Cubital fossa
The cubital fossa, also known as antecubital fossa, is a triangular-shaped area situated on most proximal part of the ventral surface of the forearm. It contains several important neurovascular structures that pass between the arm and forearm.
The cubital fossa contains a superior, medial and lateral border, as well as an apex which is directed inferiorly. The cubital fossa also has a floor and roof, and it is traversed by structures which make up its contents.
This article will discuss the anatomy of the cubital fossa.
Definition | The cubital fossa is a triangularly-shaped area situated on most proximal part of the ventral surface of forearm |
Boundaries |
Superior border: Imaginary line joining the epicondyles of the humerus
Medial border: pronator teres muscle Lateral border: brachioradialis muscle Apex: pronator teres and brachioradialis muscles Roof: skin, fascia of forearm, bicipital aponeurosis Floor: brachialis muscle, supinator muscle |
Contents |
Median nerve, Brachial artery, Tendon of biceps brachii, Radial nerve Mnemonic: My Blood Turns Red |
Clinical points | Venipuncture, blood pressure measurements |
Boundaries
The shape of the cubital fossa resembles a triangle that contains three borders, an apex, floor and roof.
- The superior border – also known as the base – is formed by an imaginary line that runs from the medial epicondyle to the lateral epicondyle of the humerus.
- The medial border is formed by the pronator teres muscle.
- The lateral border is formed by the brachioradialis muscle.
- The apex is directed inferiorly, and represents the sharp angle formed by the pronator teres and brachioradialis muscles at the point where these two muscles meet.
- The roof is formed (from superficial to deep) by the skin, fascia of the forearm and the bicipital aponeurosis (medially). The bicipital aponeurosis forms a partial protective covering to the medial nerve, brachial artery, radial artery and ulnar artery.
- The floor consists of the brachialis muscle (proximally) and the supinator muscle (distally).
Contents
The cubital fossa contains four structures (from medial to lateral):
- Median nerve
- Brachial artery
- Tendon of biceps brachii
- Radial nerve
Remembering the cubital fossa contents is incredibly easy if you use the following mnemonic:
My Blood Turns Red
- Median nerve
- Brachial artery
- Tendon of biceps
- Radial nerve
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Within the cubital fossa, the brachial artery bifurcates to form two more arteries. These arteries are the radial artery (laterally) and the ulnar artery (medially). These two arteries are named and situated in accordance with the radial and ulnar bones of the forearm.
The fascia forming the roof also contains the median cubital vein, the lateral cutaneous nerve of the forearm, and medial cutaneous nerve of the forearm. On the bicipital aponeurosis lies the basilic vein (medially) and the cephalic vein (laterally).
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Clinical applications
Venipuncture
The cubital fossa is a common site for sampling and transfusion of blood, and intravenous injections because of the prominence and accessibility of the 'attending' veins. The median cubital vein is most commonly accessed for venipuncture. A tourniquet is placed around the midarm to distend the veins in the cubital fossa. Once the vein is punctured, the tourniquet is removed so that when the needle is removed, the vein will not bleed extensively. The median cubital vein is also a site for the introduction of cardiac catheters to secure blood samples from the great vessels and chambers of the heart. This route may also be used for coronary angiography.
Blood pressure measurements
The cubital fossa is a site for placement of the diaphragm of the stethoscope during blood pressure measurement to palpate the pulse of the brachial artery.
Cubital fossa: want to learn more about it?
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