bicipital aponeurosis
{{Short description|Distal end of the biceps muscle}}
{{Infobox anatomy
| Name = Bicipital aponeurosis
| Latin = aponeurosis musculi bicipitis brachii
| Image = Gray410.png
| Caption = Superficial muscles of the chest and front of the arm. (Lacertus fibrosus visible as white band at lower right.)
| Image2 =
| Caption2 =
| System =
| Precursor =
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The bicipital aponeurosis (also known as lacertus fibrosus) is a broad aponeurosis of the biceps brachii, which is located in the cubital fossa of the elbow. It separates superficial from deep structures in much of the fossa.
Structure
The bicipital aponeurosis originates from the distal insertion of the biceps brachii, and inserts into the deep fascia of the forearm.{{Citation|last=Morrey|first=Bernard F.|title=2 - Anatomy of the Elbow Joint|date=2018-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780323341691000024|work=Morrey's the Elbow and its Disorders (Fifth Edition)|pages=9–32|editor-last=Morrey|editor-first=Bernard F.|place=Philadelphia|publisher=Elsevier|language=en|doi=10.1016/b978-0-323-34169-1.00002-4|isbn=978-0-323-34169-1|access-date=2020-11-19|last2=Llusá-Pérez|first2=Manuel|last3=Ballesteros-Betancourt|first3=José R.|editor2-last=Sanchez-Sotelo|editor2-first=Joaquin|editor3-last=Morrey|editor3-first=Mark E.}} The biceps tendon inserts on the radial tuberosity, and the bicipital aponeurosis lies medially to it.{{Citation|last=Brown|first=Matthew|title=Procedure 87 - Biceps and Brachialis Lengthening|date=2018-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780323401913000871|work=Operative Techniques: Hand and Wrist Surgery (Third Edition)|pages=771–777|editor-last=Chung|editor-first=Kevin C.|publisher=Elsevier|language=en|doi=10.1016/b978-0-323-40191-3.00087-1|isbn=978-0-323-40191-3|access-date=2020-11-19|last2=Chung|first2=Kevin C.}} It reinforces the cubital fossa, helping to protect the brachial artery and the median nerve running underneath.{{Citation|last=Savastano|first=Luis|title=Chapter 41 - Anatomy of the Median Nerve and Its Branches|date=2015-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780124103900000433|work=Nerves and Nerve Injuries|pages=553–562|editor-last=Tubbs|editor-first=R. Shane|place=San Diego|publisher=Academic Press|language=en|doi=10.1016/b978-0-12-410390-0.00043-3|isbn=978-0-12-410390-0|access-date=2020-11-19|last2=Yang|first2=Lynda J. -S.|editor2-last=Rizk|editor2-first=Elias|editor3-last=Shoja|editor3-first=Mohammadali M.|editor4-last=Loukas|editor4-first=Marios}}{{Citation|last=Pezeshk|first=Parham|title=Chapter 13 - Imaging of Entrapped Peripheral Nerves|date=2015-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780124103900000147|work=Nerves and Nerve Injuries|pages=167–171|editor-last=Tubbs|editor-first=R. Shane|place=San Diego|publisher=Academic Press|language=en|doi=10.1016/b978-0-12-410390-0.00014-7|isbn=978-0-12-410390-0|access-date=2020-11-19|editor2-last=Rizk|editor2-first=Elias|editor3-last=Shoja|editor3-first=Mohammadali M.|editor4-last=Loukas|editor4-first=Marios}}
= Variations =
Some individuals (about 3% of the population) have a superficial ulnar artery that runs superficially to the bicipital aponeurosis instead of underneath it. These individuals are at risk for accidental injury to the ulnar artery during venipuncture.{{cite journal |doi=10.1093/bja/aei548 |title=The superficial ulnar artery--a potential hazard in patients with difficult venous access |first2=K |last2=Singh |author= Chin and Singh |volume=94 |issue=5 |journal= British Journal of Anaesthesia |year=2005 |pmid=15814810 |pages=692–3|doi-access=free }}
Clinical significance
The bicipital aponeurosis is superficial to the brachial artery and the median nerve, but deep to the median cubital vein. This protection is important during venipuncture (taking blood).
It is one structure that has to be incised during fasciotomy in the treatment of acute compartment syndrome of the forearm and elbow region.{{Medical citation needed|date=December 2024}}
References
{{Gray's}}
{{Reflist}}
External links
- [https://web.archive.org/web/20070927093418/http://www.radsource.us/rf/RADS/Internal.aspx?PID=670 Diagram at radsource.edu (seventh diagram from top)]
- {{SUNYAnatomyLabs|07|01|02|01}} - "Flexor Region of the Forearm: Muscles that Border the Cubital Fossa"
{{Upper limb general}}
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