Anatomical snuff box
The anatomical snuffbox is one of those anatomy mysteries that most students hear about and can usually identify, but have little concrete knowledge on the subject and even less information to use as a reference.
This article aims to clarify any uncertainties about this topic and to create a solid block of information for those who wish to study this rather interesting landmark.
The anatomical snuffbox is an anatomical landmark which is located on the upper limb. It is located more precisely on the lateral side of the hand between the wrist and the thumb. Although not visible on every person, it is seen as a hollow indentation when the thumb is fully extended. The reason behind its peculiar name is simple: tobacco or snuff can be placed there and inhaled.
The anterior border (lateral border) is formed by the tendons of the extensor pollicis brevis and the abductor pollicis longus, while the posterior border (medial border) consists of the tendon of the extensor pollicis longus.
Proximally, the box is limited by the styloid process of the radius and distally by the rough apex of the snuffbox known as the isosceles triangle. The floor of the snuffbox varies according to the exact position of the wrist, but its structures usually include the scaphoid, the trapezium and the base of the first metacarpal bone.
The structures that run in the anatomical snuffbox include:
- the cephalic vein
- the radial artery
- the superficial radial nerve.
De Quervain's Tenosynovitis
De Quervain's tenosynovitis is an inflammation of the tendons of the extensor pollicis brevis and the abductor pollicis longus. The main cause of the tendonitis is overuse due to the repeated grasping and gripping movements. Pain is felt when any movement that is made activates the mentioned tendons, which radiates along the lateral side of the wrist and forearm.
In order to diagnose this specific injury, Finkelstein’s maneuver is performed, which engages the tendons by making a fist of the hand over the thumb and rotating the wrist laterally. This maneuver causes significant pain. Rest is essential for the recovery of the tendons.