Triangular interval

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Triangular interval
Triangular interval.PNG
Suprascapular and axillary nerves of right side, seen from behind. Triangular interval is labeled.)
Gray524.png
The scapular and circumflex arteries. (Triangular interval is visible but not labeled.)
Anatomical terminology

The triangular interval (also known as the lateral triangular space, [1] lower triangular space, [2] and triceps hiatus) 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. [3]

Contents

Borders

Two of its borders are as follows:

Some sources state the lateral border is the humerus, [4] [5] while others define it as the lateral head of the triceps. [2] (The effective difference is relatively minor, though.)

Contents

The contents of its borders are as follows:

The radial nerve is visible through the triangular interval, on its way to the posterior compartment of the arm. Profunda brachii also passes through the triangular interval from anterior to posterior.

Additional images

Triangular Interval Syndrome

Triangular Interval Syndrome (TIS) was described as a differential diagnosis for radicular pain in the upper extremity. [6] It is a condition where the radial nerve is entrapped in the triangular interval resulting in upper extremity radicular pain. The radial nerve and profunda brachii pass through the triangular interval and are hence vulnerable. The triangular interval has a potential for compromise secondary alterations in thickness of the teres major and triceps. [7] It is described based on cadaveric studies that fibrous bands were commonly present between the teres major and triceps. When these bands were present, rotation of the shoulder caused a reduction in cross sectional area of the space. Normal resting postures of humeral adduction and internal rotation with scapular protraction may be speculated as a precedent for teres major contractures owing to the shortened position of this muscle in this position. In addition, hypertrophy of this muscle can occur secondary to weight training and potentially compromise the triangular interval with resultant entrapment of the radial nerve. [8] Shoulder dysfunctions have a potential for shortening and hypertrophy of the teres major. Shoulders that exhibit stiffness, secondary to capsular tightness, contribute to contracture and hypertrophy of the teres major. [9] Hence, restricted external rotation can encourage adaptive shortening and thickening of the internal rotators of the shoulder principally the teres major and subscapularis. One may speculate that the lateral arm pain presented in shoulder dysfunctions may be of a nerve origin secondary to adverse neural tension of the radial nerve. The triceps brachii has a potential to entrap the radial nerve in the triangular interval secondary to hypertrophy. The presence of a fibrous arch in the long head and lateral head further complicates the situation. Repeated forceful extension seen in weight training and sport involving punching may be a precedent to this scenario. The radial nerve is vulnerable as it passes through this space, for all of the reasons mentioned above.

See also

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">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">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. The latissimus dorsi is the largest muscle in the upper body.

<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">Wrist drop</span> Medical condition

Wrist drop is a medical condition in which the wrist and the fingers cannot extend at the metacarpophalangeal joints. The wrist remains partially flexed due to an opposing action of flexor muscles of the forearm. As a result, the extensor muscles in the posterior compartment remain paralyzed.

<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">Upper limb</span> Consists of the arm, forearm, and hand

The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the arm, forearm and hand, and is primarily used for climbing, lifting and manipulating objects.

<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">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">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">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">Quadrangular space</span>

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.

<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">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">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 it is not used. In those cases, forelimb plus joint is used.

References

  1. Photo at tufts.edu
  2. 1 2 Kyung Won Chung (2005). Gross Anatomy (Board Review). Hagerstown, MD: Lippincott Williams & Wilkins. p. 34. ISBN   0-7817-5309-0.
  3. 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.
  4. Adam Mitchell; Drake, Richard; Gray, Henry David; Wayne Vogl (2005). Gray's anatomy for students. Elsevier/Churchill Livingstone. p. 650. ISBN   0-443-06612-4.
  5. "uams.edu" . Retrieved January 2, 2008.
  6. Sebastian D. Triangular Interval Syndrome. A differential diagnosis for upper extremity radicular pain. Physiother Theory Pract. 2010 Feb;26(2):113-9.
  7. Ng ABY, Borhan J, Ashton HR, Misra AN, Redfern DRM. Radial nerve palsy in an elite bodybuilder. Br J Sports Med 2003;37:185-186.
  8. McClelland D, Paxinos A. The anatomy of the quadrilateral space with reference to quadrilateral space syndrome. J Shoulder Elbow Surg. 2007 Nov 9
  9. Jiu-jenk Lin, Jing-Lan Yang. Reliability and validity of shoulder tightness measurement in patients with stiff shoulders. Manual Therapy. 2006; 11 (146-52).