Location and projection
The medial bicipital sulcus is located on the arm at the medial margin of the biceps brachii muscle (m. biceps brachii). Distally, both bicipital sulci transition into the anterior cubital region.
The projection line of the main neurovascular bundle runs from a point at the border of the upper and middle thirds of the superior boundary of the region to the middle of the elbow crease; more precisely, 1 cm medially to the tendon of the m. biceps brachii. If the sulcus is well pronounced, this line coincides with the sulcus bicipitalis medialis. The v. basilica is projected along this same line.
Muscular surroundings
The biceps brachii muscle (m. biceps brachii) belongs to the anterior group of arm muscles — the flexors. This same group includes the coracobrachialis (m. coracobrachialis) and brachialis (m. brachialis) muscles.
The posterior group of arm muscles — the extensors: triceps brachii muscle (m. triceps brachii), anconeus muscle (m. anconeus), and articular muscle of the elbow (m. articularis cubiti).
On either side of the biceps muscle on the arm run the medial and lateral sulci — sulcus bicipitalis medialis et lateralis. The lateral sulcus is located at the lateral margin of the biceps muscle; the cephalic vein (v. cephalica) runs along it, and at the upper boundary of the region it transitions into the deltopectoral sulcus (sulcus deltopectoralis).
Structures associated with the medial bicipital sulcus
Main neurovascular bundle:
- the projection line coincides with the sulcus bicipitalis medialis, if the sulcus is well pronounced;
- the brachial artery (a. brachialis) and median nerve (n. medianus) are indicated as components of the main neurovascular bundle.
Superficial neurovascular structures on the medial side — along the sulcus bicipitalis medialis:
- localization: lower third of the arm;
- basilic vein (v. basilica);
- branches of the medial cutaneous nerve of the forearm (n. cutaneus antebrachii medialis).
Clinical significance
- Bone palpation: the humerus is palpable along the course of the medial sulcus.
- Hemostasis: digital compression of the brachial artery (a. brachialis) against the bone is performed at this site during hemorrhage.
- Tourniquet application: the region of the medial sulcus is the most effective site for tourniquet application.
Class and exam questions
Which nerves are associated with the medial bicipital sulcus?
The main neurovascular bundle, including the median nerve (n. medianus), is projected along the line of the medial bicipital sulcus. In the lower third of the arm on the medial side, branches of the medial cutaneous nerve of the forearm (n. cutaneus antebrachii medialis) are located along the sulcus.
Where is the brachial artery compressed during hemorrhage?
Digital compression of the brachial artery (a. brachialis) against the bone is performed along the course of the medial bicipital sulcus.
Which vein is projected along the line of the medial sulcus?
The basilic vein (v. basilica) is projected along this same line. In the lower third of the arm, it is located on the medial side along the sulcus bicipitalis medialis.
What else to study on this topic
- Brachial artery (a. brachialis)
- Median nerve (n. medianus)
- Lateral bicipital sulcus (sulcus bicipitalis lateralis)
- Muscles of the arm (mm. brachii)
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