscle that, along with the pronator quadratus, serves to pronate the forearm. It has two origins, at the medial humeral supracondylar ridge and the ulnar tuberosity, and inserts near the middle of the radius.

<span class="mw-page-title-main">Thoracodorsal nerve</span>

The thoracodorsal nerve is a nerve present in humans and other animals, also known as the middle subscapular nerve or the long subscapular nerve. It supplies the latissimus dorsi muscle.

<span class="mw-page-title-main">Posterior cutaneous nerve of thigh</span> Sensory nerve that supplies the back of the thigh, leg, buttock, and perineum

The posterior cutaneous nerve of the thigh is a sensory nerve of the thigh. It is a branch of the sacral plexus. It supplies the skin of the posterior surface of the thigh, leg, buttock, and also the perineum.

<span class="mw-page-title-main">Medial cutaneous nerve of forearm</span>

The medial cutaneous nerve of the forearm is a sensory branch of the medial cord of the brachial plexus derived from the ventral rami of spinal nerves C8-T1. It provides sensory innervation to the skin of the medial forearm and skin overlying the olecranon. It descends through the (upper) arm within the brachial fascia alongside the basilic vein, then divides into an anterior branch and a posterior branch upon emerging from the brachial fascia; the two terminal branches travel as far distally as the wrist.

<span class="mw-page-title-main">Lateral pectoral nerve</span>

The lateral pectoral nerve arises from the lateral cord of the brachial plexus, and through it from the C5-7.

<span class="mw-page-title-main">Fascial compartments of arm</span> Anatomical compartments

The fascial compartments of arm refers to the specific anatomical term of the compartments within the upper segment of the upper limb of the body. The upper limb is divided into two segments, the arm and the forearm. Each of these segments is further divided into two compartments which are formed by deep fascia – tough connective tissue septa (walls). Each compartment encloses specific muscles and nerves.

<span class="mw-page-title-main">Elbow</span> Joint between the upper and lower parts of the arm

The elbow is the region between the upper arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa, and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body. The term elbow is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used.

References

PD-icon.svgThis article incorporates text in the public domain from page 444 of the 20th edition of Gray's Anatomy (1918)

  1. 1 2 Morrey, Bernard F.; Llusá-Pérez, Manuel; Ballesteros-Betancourt, José R. (2018-01-01), Morrey, Bernard F.; Sanchez-Sotelo, Joaquin; Morrey, Mark E. (eds.), "2 - Anatomy of the Elbow Joint", Morrey's the Elbow and its Disorders (Fifth Edition), Philadelphia: Elsevier, pp. 9–32, doi:10.1016/b978-0-323-34169-1.00002-4, ISBN   978-0-323-34169-1 , retrieved 2020-11-19
  2. Brown, Matthew; Chung, Kevin C. (2018-01-01), Chung, Kevin C. (ed.), "Procedure 87 - Biceps and Brachialis Lengthening", Operative Techniques: Hand and Wrist Surgery (Third Edition), Elsevier, pp. 771–777, doi:10.1016/b978-0-323-40191-3.00087-1, ISBN   978-0-323-40191-3 , retrieved 2020-11-19
  3. Savastano, Luis; Yang, Lynda J. -S. (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 41 - Anatomy of the Median Nerve and Its Branches", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 553–562, doi:10.1016/b978-0-12-410390-0.00043-3, ISBN   978-0-12-410390-0 , retrieved 2020-11-19
  4. Pezeshk, Parham (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 13 - Imaging of Entrapped Peripheral Nerves", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 167–171, doi:10.1016/b978-0-12-410390-0.00014-7, ISBN   978-0-12-410390-0 , retrieved 2020-11-19
  5. Chin and Singh; Singh, K (2005). "The superficial ulnar artery--a potential hazard in patients with difficult venous access". British Journal of Anaesthesia. 94 (5): 692–3. doi: 10.1093/bja/aei548 . PMID   15814810.