Understanding the anatomy of the cubital fossa has several clinical uses. First, the brachial pulse can be identified more easily by palpating the brachial artery, which is medial to the biceps tendon in the cubital fossa. Next, since the superficial veins of the cubital fossa are easily accessible, they’re often used for drawing blood and inserting intravenous catheters, as well as other procedures, like the creation of an AV fistula.
In preparation for dialysis, individuals typically undergo a surgical procedure to create the AV fistula, which is when an artery and vein are surgically ligated to create a dialysis access. The fistula causes extra pressure and blood to flow into the vein, turning it into a stronger blood vessel. The larger vein provides reliable, long-term access to vessels to allow large volumes of blood to be removed from the body through the dialyzer, which after filtration is returned to the body through the fistula. Without the fistula, regular hemodialysis sessions would not be possible, as untreated veins tend to collapse with repeated needle insertions.
Finally, the contents of the cubital fossa can become damaged due to trauma to this region, such as with supracondylar fractures of the
humerus. These fractures are more common in children and typically occur due to a fall onto an outstretched arm. Although the fracture occurs above the epicondyles of the humerus, displaced fragments may cause injury to the contents of the cubital fossa. For example, an anteriorly displaced portion of the
fractured humerus on the medial supracondylar region could injure the
median nerve, resulting in wrist flexion weakness and cutaneous deficits of the anterior three and a half digits. Alternatively, an anterior displaced fracture of the lateral supracondylar region could cause damage to the
radial nerve, causing weakness of wrist and hand
extensors, as well as posterior forearm and hand sensory loss.
