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of or relating to the structure of the body; "anatomical features" (同)anatomical
of or relating to the branch of morphology that studies the structure of organisms; "anatomical research" (同)anatomical
a small ornamental box for carrying snuff in your pocket

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かぎたばこ入れ

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/11/16 23:00:27」(JST)

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The anatomical snuff box or snuffbox is a triangular deepening on the radial, dorsal aspect of the hand—at the level of the carpal bones, specifically, the scaphoid and trapezium bones forming the floor. The name originates from the use of this surface for placing and then sniffing powdered tobacco, or "snuff." It is sometimes referred to by its French name tabatière.

Structure

Boundaries

The medial border (ulnar side) of the snuffbox is the tendon of the extensor pollicis longus.
The lateral border (radial side) is a pair of parallel and intimate tendons, of the extensor pollicis brevis and the abductor pollicis longus.^[1] (Accordingly, the anatomical snuffbox is most visible, having a more pronounced concavity, during thumb extension.)
The proximal border is formed by the styloid process of the radius
The distal border is formed by the approximate apex of the schematic snuffbox isosceles triangle.
The floor of the snuffbox varies depending on the position of the wrist, but both the trapezium and primarily the scaphoid can be palpated.

Neurovascular anatomy

Deep to the tendons which form the borders of the anatomical snuff box lies the radial 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 second metacarpals to contribute to the superficial and deep palmar arches. The cephalic vein arises within the anatomical snuffbox, while the dorsal cutaneous branch of the radial nerve can be palpated by stroking along the extensor pollicis longus with the dorsal aspect of a fingernail.

Clinical significance

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 localized tenderness within the snuffbox, knowledge of wrist anatomy leads to the speedy conclusion that the fracture is likely to be of the scaphoid. 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—avascularly necrose 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.

Additional images

Tendons of forefinger and vincula tendina.
The veins on the dorsum of the hand.
Palm of left hand, showing position of skin creases and bones, and surface markings for the volar arches.
A particularly cavernous anatomical snuff box.

References

^ "Chapter 10: THE FOREARM". Archived from the original on 9 December 2007. Retrieved 2008-01-05.

External links

"Instant Anatomy"

UpToDate Contents

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4. 舟状骨骨折 scaphoid fractures
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English Journal

How Trustworthy Are Clinical Examinations and Plain Radiographs for Diagnosis of Scaphoid Fractures?

Ghane MR1, Rezaee-Zavareh MS2, Emami-Meibodi MK1, Dehghani V3.
Trauma monthly.Trauma Mon.2016 Feb 24;21(5):e23345. doi: 10.5812/traumamon.23345. eCollection 2016.
BACKGROUND: Sometimes patients with a scaphoid fracture, especially in an acute phase of injury, can have normal radiographs and, therefore, initial diagnosis of the scaphoid fracture may be neglected. In this study, we determined the value in of clinical examination and a radiograph in the diagnosi
PMID 28184356

Variant Superficial Branch of Radial Artery along with Supplementary Tendons on the Dorsum of the Hand and Their Surgical Implications.

Nayak SB1, Kumar N1, Aithal Padur A1, Shetty SD1.
Case reports in surgery.Case Rep Surg.2016;2016:9581759. Epub 2016 Oct 5.
Variations of radial artery, in both its course and branching pattern in the anatomical snuffbox, are clinically significant for the plastic surgeons, cardiologists, and radiologists. Reports on its abnormal high origin and subsequent superficial course have been well documented. Herein, we report a
PMID 27818829

[The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma].

Walenkamp MM1, Bentohami A, Slaar A, Beerekamp MS, Maas M, Jager LC, Sosef NL, van Velde R, Ultee JM, Steyerberg EW, Goslings JC, Schep NW.
Nederlands tijdschrift voor geneeskunde.Ned Tijdschr Geneeskd.2016;160:D234.
BACKGROUND: Although only 39% of patients with wrist trauma have sustained a fracture, the majority of patients is routinely referred for radiography. The purpose of this study was to derive and externally validate a clinical decision rule that selects patients with acute wrist trauma in the Emergen
PMID 27189095

Japanese Journal

Novel Doppler Technique to Assess Systemic Vascular Resistance : The Snuffbox Technique

Circulation journal : official journal of the Japanese Circulation Society 69(6), 688-694, 2005-05-20
NAID 10016625994

解剖学的タバコ窩に発生した真性橈骨動脈瘤の1手術例

日本血管外科学会雑誌 = The Japanese journal of vascular surgery : official journal of the Japanese Society for Vascular Surgery 13(7), 687-690, 2004-12-25
NAID 10026113068

手背に生じた橈骨動脈瘤の一例

日本血管外科学会雑誌 = The Japanese journal of vascular surgery : official journal of the Japanese Society for Vascular Surgery 13(6), 597-601, 2004-10-25
NAID 10016230132

「嗅ぎタバコ窩」

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
Dorlands; /Elsevier	12194594
FMA	42329
	Anatomical terminology [edit on Wikidata]

　　[★]

英: anatomical snuff-box
同: 解剖学的嗅ぎタバコ入れ anatomical snuffbox (K)

図：N.427,428
内側は長母指伸筋腱、外側は単母指伸筋腱が存在し、その奥には橈骨動脈が存在する。

「anatomic」

　　[★]

解剖的な、解剖学の

関: anatomy

「anatomical」

　　[★]

解剖学的な

関: anatomically

[titleChapter_10:_THE_FOREARM-1] "Chapter 10: THE FOREARM". Archived from the original on 9 December 2007. Retrieved 2008-01-05.

v t e Surface anatomy and general regions of limbs
Arm	Cubital fossa Anatomical snuffbox
Leg	Buttocks Gluteal sulcus Intergluteal cleft Femoral triangle Popliteal fossa Lap
General anatomy: systems and organs, regional anatomy, planes and lines, superficial axial anatomy, superficial anatomy of limbs

リンク元	「嗅ぎタバコ窩」
関連記事	「anatomic」「anatomical」

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案内

anatomical snuffbox