Quadrangular space

Last updated
Quadrangular space
Axillary space.png
Suprascapular and axillary nerves of right side, seen from behind. Quadrangular space is the lateral space, labeled in green at center right. Axillary nerve is visible entering it.
Gray524.png
The scapular and circumflex arteries. (Quadrangular space is visible but not labeled. Posterior humeral circumflex artery is visible entering quadrangular space at center right.)
Anatomical terminology

The quadrangular space, also known as the quadrilateral space (of Velpeau) and the foramen humerotricipitale, is one of the three spaces in the axillary space. The other two spaces are: triangular space and triangular interval. [1]

Contents

Structure

The quadrangular space is one of the three spaces in the axillary space.

Boundaries

The quadrangular space is defined by: [2]

Contents

The quadrangular space transmits the axillary nerve, the posterior humeral circumflex artery and the posterior circumflex humeral vein. [3]

Clinical significance

The quadrangular space is a clinically important anatomic space in the arm as it provides the anterior regions of the axilla a passageway to the posterior regions. In the quadrangular space, the axillary nerve and the posterior humeral circumflex artery can be compressed or damaged due to space-occupying lesions or disruption in the anatomy due to trauma. Other common causes of axillary nerve compression at the quadrangular space include local compression due to osteophytes which are common in osteoarthritis, shoulder dislocations, fractures of the humeral neck, repetitive use, and external pressure (such as from crutches). Symptoms of axillary nerve compression include axillary nerve related weakness of the deltoid muscle (shoulder abduction) and teres minor (external rotation of the arm) as well as numbness of the lateral shoulder. The quadrangular space is the most common site of axillary nerve compression. [5] [6]

History

The quadrangular space is so named because the three skeletal muscles and one long bone that form its boundaries leave a space in the shape of a complete quadrangle.

The quadrangular space is also known as the quadrilateral space, [4] the quadrilateral space of Velpeau, and the foramen humerotricipitale.

See also

Additional images

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">Scapula</span> Bone that connects the humerus (upper arm bone) with the clavicle (collar bone)

The scapula, also known as the shoulder blade, is the bone that connects the humerus with the clavicle. Like their connected bones, the scapulae are paired, with each scapula on either side of the body being roughly a mirror image of the other. The name derives from the Classical Latin word for trowel or small shovel, which it was thought to resemble.

<span class="mw-page-title-main">Humerus</span> Long bone of the upper arm

The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.

<span class="mw-page-title-main">Latissimus dorsi muscle</span> Large, flat back muscle

The latissimus dorsi is a large, flat muscle on the back that stretches to the sides, behind the arm, and is partly covered by the trapezius on the back near the midline. The word latissimus dorsi comes from Latin and means "broadest [muscle] of the back", from "latissimus" and "dorsum". The pair of muscles are commonly known as "lats", especially among bodybuilders.

<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">Deltoid muscle</span> Shoulder muscle

The deltoid muscle is the muscle forming the rounded contour of the human shoulder. It is also known as the 'common shoulder muscle', particularly in other animals such as the domestic cat. Anatomically, the deltoid muscle appears to be made up of three distinct sets of muscle fibers, namely the

  1. anterior or clavicular part
  2. posterior or scapular part
  3. intermediate or acromial part
<span class="mw-page-title-main">Teres minor muscle</span> Muscle of the rotator cuff

The teres minor is a narrow, elongated muscle of the rotator cuff. The muscle originates from the lateral border and adjacent posterior surface of the corresponding right or left scapula and inserts at both the greater tubercle of the humerus and the posterior surface of the joint capsule.

<span class="mw-page-title-main">Triceps</span> Muscle on the back of the upper arm

The triceps, or triceps brachii, is a large muscle on the back of the upper limb of many vertebrates. It consists of 3 parts: the medial, lateral, and long head. It is the muscle principally responsible for extension of the elbow joint.

<span class="mw-page-title-main">Axillary artery</span> Large blood vessel bringing oxygenated blood to the thorax

In human anatomy, the axillary artery is a large blood vessel that conveys oxygenated blood to the lateral aspect of the thorax, the axilla (armpit) and the upper limb. Its origin is at the lateral margin of the first rib, before which it is called the subclavian artery.

<span class="mw-page-title-main">Shoulder joint</span> Synovial ball and socket joint in the shoulder

The shoulder joint is structurally classified as a synovial ball-and-socket joint and functionally as a diarthrosis and multiaxial joint. It involves an articulation between the glenoid fossa of the scapula and the head of the humerus. Due to the very loose joint capsule that gives a limited interface of the humerus and scapula, it is the most mobile joint of the human body.

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

The teres major muscle is a muscle of the upper limb. It attaches to the scapula and the humerus and is one of the seven scapulohumeral muscles. It is a thick but somewhat flattened muscle.

<span class="mw-page-title-main">Circumflex scapular artery</span> Artery of the upper body

The circumflex scapular artery is a branch of the subscapular artery and part of the scapular anastomoses.

<span class="mw-page-title-main">Deep artery of arm</span> Deep arterial system of the arm

The deep artery of arm is a large artery of the arm which arises from the brachial artery. It descends in the arm before ending by anastomosing with the radial recurrent artery.

<span class="mw-page-title-main">Anterior humeral circumflex artery</span>

The anterior humeral circumflex artery is an artery in the arm. It is one of two circumflexing arteries that branch from the axillary artery, the other being the posterior humeral circumflex artery. The anterior humeral circumflex artery is considerably smaller than the posterior and arises nearly opposite to it, from the lateral side of the axillary artery.

<span class="mw-page-title-main">Posterior humeral circumflex artery</span>

The posterior humeral circumflex artery arises from the third part of the axillary artery at the distal border of the subscapularis.

<span class="mw-page-title-main">Surgical neck of the humerus</span> Part of one of the bones of the arm

The surgical neck of the humerus is a bony constriction at the proximal end of shaft of humerus. It is situated distal to the greater tubercle and lesser tubercle, and proximal to the deltoid tuberosity.

<span class="mw-page-title-main">Triangular space</span> Anatomic space of the upper body

The triangular space is one of the three spaces found at the axillary space. The other two spaces are the quadrangular space and the triangular interval.

<span class="mw-page-title-main">Triangular interval</span> Intermuscular space of the upper body

The triangular interval is a space found in the axilla. It is one of the three intermuscular spaces found in the axillary space. The other two spaces are: quadrangular space and triangular space.

<span class="mw-page-title-main">Axillary space</span>

The axillary spaces are anatomic spaces. through which axillary contents leave the axilla. They consist of the quadrangular space, triangular space, and triangular interval. It is bounded by teres major, teres minor, medial border of the humerus, and long head of triceps brachii.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

References

PD-icon.svgThis article incorporates text in the public domain from page 589 of the 20th edition of Gray's Anatomy (1918)

  1. Krishna, Garg (2010). "7 - Scapula". BD Chaurasia's Human Anatomy (Regional and Applied Dissection and Clinical) Volume 1 - Upper limb and thorax (Fifth ed.). India: CBS Publishers and Distributors Pvt Ltd. p. 81. ISBN   978-81-239-1863-1.
  2. Anatomy photo:03:04-0101 at the SUNY Downstate Medical Center - "Scapular Region: Quadrangular Space of Scapular Region"
  3. 1 2 3 4 5 Pinkas, D.; Wiater, J. M. (2017-01-01). "37 - Functional Anatomy of the Shoulder". Orthopaedic Physical Therapy Secrets (3rd ed.). Elsevier. pp. 318–326. doi:10.1016/b978-0-323-28683-1.00037-0. ISBN   978-0-323-28683-1.{{cite book}}: CS1 maint: date and year (link)
  4. 1 2 Adam Mitchell; Drake, Richard; Gray, Henry David; Wayne Vogl (2005). Gray's anatomy for students. Elsevier/Churchill Livingstone. p. 649. ISBN   0-443-06612-4.
  5. Silver, S; Ledford, CC; Vogel, KJ; Arnold, JJ (1 March 2021). "Peripheral Nerve Entrapment and Injury in the Upper Extremity". American Family Physician. 103 (5): 275–285. PMID   33630556.
  6. Mangi, Mohammad Danish; Zadow, Steven; Lim, WanYin (12 October 2022). "Nerve entrapment syndromes of the upper limb: a pictorial review". Insights into Imaging. 13 (1): 166. doi: 10.1186/s13244-022-01305-5 . PMC   9556688 . PMID   36224295.