Anatomical snuffbox

The anatomical snuff box or snuffbox or foveola radialis 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. (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. In the anatomical snuffbox, the radial artery is closely related (<2 mm) with the superficial branch of radial nerve near the styloid process of radius in 48%, while in 24% the radial artery is openly related to the lateral cutaneous nerve of forearm. 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.