Quadrangular space

{{Short description|Anatomical region of the shoulder joint}} {{Infobox anatomy | Name = Quadrangular space | Latin = | Image = Axillary_space.png | Caption = Suprascapular and axillary nerves of right side, seen from behind. Quadrangular space is the lateral space, labeled in green at center right. Axillary nerve is visible entering it. | Image2 = Gray524.png | Caption2 = The scapular and circumflex arteries. (Quadrangular space is visible but not labeled. Posterior humeral circumflex artery is visible entering quadrangular space at center right.) | Precursor = | System = | Artery = | Vein = | Nerve = | Lymph = }} The '''quadrangular space''', also known as the '''quadrilateral 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]].<ref name="BD Chaurasia 2010">{{cite book|last1=Krishna|first1=Garg|title=BD Chaurasia's Human Anatomy (Regional and Applied Dissection and Clinical) Volume 1 - Upper limb and thorax|date=2010|publisher=CBS Publishers and Distributors Pvt Ltd|location=India|isbn=978-81-239-1863-1|page=81|edition=Fifth|chapter=7 - Scapula}}</ref>

== Structure ==

===Boundaries=== The quadrangular space is defined by:<ref>{{SUNYAnatomyLabs|03|04|01|01}} - "Scapular Region: Quadrangular Space of Scapular Region"</ref> * ''above/superior:'' [[teres minor muscle]].<ref name=":0">{{Cite book|last1=Pinkas|first1=D.|chapter-url=https://www.sciencedirect.com/science/article/pii/B9780323286831000370|title=Orthopaedic Physical Therapy Secrets|last2=Wiater|first2=J. M.|date=2017-01-01|publisher=[[Elsevier]]|isbn=978-0-323-28683-1|edition=3rd|pages=318–326|language=en|chapter=37 - Functional Anatomy of the Shoulder|doi=10.1016/b978-0-323-28683-1.00037-0}}</ref><ref name="isbn0-443-06612-4">{{cite book |author1=Adam Mitchell |author2=Drake, Richard |author3=Gray, Henry David |author4=Wayne Vogl |title=Gray's anatomy for students |publisher=Elsevier/Churchill Livingstone |year=2005 |isbn=0-443-06612-4 |page=649}}</ref> * ''below/inferior:'' [[teres major muscle]].<ref name=":0" /> * ''medially:'' long head of the [[Triceps|triceps brachii muscle]] (lateral margin).<ref name=":0" /> * ''laterally:'' [[surgical neck of the humerus]].<ref name=":0" /> * ''anteriorly:'' [[subscapularis muscle]].

===Contents=== The quadrangular space transmits the [[axillary nerve]], the [[posterior humeral circumflex artery]] and the [[posterior circumflex humeral vein]].<ref name=":0" />

==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). [[Signs and symptoms|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.<ref name="Silver 2021">{{cite journal |last1=Silver |first1=S |last2=Ledford |first2=CC |last3=Vogel |first3=KJ |last4=Arnold |first4=JJ |title=Peripheral Nerve Entrapment and Injury in the Upper Extremity. |journal=American Family Physician |date=1 March 2021 |volume=103 |issue=5 |pages=275–285 |pmid=33630556}}</ref><ref name="Mangi 2022">{{cite journal |last1=Mangi |first1=Mohammad Danish |last2=Zadow |first2=Steven |last3=Lim |first3=WanYin |title=Nerve entrapment syndromes of the upper limb: a pictorial review |journal=Insights into Imaging |date=12 October 2022 |volume=13 |issue=1 |page=166 |doi=10.1186/s13244-022-01305-5|doi-access=free |pmid=36224295 |pmc=9556688 }}</ref>

== History == The quadrangular space is so named because the three [[skeletal muscle]]s 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,<ref name="isbn0-443-06612-4" /> the quadrilateral space of Velpeau, and the foramen humerotricipitale.

==See also== * [[Quadrilateral space syndrome]] * [[Triangular space]] * [[Triangular interval]]

==Additional images== <gallery> File:Gray412-spaces.png|Muscles on the dorsum of the scapula, and the triceps brachii. </gallery>

==References== {{Gray's}} {{reflist}}

==External links== * {{DukeOrtho|Quadrangular_space}} * [https://web.archive.org/web/20070311211600/http://www.med.umich.edu/anatomy/plastinate/PlastinationGallery/images/UpperLimb/UL-Red/UL-Red-Pages/Image17.html Photo at umich.edu] * [https://web.archive.org/web/20070310211822/http://www.neuro.wustl.edu/neuromuscular/pics/diagrams/quadrangsp3.jpg Diagram at wustl.edu] * [https://web.archive.org/web/20061109013705/http://iris3.med.tufts.edu/dentgross/labguide/Shoulder4.html Photo at tufts.edu] * [https://web.archive.org/web/20130510141404/http://www.ithaca.edu/faculty/lahr/LE2000/UE_Ind_Study_99/shoulder/edited/superficial_post.jpeg Photo at ithaca.edu]

[[Category:Upper limb anatomy]]