# Quadrangular space

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Anatomical region of the shoulder joint

Quadrangular space 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. The scapular and circumflex arteries. (Quadrangular space is visible but not labeled. Posterior humeral circumflex artery is visible entering quadrangular space at center right.) Anatomical terminology [edit on Wikidata]

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

## Structure

### Boundaries

The quadrangular space is defined by:[2]

- *above/superior:* [teres minor muscle](/source/Teres_minor_muscle).[3][4]

- *below/inferior:* [teres major muscle](/source/Teres_major_muscle).[3]

- *medially:* long head of the [triceps brachii muscle](/source/Triceps) (lateral margin).[3]

- *laterally:* [surgical neck of the humerus](/source/Surgical_neck_of_the_humerus).[3]

- *anteriorly:* [subscapularis muscle](/source/Subscapularis_muscle).

### Contents

The quadrangular space transmits the [axillary nerve](/source/Axillary_nerve), the [posterior humeral circumflex artery](/source/Posterior_humeral_circumflex_artery) and the [posterior circumflex humeral vein](https://en.wikipedia.org/w/index.php?title=Posterior_circumflex_humeral_vein&action=edit&redlink=1).[3]

## Clinical significance

The quadrangular space is a clinically important anatomic space in the arm as it provides the anterior regions of the [axilla](/source/Axilla) a passageway to the posterior regions. In the quadrangular space, the [axillary nerve](/source/Axillary_nerve) and the [posterior humeral circumflex artery](/source/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](/source/Osteophytes) which are common in [osteoarthritis](/source/Osteoarthritis), shoulder dislocations, fractures of the humeral neck, repetitive use, and external pressure (such as from crutches). [Symptoms](/source/Signs_and_symptoms) of axillary nerve compression include axillary nerve related weakness of the [deltoid muscle](/source/Deltoid_muscle) (shoulder abduction) and [teres minor](/source/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](/source/Skeletal_muscle) and one [long bone](/source/Long_bone) that form its boundaries leave a space in the shape of a [complete quadrangle](/source/Complete_quadrangle).

The quadrangular space is also known as the quadrilateral space,[4] the quadrilateral space of Velpeau, and the foramen humerotricipitale.

## See also

- [Quadrilateral space syndrome](/source/Quadrilateral_space_syndrome)

- [Triangular space](/source/Triangular_space)

- [Triangular interval](/source/Triangular_interval)

## Additional images

		- Muscles on the dorsum of the scapula, and the triceps brachii.

## References

*This article incorporates text in the [public domain](/source/Public_domain) from [page 589](https://archive.org/stream/anatomyofhumanbo1918gray#page/589/mode/2up) of the 20th edition of* [Gray's Anatomy](/source/Gray's_Anatomy) *(1918)*

1. **[^](#cite_ref-BD_Chaurasia_2010_1-0)** Krishna, Garg (2010). "7 - Scapula". *BD Chaurasia's Human Anatomy (Regional and Applied Dissection and Clinical) Volume 1 - Upper limb and thorax* (Fifth ed.). India: CBS Publishers and Distributors Pvt Ltd. p. 81. [ISBN](/source/ISBN_(identifier)) [978-81-239-1863-1](https://en.wikipedia.org/wiki/Special:BookSources/978-81-239-1863-1).

1. **[^](#cite_ref-2)** [Anatomy photo:03:04-0101](http://ect.downstate.edu/courseware/haonline/labs/l03/040101.htm) at the SUNY Downstate Medical Center - "Scapular Region: Quadrangular Space of Scapular Region"

1. ^ [***a***](#cite_ref-:0_3-0) [***b***](#cite_ref-:0_3-1) [***c***](#cite_ref-:0_3-2) [***d***](#cite_ref-:0_3-3) [***e***](#cite_ref-:0_3-4) Pinkas, D.; Wiater, J. M. (2017-01-01). ["37 - Functional Anatomy of the Shoulder"](https://www.sciencedirect.com/science/article/pii/B9780323286831000370). *Orthopaedic Physical Therapy Secrets* (3rd ed.). [Elsevier](/source/Elsevier). pp. 318–326. [doi](/source/Doi_(identifier)):[10.1016/b978-0-323-28683-1.00037-0](https://doi.org/10.1016%2Fb978-0-323-28683-1.00037-0). [ISBN](/source/ISBN_(identifier)) [978-0-323-28683-1](https://en.wikipedia.org/wiki/Special:BookSources/978-0-323-28683-1).

1. ^ [***a***](#cite_ref-isbn0-443-06612-4_4-0) [***b***](#cite_ref-isbn0-443-06612-4_4-1) Adam Mitchell; Drake, Richard; Gray, Henry David; Wayne Vogl (2005). *Gray's anatomy for students*. Elsevier/Churchill Livingstone. p. 649. [ISBN](/source/ISBN_(identifier)) [0-443-06612-4](https://en.wikipedia.org/wiki/Special:BookSources/0-443-06612-4).

1. **[^](#cite_ref-Silver_2021_5-0)** Silver, S; Ledford, CC; Vogel, KJ; Arnold, JJ (1 March 2021). "Peripheral Nerve Entrapment and Injury in the Upper Extremity". *American Family Physician*. **103** (5): 275–285. [PMID](/source/PMID_(identifier)) [33630556](https://pubmed.ncbi.nlm.nih.gov/33630556).

1. **[^](#cite_ref-Mangi_2022_6-0)** Mangi, Mohammad Danish; Zadow, Steven; Lim, WanYin (12 October 2022). ["Nerve entrapment syndromes of the upper limb: a pictorial review"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9556688). *Insights into Imaging*. **13** (1): 166. [doi](/source/Doi_(identifier)):[10.1186/s13244-022-01305-5](https://doi.org/10.1186%2Fs13244-022-01305-5). [PMC](/source/PMC_(identifier)) [9556688](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9556688). [PMID](/source/PMID_(identifier)) [36224295](https://pubmed.ncbi.nlm.nih.gov/36224295).

## External links

- [Quadrangular space](https://www.wheelessonline.com/ortho/quadrangular_space) at the [Duke University Health System](/source/Duke_University_Health_System)'s Orthopedics program

- [Photo at umich.edu](https://web.archive.org/web/20070311211600/http://www.med.umich.edu/anatomy/plastinate/PlastinationGallery/images/UpperLimb/UL-Red/UL-Red-Pages/Image17.html)

- [Diagram at wustl.edu](https://web.archive.org/web/20070310211822/http://www.neuro.wustl.edu/neuromuscular/pics/diagrams/quadrangsp3.jpg)

- [Photo at tufts.edu](https://web.archive.org/web/20061109013705/http://iris3.med.tufts.edu/dentgross/labguide/Shoulder4.html)

- [Photo at ithaca.edu](https://web.archive.org/web/20130510141404/http://www.ithaca.edu/faculty/lahr/LE2000/UE_Ind_Study_99/shoulder/edited/superficial_post.jpeg)

v t e Muscles of the arm Shoulder deltoid rotator cuff supraspinatus infraspinatus teres minor subscapularis teres major fascia: deltoid fascia supraspinous fascia infraspinous fascia Arm (compartments) anterior coracobrachialis biceps brachialis posterior triceps brachii anconeus articularis cubiti fascia axillary sheath axillary fascia brachial fascia intermuscular septa lateral medial other spaces quadrangular space triangular space triangular interval Forearm (compartments) anterior superficial: pronator teres palmaris longus flexor carpi radialis flexor carpi ulnaris flexor digitorum superficialis deep: pronator quadratus flexor digitorum profundus flexor pollicis longus posterior superficial: mobile wad brachioradialis extensor carpi radialis longus and brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris deep: supinator anatomical snuffbox abductor pollicis longus extensor pollicis brevis extensor pollicis longus extensor indicis fascia bicipital aponeurosis common tendons extensor flexor antebrachial fascia other cubital tunnel osborne's ligament Hand lateral volar thenar opponens pollicis flexor pollicis brevis abductor pollicis brevis adductor pollicis medial volar hypothenar opponens digiti minimi flexor digiti minimi brevis abductor digiti minimi palmaris brevis intermediate lumbrical interossei dorsal palmar fascia posterior: extensor retinaculum extensor expansion anterior: flexor retinaculum palmar aponeurosis

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Adapted from the Wikipedia article [Quadrangular space](https://en.wikipedia.org/wiki/Quadrangular_space) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Quadrangular_space?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.