 now let me show you an important anatomical and surgical landmark called the anatomical snuff box this is the region of the anatomical snuff box so we can see the anatomical snuff box in our own hand on the lateral aspect of the between the junction to the forearm and the hand and this is the location so let's take a look at the boundaries of the anatomical snuff box the lateral boundary of the anatomical snuff box is formed by two tendons and we can see for the tendons here this is the tractor policy is longest and this is the extensor policy is braves i told you in this case the tractor policy longest is by fate and extensor policy is braves so the lateral boundary is the same as the contents of the first compartment which we mentioned the beginning then let's come to the media boundary of the anatomical snuff box the media boundary is formed by this tendon this is the extensor policy is longest extensor policy is longest tendon was in the third compartment which we had mentioned in the beginning so the anatomical snuff box is bounded laterally by the tendons of the first compartment and medially by the tendon of the third compartment through the anatomical snuff box is formed by four bones one we can feel here that is the radial starlet process then deep we have the scaphoid then we have the trapezium and then we have the base of the first metacarpal so in sequence these are the bones which form the flow and this is bridged over by fascia which has been removed and coming to the contents of the anatomical snuff box the most important content that we can see here and we have dissected it out this is the radial artery so let's take a look at the radial artery on the forearm this is the origin of the radial artery from the cubital fossa and we can see that the radial artery is running again under the cover of the brachioradialis it runs all the way down and here in front of the lower end of the radius is where we can feel the radial position and from here the radial artery then goes under the tendons and here it comes to the anatomical snuff box and when i exert traction here you can see that it is moving here in the anatomical snuff box it was following a slightly torches course and we have dissected out and then it comes out of the snuff box and we can see the course of the radial artery here and then it pierces through first dorsal interosseous muscle and we can see it piercing and then it comes to the palm and here it becomes the deep palm arch so this is one important content of the anatomical snuff box the next important content of the snuff box is this now this is the superficial branch of the radial nerve or the cutaneous branch of the radial nerve which crosses over and comes to the dorsal of the hand and what is not visible here is that the beginning of the cephalic vein also goes across the anatomical snuff box so these are the contents of the anatomical snuff box now let's come to a few clinical correlations per day into the extensor tendons and the snuff box there's something called decuberbans stenosing tino vaginitis also known as washer woman's hand also known as the black penny hand or texting hand when the hand is constantly used in motion there is a septic inflammation of the tendons within the sinoval sheet or within the sinoval sheet itself especially the abductor policies longest and the extensor policies bravest and that condition is known as decuberbans stenosing tino vaginitis and there will be tenderness in the anatomical snuff box that is one condition previously it used to be seen in washer women who used to wash clothes with their hands but nowadays everybody uses the washing machine but that's why it is referred to as a blackberry hand because people used to use their mobile phones too much or it's also known as the texting hand another important clinical correlation is not very common though is what is known as the bull rider's thumb the bull rider's thumb actually is a rupture of the radial collateral ligament of the wrist joint which extends from the radial steroid process to the base of the first metacarpal bone and then that is known those people who write mechanical bulls that is known as the bull rider's thumb we can have something called the skier's thumb which is actually basically a dislocation of the first metacarpal phalangea joint and aversion fracture of the head of the first metacarpal which is actually strictly speaking not in the snuff box but a little distal then we can have fracture of the waist of the scaphoid bone which i told you is one of the bones which form the floor of the snuff box that happens when the person falls on his hand and the scaphoid bone is shaped like a bone and then middle portion is set in arrow which is known as the waist of the scaphoid and it fractures there when that happens the scaphoid bone receives blood supply from the radial artery from the palm or carpal branches of the radial artery and it goes the arteries go from distal to proximal so when there's a fracture of the waist of the scaphoid the proximal portion undergoes abascular necrosis and can lead to non-union and persistent disability we mentioned two tendons going through the second compartment the extensive carpal radial is longus and the extensive carpal radial is bravix they can be the site of what is known as gangion actually gangion is nothing but a mix of matters degeneration of the sanival sheet it is most commonly seen in relation to these tendons extensive carpal radial is longus and bravix though it can be seen in relation to other extensor tendons and rarely in my clinical experience i have seen them even in a relation with the flexor tendons that is known as ganglion and this ganglion is very difficult to treat even after surgical excision it has a tendency to raker the best way to test the extensor tendons is as a patient to dorsiflex the wrist against resistance that is to test the extensors of the wrist and to test for the extensors of the digits we give resistance to the proximal phallens and ask the patient to extend it and we can see the tendons standing upon the dorsum of the digits so these are the ways of testing the extensor tendons and the integrity of the nerve سپلائیں that the brachioradialis tendon gets inserted this is the brachioradialis and the tendon gets inserted onto the radial styloid process so just above the lower end of the radius is the narrow tendon and this is the site which is used to elicit brachioradialis reflex which is one of the clinical testing of the integrity of the radial nerve that is for the brachioradialis brachioradialis so these are some of the clinical correlations put it into the extensor tendons and the anatomical snub box and the compartments thank you very much for watching if you have any questions or comments please put them in the comment section below Dr. Sanjay Sanyal signing out have a nice day