Damage to which nerve is most at risk at the antecubital fossa due to extravasation of IV drugs such as thiopental?

Damage to which nerve is most at risk at the antecubital fossa due to extravasation of IV drugs such as thiopental?

• A. Radial
• B. Ulnar
• C. Median
• D. Musculocutaneous

Answer: (C)

In the cubital fossa, the structures lie in a predictable order from lateral to medial: tendon of the biceps, brachial artery, then the median nerve. This makes the median nerve the one most at risk if IV drugs leak (extravasate) into the surrounding tissues at the antecubital fossa. Thiopental, when extravasated, can cause local chemical irritation and tissue damage, and because the median nerve sits directly adjacent to the brachial artery within the fossa, it is most exposed to injury from such leakage. The other nerves are less at risk in this location: the radial nerve runs more laterally and is associated with the arm and forearm compartments rather than the cubital fossa contents; the ulnar nerve lies posterior to the medial epicondyle and is not within the fossa; the musculocutaneous nerve travels in the arm, remaining outside the cubital fossa contents.

In the cubital fossa, the structures lie in a predictable order from lateral to medial: tendon of the biceps, brachial artery, then the median nerve. This makes the median nerve the one most at risk if IV drugs leak (extravasate) into the surrounding tissues at the antecubital fossa. Thiopental, when extravasated, can cause local chemical irritation and tissue damage, and because the median nerve sits directly adjacent to the brachial artery within the fossa, it is most exposed to injury from such leakage.

The other nerves are less at risk in this location: the radial nerve runs more laterally and is associated with the arm and forearm compartments rather than the cubital fossa contents; the ulnar nerve lies posterior to the medial epicondyle and is not within the fossa; the musculocutaneous nerve travels in the arm, remaining outside the cubital fossa contents.