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{{Short description|Indent on back of hand between tendons}}
{{Infobox anatomy
{{Infobox anatomy
| Name = Anatomical snuffbox
| Name = Anatomical snuffbox
| Latin = fovea radialis
| Latin = fovea radialis
| Greek =
| Greek =
| Image = anatomical-snuff-box.jpg
| Image = Anatomical snuffbox IMG 6853 a.jpg
| Caption = anatomical snuffbox
| Caption = Anatomical snuffbox
| Width =
| Width =
| Image2 = Gray424.png
| Image2 = Gray424.png
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| Precursor =
| Precursor =
| System =
| System =
| Artery = [[radial artery]]
| Artery = [[Radial artery]]
| Vein = [[cephalic vein]]
| Vein = [[Cephalic vein]]
| Nerve = [[radial nerve]]
| Nerve = [[Radial nerve]]
| Lymph =
| Lymph =
}}
}}
The '''anatomical snuff box''' or '''snuffbox''' is a triangular deepening on the [[Anatomical terms of location#Relative directions|radial]], [[Dorsum (biology)|dorsal]] aspect of the [[hand]]—at the level of the [[carpal bones]], specifically, the [[Scaphoid_bone|scaphoid]] and [[Trapezium_(bone)|trapezium]] bones forming the floor. The name originates from the use of this surface for placing and then sniffing powdered [[tobacco]], or "[[Snuff (tobacco)|snuff]]." It is sometimes referred to by its [[French language|French]] name ''tabatière''.
The '''anatomical snuff box''' or '''snuffbox''' or '''foveola radialis''' is a triangular deepening on the [[Anatomical terms of location#Relative directions|radial]], [[Dorsum (biology)|dorsal]] aspect of the [[hand]]—at the level of the [[carpal bones]], specifically, the [[Scaphoid bone|scaphoid]] and [[Trapezium (bone)|trapezium]] bones forming the floor. The name originates from the use of this surface for placing and then sniffing powdered [[tobacco]], or "[[Snuff (tobacco)|snuff]]."{{Citation needed|date=September 2021}} It is sometimes referred to by its [[French language|French]] name ''tabatière''.


==Structure==
==Structure==
===Boundaries===
===Boundaries===
* The medial border (medial side) of the snuffbox is the [[tendon]] of the [[extensor pollicis longus]].
* The medial border (ulnar side) of the snuffbox is the [[tendon]] of the [[extensor pollicis longus]]
* The lateral border (radial side) is a pair of parallel and intimate tendons, of the [[extensor pollicis brevis]] and the [[abductor pollicis longus]].<ref name="titleChapter 10: THE FOREARM">{{cite web |url=http://www.dartmouth.edu/~humananatomy/part_2/chapter_10.html#chpt_10_muscles_back |title=Chapter 10: THE FOREARM |accessdate=2008-01-05 |format= |work=| archiveurl= https://web.archive.org/web/20071209190234/http://www.dartmouth.edu/~humananatomy/part_2/chapter_10.html| archivedate= 9 December 2007 <!--DASHBot-->| deadurl= no}}</ref> (Accordingly, the anatomical snuffbox is most visible, having a more pronounced concavity, during thumb [[Extension (kinesiology)|extension]].)
* The lateral border (radial side) is a pair of parallel and intimate tendons, of the [[extensor pollicis brevis]] and the [[abductor pollicis longus]].<ref name="titleChapter 10: THE FOREARM">{{cite web |url=http://www.dartmouth.edu/~humananatomy/part_2/chapter_10.html#chpt_10_muscles_back |title=Chapter 10: THE FOREARM |access-date=2008-01-05 | archive-url= https://web.archive.org/web/20071209190234/http://www.dartmouth.edu/~humananatomy/part_2/chapter_10.html| archive-date= 9 December 2007 | url-status= live}}</ref> (Accordingly, the anatomical snuffbox is most visible, having a more pronounced concavity, during thumb [[Extension (kinesiology)|extension]].)
* The [[Anatomical terms of location#Proximal and distal|proximal]] border is formed by the [[Radial styloid process|styloid process]] of the [[Radius (bone)|radius]]
* The [[Anatomical terms of location#Proximal and distal|proximal]] border is formed by the [[Radial styloid process|styloid process]] of the [[Radius (bone)|radius]]
* The [[Anatomical terms of location#Proximal and distal|distal]] border is formed by the approximate apex of the schematic snuffbox [[isosceles]] triangle.
* The [[Anatomical terms of location#Proximal and distal|distal]] border is formed by the approximate apex of the schematic snuffbox [[isosceles]] triangle.
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=== Neurovascular anatomy ===
=== Neurovascular anatomy ===
Deep to the tendons which form the borders of the anatomical snuff box lies the [[radial artery]], which passes through the anatomical snuffbox on its course from the normal radial pulse detecting area, to the proximal space in between the first and second [[metacarpals]] to contribute to the superficial and deep palmar arches. In the anatomical snuffbox, the radial artery is closely related (<2 mm) with the [[Superficial branch of radial nerve|superficial branch of radial nerve]] near the styloid process of radius in 48%, while in 24% the radial artery is closely related to the [[Lateral cutaneous nerve of forearm|lateral cutaneous nerve of forearm]].<ref>{{Cite journal|last=Robson|first=A. J.|last2=See|first2=M. S.|last3=Ellis|first3=H.|date=2008|title=Applied anatomy of the superficial branch of the radial nerve|url=https://www.ncbi.nlm.nih.gov/pubmed/18092362|journal=Clinical Anatomy (New York, N.Y.)|volume=21|issue=1|pages=38–45|doi=10.1002/ca.20576|issn=1098-2353|pmid=18092362|via=}}</ref> The [[cephalic vein]] arises within the anatomical snuffbox, while the [[Superficial branch of radial nerve|dorsal cutaneous branch]] of the [[radial nerve]] can be palpated by stroking along the extensor pollicis longus with the dorsal aspect of a fingernail.
Deep to the tendons which form the borders of the anatomical snuff box lies the [[radial artery]], which passes through the anatomical snuffbox on its course from the normal radial pulse detecting area, to the proximal space in between the first and second [[metacarpals]] to contribute to the [[Superficial palmar arch|superficial]] and [[deep palmar arch]]es. In the anatomical snuffbox, the radial artery is closely related (<2&nbsp;mm) with the [[superficial branch of radial nerve]] near the styloid process of radius in 48%, while in 24% the radial artery is openly related to the [[lateral cutaneous nerve of forearm]].<ref>{{Cite journal|last=Robson|first=A. J.|last2=See|first2=M. S.|last3=Ellis|first3=H.|date=2008|title=Applied anatomy of the superficial branch of the radial nerve|journal=Clinical Anatomy|volume=21|issue=1|pages=38–45|doi=10.1002/ca.20576|issn=1098-2353|pmid=18092362}}</ref> The [[cephalic vein]] arises within the anatomical snuffbox, while the [[Superficial branch of radial nerve|dorsal cutaneous branch]] of the [[radial nerve]] can be palpated by stroking along the extensor pollicis longus with the dorsal aspect of a fingernail.


==Clinical significance==
==Clinical significance==
The radius and scaphoid articulate deep to the snuffbox to form the basis of the wrist joint. In the event of a fall onto an outstretched hand (FOOSH), this is the area through which the brunt of the force will focus. This results in these two bones being the most often fractured of the wrist. In a case where there is localized [[Tenderness (medicine)|tenderness]] within the snuffbox, knowledge of wrist anatomy leads to the speedy conclusion that the fracture is likely to be of the [[Scaphoid_bone|scaphoid]]. This is understandable as the scaphoid is a small, oddly shaped bone whose purpose is to facilitate mobility rather than confer stability to the wrist joint {{citation needed|date=July 2015}}. In the event of inordinate application of force over the wrist, this small scaphoid is likely to be the weak link {{citation needed|date=July 2015}}. [[Scaphoid fracture]] is one of the most frequent causes of medico-legal issues.
The radius and scaphoid articulate deep to the snuffbox to form the basis of the wrist joint. In the event of a fall onto an outstretched hand (FOOSH), this is the area through which the brunt of the force will focus. This results in these two bones being the most often fractured of the wrist. In a case where there is localized [[Tenderness (medicine)|tenderness]] within the snuffbox, knowledge of wrist anatomy leads to the speedy conclusion that the fracture is likely to be of the [[Scaphoid bone|scaphoid]]. This is understandable as the scaphoid is a small, oddly shaped bone whose purpose is to facilitate mobility rather than confer stability to the wrist joint {{citation needed|date=July 2015}}. In the event of inordinate application of force over the wrist, this small scaphoid is likely to be the weak link {{citation needed|date=July 2015}}. [[Scaphoid fracture]] is one of the most frequent causes of medico-legal issues.


An anatomical anomaly in the vascular supply to the scaphoid is the area to which the blood supply is first delivered. Blood enters the scaphoid distally. Consequently, in the event of a fracture the proximal segment of the scaphoid will be devoid of a vascular supply, and will—if action is not taken—avascularly [[necrosis|necrose]] within a sufferer's snuffbox. Due to the small size of the scaphoid and its shape, it is difficult to determine, early on, whether or not the scaphoid is indeed fractured with an x-ray. Further complications include; carpal instability (ligament disruption) and fracture-dislocations.
An anatomical anomaly in the vascular supply to the scaphoid is the area to which the blood supply is first delivered. Blood enters the scaphoid distally. Consequently, in the event of a fracture the proximal segment of the scaphoid will be devoid of a vascular supply, and will—if action is not taken—avascularly [[necrosis|necrose]] within a sufferer's snuffbox. Due to the small size of the scaphoid and its shape, it is difficult to determine, early on, whether or not the scaphoid is indeed fractured with an x-ray. Further complications include; carpal instability (ligament disruption) and fracture-dislocations.
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File:Gray1237.svg|Palm of left hand, showing position of skin creases and bones, and surface markings for the volar arches.
File:Gray1237.svg|Palm of left hand, showing position of skin creases and bones, and surface markings for the volar arches.
File:Anatomical snuff box2.jpg|A particularly cavernous anatomical snuff box.
File:Anatomical snuff box2.jpg|A particularly cavernous anatomical snuff box.
File:Schematic drawing of anatomical snuffbox.png|Schematic drawing of anatomical snuffbox
</gallery>
</gallery>

==See also==
* [[Anatomical terminology]]
* [[Anatomical terms of bone]]


==References==
==References==
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{{Superficial anatomy of limbs}}
{{Superficial anatomy of limbs}}
{{Muscles_of_upper limb}}


{{DEFAULTSORT:Anatomical Snuff Box}}
{{DEFAULTSORT:Anatomical Snuff Box}}
[[Category:Hand]]
[[Category:Hand]]
[[Category:Anatomy]]

Latest revision as of 17:14, 20 December 2024

Anatomical snuffbox
Anatomical snuffbox
The mucous sheaths of the tendons on the back of the wrist. (Anatomical snuffbox not labeled, but visible at right.)
Details
ArteryRadial artery
VeinCephalic vein
NerveRadial nerve
Identifiers
Latinfovea radialis
TA2301
FMA42329
Anatomical terminology

The anatomical snuff box or snuffbox or foveola radialis is a triangular deepening on the radial, dorsal aspect of the hand—at the level of the carpal bones, specifically, the scaphoid and trapezium bones forming the floor. The name originates from the use of this surface for placing and then sniffing powdered tobacco, or "snuff."[citation needed] It is sometimes referred to by its French name tabatière.

Structure

[edit]

Boundaries

[edit]

Neurovascular anatomy

[edit]

Deep to the tendons which form the borders of the anatomical snuff box lies the radial artery, which passes through the anatomical snuffbox on its course from the normal radial pulse detecting area, to the proximal space in between the first and second metacarpals to contribute to the superficial and deep palmar arches. In the anatomical snuffbox, the radial artery is closely related (<2 mm) with the superficial branch of radial nerve near the styloid process of radius in 48%, while in 24% the radial artery is openly related to the lateral cutaneous nerve of forearm.[2] The cephalic vein arises within the anatomical snuffbox, while the dorsal cutaneous branch of the radial nerve can be palpated by stroking along the extensor pollicis longus with the dorsal aspect of a fingernail.

Clinical significance

[edit]

The radius and scaphoid articulate deep to the snuffbox to form the basis of the wrist joint. In the event of a fall onto an outstretched hand (FOOSH), this is the area through which the brunt of the force will focus. This results in these two bones being the most often fractured of the wrist. In a case where there is localized tenderness within the snuffbox, knowledge of wrist anatomy leads to the speedy conclusion that the fracture is likely to be of the scaphoid. This is understandable as the scaphoid is a small, oddly shaped bone whose purpose is to facilitate mobility rather than confer stability to the wrist joint [citation needed]. In the event of inordinate application of force over the wrist, this small scaphoid is likely to be the weak link [citation needed]. Scaphoid fracture is one of the most frequent causes of medico-legal issues.

An anatomical anomaly in the vascular supply to the scaphoid is the area to which the blood supply is first delivered. Blood enters the scaphoid distally. Consequently, in the event of a fracture the proximal segment of the scaphoid will be devoid of a vascular supply, and will—if action is not taken—avascularly necrose within a sufferer's snuffbox. Due to the small size of the scaphoid and its shape, it is difficult to determine, early on, whether or not the scaphoid is indeed fractured with an x-ray. Further complications include; carpal instability (ligament disruption) and fracture-dislocations.

Additional images

[edit]
  • Tendons of forefinger and vincula tendina.
    Tendons of forefinger and vincula tendina.
  • The veins on the dorsum of the hand.
    The veins on the dorsum of the hand.
  • Palm of left hand, showing position of skin creases and bones, and surface markings for the volar arches.
    Palm of left hand, showing position of skin creases and bones, and surface markings for the volar arches.
  • A particularly cavernous anatomical snuff box.
    A particularly cavernous anatomical snuff box.
  • Schematic drawing of anatomical snuffbox
    Schematic drawing of anatomical snuffbox

See also

[edit]

References

[edit]
  1. ^ "Chapter 10: THE FOREARM". Archived from the original on 9 December 2007. Retrieved 2008-01-05.
  2. ^ Robson, A. J.; See, M. S.; Ellis, H. (2008). "Applied anatomy of the superficial branch of the radial nerve". Clinical Anatomy. 21 (1): 38–45. doi:10.1002/ca.20576. ISSN 1098-2353. PMID 18092362.
[edit]
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