Quadrangular space explained

The quadrangular space, also known as the quadrilateral space (of Velpeau) and the foramen humerotricipitale, is one of the three spaces in the axillary space. The other two spaces are: triangular space and triangular interval.^[1]

Structure

The quadrangular space is one of the three spaces in the axillary space.

Boundaries

The quadrangular space is defined by:^[2]

• above/superior: teres minor muscle.^{[3] [4]}
• below/inferior: teres major muscle.
• medially: long head of the triceps brachii muscle (lateral margin).
• laterally: surgical neck of the humerus.
• anteriorly: subscapularis muscle.

Contents

The quadrangular space transmits the axillary nerve, the posterior humeral circumflex artery and the posterior circumflex humeral vein.

Clinical significance

The quadrangular space is a clinically important anatomic space in the arm as it provides the anterior regions of the axilla a passageway to the posterior regions. In the quadrangular space, the axillary nerve and the posterior humeral circumflex artery can be compressed or damaged due to space-occupying lesions or disruption in the anatomy due to trauma. Other common causes of axillary nerve compression at the quadrangular space include local compression due to osteophytes which are common in osteoarthritis, shoulder dislocations, fractures of the humeral neck, repetitive use, and external pressure (such as from crutches). Symptoms of axillary nerve compression include axillary nerve related weakness of the deltoid muscle (shoulder abduction) and teres minor (external rotation of the arm) as well as numbness of the lateral shoulder. The quadrangular space is the most common site of axillary nerve compression.^{[5] [6]}

History

The quadrangular space is so named because the three skeletal muscles and one long bone that form its boundaries leave a space in the shape of a complete quadrangle.

The quadrangular space is also known as the quadrilateral space, the quadrilateral space of Velpeau, and the foramen humerotricipitale.

See also

• Quadrilateral space syndrome
• Triangular space
• Triangular interval

External links

• • Photo at umich.edu
• Diagram at wustl.edu
• Photo at tufts.edu
• Photo at ithaca.edu

Notes and References

1. Book: Krishna. Garg. BD Chaurasia's Human Anatomy (Regional and Applied Dissection and Clinical) Volume 1 - Upper limb and thorax. 2010. CBS Publishers and Distributors Pvt Ltd. India. 978-81-239-1863-1. 81. Fifth. 7 - Scapula.
2. - "Scapular Region: Quadrangular Space of Scapular Region"
3. Book: Pinkas. D.. https://www.sciencedirect.com/science/article/pii/B9780323286831000370. Orthopaedic Physical Therapy Secrets. Wiater. J. M.. 2017-01-01. Elsevier. 2017. 978-0-323-28683-1. 3rd. 318–326. en. 37 - Functional Anatomy of the Shoulder. 10.1016/b978-0-323-28683-1.00037-0.
4. Book: Adam Mitchell . Drake, Richard . Gray, Henry David . Wayne Vogl . Gray's anatomy for students . Elsevier/Churchill Livingstone . 2005 . 0-443-06612-4 . 649.
5. Silver . S . Ledford . CC . Vogel . KJ . Arnold . JJ . Peripheral Nerve Entrapment and Injury in the Upper Extremity. . American Family Physician . 1 March 2021 . 103 . 5 . 275–285 . 33630556.
6. Mangi . Mohammad Danish . Zadow . Steven . Lim . WanYin . Nerve entrapment syndromes of the upper limb: a pictorial review . Insights into Imaging . 12 October 2022 . 13 . 1 . 166 . 10.1186/s13244-022-01305-5. free . 36224295 . 9556688 .