1. CUBITAL FOSSA

2. DEFINITION  Derived From the Latin cubitum meaning elbow or cubit.  Cubital al fossa is a triangular hollow situated on the front of the elbow  It is homologous with the popletial fossa of the lower limb situated on the posterior side of the knee

5. BOUNDARIES  Medial:  Lateral border of pronator teres muscle.  Laterally  Medial border of brachioradialis muscle  Origin and insertion  Pronator teres  Origin:  pronator teres (humeral head) originates from the lower one third of the medial supracondylar ridge  Insertion:  pronator teres is inserted into the middle of the lateral surface of shaft of the radius

6.  Brachioradialis  Origin:  Brachiordialis originates from the upper two-thirds of the lateralsupracondylar ridge  Insertion:  Brachioradialis is inserted into the lowest part of the lateral surface of the shaft of the radius just above the styloid process

8.  BASE:  Base is directed upwards  It is represented by an imaginary line joining the front of two epicondyles of the humerus  APEX:  Apex is directed downwards  It is formed by the meeting point of lateral and medial boundaries

10. ROOF  It is formed by  Skin  Superficial fascia  Deep fascia  Bicipital aponeurosis  Fascia: Fascia is made up of sheets of connective tissue that is found below the skin. These tissues attach, stabilize, impart strength, maintain vessel patency, separate muscles, and enclose different organs.

11.  The superficial fascia is a loose connective tissue layer immediately deep to the skin. It contains fat, blood vessels, lymphatics, glands, and nerves. The deep fascia, also known as the investing fascia, envelops muscles and serves to support the tissues like an elastic sheath. ROOF

12. Superficial fascia  Superficial fascia contains the median cubital vein joining the cephalic and basilic veins.  The lateral cutaneous nerve of forearm lies along with the cephalic vein  The medial cutaneous nerve of forearm lies along with the basilic vein

14. FLOOR  Floor is formed by  Brachialis  Supinator surrounding the upper part of radius

15.  Origin  The brachial originates from the lower halves of the anteromedial and anerolateral surfaces of the shaft of humers Part of area extends up to posterior surface  Insertion:  Brachialis is inserted into the anterior surface of coronoid process of including the tuberosity of ulna  Origin  Supinator originates from lateral epicondyle of the humerus  Supinator crest and triangular area in front of the crest of the ulna  Insertion  Supinator is inserted into upper part of the lateral surface of the radius Brachialis supinator

18. CONTENTS  The cubital fossa is very narrow  After retracting the boundaries we can see the contents from medial to lateral in the following manner  The Median nerve  The Brachial artery  The Biceps brachi  The Radial nerve

21. MEDIAN NERVE  It gives branches to the following muscles  Flexor carpi radialis  Palmaris longus  Flexor digitorum superficialis  Median nerve leaves the cubital fossa by passing between the two heads of pronator teres (medial boundary of the cubital fossa)

24. BRACHIAL ARTERY  the termination of brachial artery lies in the cubital fossa  The origin of radial artery and ulnar artery takes place in the cubital fossa  Radial artery  Radial artery is small and superficial  It gives off the radial recurrent branch in the cubital fossa

26.  Ulnar artery  Ulnar artery is deep in the cubital fossa  It goes deep to both the heads of pronater teres and runs downwards and medially  It separates from the median nerve by the deep head of the pronator teres  Ulnar artery gives off the following branches in the cubital fossa

27.  Anterior ulnar recurrent branch  Posterior ulnar recurrent branch  Common interosseous branch  Again common interosseous branch divides into  Anterior(volar) interosseous branch  Posterior interosseous(dorsal) branch and latter gives off  The interosseous recurrent branch

29. BICEPS BRACHI  The tendon of biceps brachi with bicipital aponeurosis  Aponeurosis, a flat sheet or ribbon of tendonlike material that anchors a muscle or connects it with the part that the muscle moves.

31. RADIAL NERVE  Radial nerve is terminated just below the lateral epicondyle in the fossa by dividing into  Superficial branch  Deep branch (interosseous branch) leaves the fossa by piercing supinator muscle and foes posteriorly  Radial nerve(superficial branch) is appeared in the gap between the brachialis (medially) and the brachioradialis and extensor carpi radialis longus (laterally)  While running between the intermuscular gap the radial nerve supplies the above flanking muscles and runs in the fore arm for some distance

33. THANK YOU CUBITAL FOSSA