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 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). 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 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,<ref name="isbn0-443-06612-4" /> the quadrilateral space of Velpeau, and the foramen humerotricipitale.

==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