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Examination of Pediatric Hand and Wrist
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Mohsina Subair, Satyaswarup Tripathy, Ranjit Kumar Sahu
Dorsal surface (Figure 7.1b): Skin is thin and loose.Extensor tendons and superficial veins are easily visible on the dorsum.Knuckles: Formed by heads of metacarpal.Web spaces: Characteristic hourglass appearance.Intermetacarpal spaces formed by interossei muscles: Hollowing of these spaces indicates wasting of the muscles.Anatomical snuffbox: Triangular deepening bounded by abductor pollicis longus (APL) and extensor pollicis brevis (EPB) anteriorly and extensor pollicis longus (EPL) posteriorly.3 The floor is formed by the scaphoid and trapezium.
Upper Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The continuation of the ulnar artery then forms, distally, the superficial palmar arch, which gives rise to the common digital arteries that in turn give rise to the proper digital arteries (Figure 4.4). The continuation of the radial artery forms, distally, the deep palmar arch, which is connected via the superficial palmar branch of the radial artery to the superficial palmar arch (Plates 4.17b and 4.18). A clinically important feature of the radial artery is that it passes through the anatomicalsnuffbox—enclosed by the tendons of the extensor pollicis brevis and extensor pollicis longus (Plate 4.15)—to reach the dorsum of the hand. Then the artery returns to the palmar surface by passing between the heads of the 1st dorsal interosseous muscle. In the palm, it then gives rise to the deep palmar arch and to a distinct artery for the thumb: the princeps pollicis artery.
Upper limb
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Anatomical snuffbox– best seen when thumb is extended and abducted– lateral border = tendon of extensor pollicis brevis and tendon of abductor pollicis longus– medial border = tendon of extensor pollicis longus– floor = scaphoid + trapezium– contents = radial a.
Contemporary review of management techniques for cephalic arch stenosis in hemodialysis
Published in Renal Failure, 2023
Gift Echefu, Shivangi Shivangi, Ramanath Dukkipati, Jon Schellack, Damodar Kumbala
The Cephalic vein is part of the upper extremity’s superficial venous system. It originates in the anatomical snuffbox from the radial aspect of the superficial venous network of the dorsum of the hand. Coursing along the anterolateral forearm to the elbow, it communicates with the basilic veins via median ante-cubital veins. It then courses along the lateral aspect of the biceps toward the pectoralis major muscle as it enters the deltopectoral groove (a triangular space formed by the adjacent borders of the deltoid and pectoralis major muscles Figure 2). It then passes under the clavicle, turning sharply to pierce the clavipectoral fascia terminating as the axillary vein. The cephalic arch refers to the final arch of the cephalic vein before it drains into the first part of the axillary vein.
Feasibility of distal transradial access for coronary angiography and percutaneous coronary intervention: an observational and prospective study in a Latin-American Centre
Published in Acta Cardiologica, 2023
Héctor Hugo Escutia-Cuevas, Marco Alcantara Melendez, Arnoldo Santos Jiménez-Valverde, Gregorio Zaragoza-Rodriguez, Antonio Vargas-Cruz, Juan Francisco Garcia-Garcia, Bayardo Antonio Ordonez-Salazar, Antonio Flores-Morgado, Guillermo Orozco Guerra, Diego Alvaro Renteria-Valencia
The distal radial technique, which consists of canalising the radial artery through the anatomical structure called snuffbox (anatomical snuffbox, radial fossa, fovea radialis), has recently emerged as an alternative arterial intervention for diagnostic and therapeutic coronary catheterisation, allowing the conservation of the radial artery for classical transradial intervention [5,6]. The radial fossa is a hollow space on the radial side of the wrist that becomes evident when the thumb is extended; it is limited by the extensor pollicis longus tendon of the thumb, the extensor pollicis brevis and the abductor pollicis longus tendons of the thumb. The radial artery crosses the surface formed by the scaphoid and trapezium (Figure 1). Distal artery access from the radial fossa was first described in 2011 with the aim of permeabilize the ipsilateral radial arteries with retrograde occlusion [7]. If the artery is well developed it can be used as the entry site for 4, 5, 6, 7 or even 8 Fr catheters and sheaths [8].
Free serratus anterior fascial flap combined with vascularized scapular bone for reconstruction of dorsal hand and finger defects
Published in Case Reports in Plastic Surgery and Hand Surgery, 2018
Takeshi Kitazawa, Masato Shiba, Kazuhiro Tsunekawa
The wound was temporarily covered with artificial dermis and reconstruction was performed 14 days after injury. After surgical debridement, an 8 × 8-cm area of serratus fascia and a block of bone measuring 3 × 1×0.5 cm from the scapula on the angular branch of the thoracodorsal artery were harvested concomitantly (Figure 3). The angular branch arose from the serratus anterior pedicle of the thoracodorsal artery and the length of the pedicle dissected to the bifurcation of the subscapular artery was 8 cm. After setting the harvested bone block in the defect and suturing the disrupted tendon, a fascial flap was placed over the wound. A split-thickness skin graft from the ipsilateral chest wall in the same operative field was grafted on the fascial flap. In the anatomical snuff box, the artery of the flap was anastomosed to the radial artery and the vein of the flap was anastomosed to the cephalic vein in end-to-end fashion.