| Anatomical snuffbox | |
|---|---|
 Anatomical snuffbox | |
 The mucous sheaths of the tendons on the back of the wrist. (Anatomical snuffbox not labeled, but visible at right.) | |
| Details | |
| Artery | Radial artery |
| Vein | Cephalic vein |
| Nerve | Radial nerve |
| Identifiers | |
| Latin | fovea radialis |
| TA2 | 301 |
| FMA | 42329 |
| Anatomical terminology | |
Theanatomical snuff box orsnuffbox orfoveola radialis is a triangular deepening on theradial,dorsal aspect of thehand—at the level of thecarpal bones, specifically, thescaphoid andtrapezium bones forming the floor. The name originates from the use of this surface for placing and then sniffing powderedtobacco, or "snuff."[1] It is sometimes referred to by itsFrench nametabatière.
Deep to the tendons which form the borders of the anatomical snuff box lies theradial artery, which passes through the anatomical snuffbox on its course from the normal radial pulse detecting area, to the proximal space in between the first and secondmetacarpals to contribute to thesuperficial anddeep palmar arches. In the anatomical snuffbox, the radial artery is closely related (<2 mm) with thesuperficial branch of radial nerve near the styloid process of radius in 48%, while in 24% the radial artery is openly related to thelateral cutaneous nerve of forearm.[3] Thecephalic vein arises within the anatomical snuffbox, while thedorsal cutaneous branch of theradial nerve can be palpated by stroking along the extensor pollicis longus with the dorsal aspect of a fingernail.
The radius and scaphoid articulate deep to the snuffbox to form the basis of the wrist joint. In the event of a fall onto an outstretched hand (FOOSH), this is the area through which the brunt of the force will focus. This results in these two bones being the most often fractured of the wrist. In a case where there is localizedtenderness within the snuffbox, knowledge of wrist anatomy leads to the speedy conclusion that the fracture is likely to be of thescaphoid. This is understandable as the scaphoid is a small, oddly shaped bone whose purpose is to facilitate mobility rather than confer stability to the wrist joint[citation needed]. In the event of inordinate application of force over the wrist, this small scaphoid is likely to be the weak link[citation needed].Scaphoid fracture is one of the most frequent causes of medico-legal issues.
An anatomical anomaly in the vascular supply to the scaphoid is the area to which the blood supply is first delivered. Blood enters the scaphoid distally. Consequently, in the event of a fracture the proximal segment of the scaphoid will be devoid of a vascular supply, and will—if action is not taken—avascularlynecrose within a sufferer's snuffbox. Due to the small size of the scaphoid and its shape, it is difficult to determine, early on, whether or not the scaphoid is indeed fractured with an x-ray. Further complications include; carpal instability (ligament disruption) and fracture-dislocations.
