The median nerve was identified in the arm and dissected distally after sectioning the bicipital aponeurosis
. The ulnar head of the PTM was detached distally and retracted while the FCR and PL tendons were sectioned in the distal third after identification of the nerve branches.
To test for compression from the bicipital aponeurosis
, ask the patient to flex the elbow to approximately 120[degrees] to 130[degrees] and apply active supinated resistance.
(38-40) Of note, the tendon rarely retracts significantly into the arm because it is partially tethered by the bicipital aponeurosis
, also known as the lacertus fibrosis.
In the cubital Fossa: The SUA is present superficial to the bicipital aponeurosis
and subjacent to the median cubital vein where it is most vulnerable to injury while attempting for intra- venous injections and cannulations.
(6) The distal tendon spirals in a predictable pattern distally to the bicipital aponeurosis
, spiraling clockwise in left elbows and counterclockwise in right elbows.
Along the course, it ran superficial to the bicipital aponeurosis
& muscle of front of forearm.
The common observation noted with the variation of the artery from the arm was the course from the upper third of the brachial artery, superficial to median nerve and behind bicipital aponeurosis
at the elbow.
Along its course, part of this nerve enters the axilla of the shoulder, runs immediately adjacent to the biceps, and descends within the hollow of the elbow under the pronator teres muscle and the bicipital aponeurosis
. Other authors suggest that compression or entrapment may be present at a number of sites along the median nerve.
(28,29) The tendon does not retract if the bicipital aponeurosis
(lacertus fibrosis) remains intact.
2.12) and then crossed the median nerve under cover of bicipital aponeurosis
. The brachial artery I coursed further for a distance of 1.7cm and then divided into radial and common interosseous arteries (Fig.
In the antecubital fossa the median nerve and brachial artery are located in a closed compartment underneath the bicipital aponeurosis
. In this limited space any swelling or hemorrhage in the antecubital fossa can result in nerve compression and permanent nerve damage.
In 10% of cases a third head arises from the superomedial part of brachialis and is attached to the bicipital aponeurosis
, which descends medial side of the tendon of insertion .