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BY: TAY LO R , J O R E Y A N D V I C T O R I A
ELBOW HUMEROULNAR JOINT
SURFACE ANATOMY
• Lateral epicondyle • Medial epicondyle• Radial styloid process• Ulnar styloid process• Olecranon• Cubital fossa• Carrying angle • Medial bicipital groove• Triceps tendon• Biceps tendon
LATERAL & MEDIAL EPICONDYLE
• Lateral Epicondyle = A rough projection on the lateral side of the distal end of the humerus
• Medial epicondyle =A rough projection on the medial side of the distal end of the humerus
LATERAL & MEDIAL EPICONDYLE
RADIAL & ULNARSTYLOID PROCESS
• Radial Styloid Process = The shaft of the radius widens distally to form this process on the lateral side, which can be felt proximal to the thumb
• Ulnar Styloid Process = Is located on the posterior side of the ulna’s distal end.
RADIAL & ULNARSTYLOID PROCESS
OLECRANON
• Located at the proximal end of the ulna. It forms the prominence of the elbow
CUBITAL FOSSA
• The fossa in front of the elbow, bounded laterally and medially by the humeral origins of the extensors and flexors of the forearm
CARRYING ANGLE
• When your arms are held out at the sides and your palms are in supination, your forearm and hands should normally be about 5 to 15 degrees away from the body • This is the normal carrying angle of the elbow • It allows your forearms to clear the hips when
swinging your arms, such as during walking • Because the carrying angle varies from person to
person it is important to compare one elbow with the other when evaluating a patient
CARRYING ANGLE
MEDIAL BICIPITAL GROOVE
• The groove along the medial surface of the arm separating the Biceps Brachii from Tricep Brachii
TRICEPS & BICEPS TENDON
• Triceps tendon = My be felt as it descends along the posterior aspect of the arm to the olecranon
• Biceps tendon = Can be palpated in the cubital fossa, immediately lateral to the midline.
BICEPS & TRICEPS TENDON
BONES OF THE HUMEROULNAR JOINT
HumerusThe Humerus is the bone that is most proximal to the Upper extremityContains-
• Capitulum, • Trochlea• Coronoid Fossa• Medial Epicondyle• Lateral epicondyle• Olecranon Fossa
BONES OF THE HUMEROULNAR JOINT CONT.
• Radius and UlnaThe Radius and Ulna are more distal of the Humeroulnar Joint and attach to Humerus
Radius Contains-
• Head• Neck • Radial Tuberosity
BONES OF THE HUMEROULNAR JOINT
Ulna contains-• Olecranon Process• Coronoid Process• Trochlear Notch• Radial Notch • Ulnar Tuberosity
BICEPS BRACHII
• O:Short head: Coracoid process; • Long process: Supraglenoid
tubercle of scapula• I: Radial Tuberosity and
Bicipital aponeurosis• A: Supinates forearm, with
forearm supinated flexes foreman, long head flexes arm• N: Musculocutaneous nerve• R: C5 and C6
SYNERGIST AND ANTAGONIST OF BICEPS BRACHII
• S: Supination: Supinator Forearm Flexion: Brachialis, Brachioradialis Arm flexion: Coracobrachialis, Anterior Deltoid• A: Pronation: Pronator teres and quadratus Forearm extension: Triceps Brachii Arm Extension: Long head of Triceps, Posterior
Deltoid, Latissimus Dorsi
TRICEPS BRACHII
• O: Long head: Infraglenoid tubercle of scapula,
Lateral head: Posterior surface of humerus superior to radial groove
Medial head: Posterior surface of humerus inferior to radial groove
• I: Proximal end of Olecranon process of ulna
• A: Extension of the forearm. Long head extends arm, resists dislocation
• N:Radial nerve R: C6-C8
SYNERGIST AND ANTAGONIST OF TRICEPS BRACHII
• S: Forearm extension: Anconeus
Arm extension: Posterior Deltoid• A: Flexion of forearm:
Brachialis, Brachioradialis, Biceps brachii
Arm flexion: Biceps brachii, Anterior Deltoid
BRACHIALIS
• O:Distal half of humerus, anterior surface
• I: Coronoid process and ulnar tuberosity
• A: Flexes forearm• N:Musculocutaneous
nerve• R:C5 and C6• S: Forearm flexion: Biceps
Brachii, Brachioradialis• A: Forearm extension:
Triceps brachii
BRACHIORADIALIS
• O:Proximal 1/3 of lateral supra-epicondylar ridge of humerus• I: Lateral surface of distal
end of radius• A: Weak flexion of forearm• N: Radial nerve• R:C5-C7• S: Biceps brachii,
Brachialis• A: Triceps brachii
SUPINATOR
• O: Lateral epicondyle of humerus, radial collateral and anular ligaments • I: Lateral, posterior, and
proximal 1/3 of radius• A: Forearm supination• N: Radial nerve• R: C7 and C8• S: Supination: Biceps
brachii• A: Pronation: Pronator teres,
Pronator Quadratus
PRONATOR TERES
• O: Ulnar head: Coronoid process of Ulna
Humeral head: Medial epicondyle of humerus
• I: Middle of lateral surface of radius
• A: Forearm pronation, assistive in elbow flexion
• N: Median nerve• R:C6&C7
SYNERGIST AND ANTAGONIST OF PRONATOR TERES
• S: Pronation: Pronator quadratus• Flexion: Biceps brachii, Brachialis,
Brachioradialis• A: Supination: Supinator, Biceps brachii• Extension: Triceps brachii
PRONATOR QUADRATUS
• O:Distal fourth of anterior surface of ulna• I: Distal fourth of anterior
surface radius• A: Forearm pronation,
binds ulna and radius together• N: Median nerve, Anterior
interosseous nerve• R:C8,T1• S: Pronator teres• A: Supinstor, Biceps
Brachii
NERVES
• Ulnar nerve • Radial nerve• Median nerve • Musculocutaneous nerve
NERVES
1. Musculocutanous nerve (C5-C7)2. Radial nerve (C5-8, T1)3. Median nerve (C5-8, T1)4. Ulnar nerve (C7-8, T1)
ULNAR NERVE
RADIAL NERVE
MEDIAN NERVE
MUSCULOCUTANEOUS NERVE
LIGAMENTS
• Ligament = Connects bones to form a joint
• Articular Capsule • Radial anular ligament • Ulnar collateral ligament • Radial collateral ligament • Interosseous membrane
ARTICULAR CAPSULE
• A sac enclosing a joint, formed by an outer fibrous membrane and an inner synovial membrane. Also call joint capsule
RADIAL ANULAR LIGAMENT
• This ligament encircles and holds the head of the radius in the radial notch of the ulna, forming the proximal radio-ulnar joint and permitting pronation and supination of the forearm
INTEROSSEOUS MEMBRANE
• A thin strong sheet of fibrous tissue between and connecting the shafts of the radius and ulna
RADIAL COLLATERAL LIGAMENT
• Extends from the lateral epicondyle of the humerus and blends distally with the anular ligament of the radius
BURSAE
• Subcutaneous Olecranon bursa • Subtendinous olecranon bursa • Intratnedinous olecranon bursa
Bursitis:
SUBCUTANEOUS OLECRANON BURSA
• Is located in the subcutaneous connective tissue over the olecranon
SUBTENDINOUS OLECRANON BURSA
• Is located between the olecranon and the triceps tendon, just proximal to its attachment to the olecranon
INTRATNEDINOUS OLECRANON BURSA
• Is sometimes present in the tendon of triceps brachii.
CARTILAGE
• Articular cartilage = The cartilage covering the articular surfaces of the bones forming a synovial joint.
ARTICULAR CAPSULE
• Synovial membrane • Fibrous layer
SYNOVIAL MEMBRANE
• Lines the internal surface of the fibrous layer of the joint capsule and the intracapsular non-articular parts of the humerus. • It continuous inferiorly with the synovial
membrane of the proximal radio-ulnar joint • The joint capsule is weak anteriorly and
posteriorly but is strengthened on each side by ligaments
FIBROUS LAYER
• The outer fibrous part of the capsule of a synovial joint
ARTERIES OF THE HUMEROULNAR JOINT
• Arteries of the Humeroulnar Joint receive oxygenated blood from the heart
Arteries here include• Brachial• Ulnar• Radial• Deep Brachial • Superficial Palmar arch
ARTERIES CONT.
Other Arteries involved-• Posterior
Interosseous
• Recurrent Interosseous
• Anterior Interosseous
VEINS OF THE HUMEROULNAR JOINT
• Veins of the Humeroulnar joint deliver deoxygenated blood back to the heart
Veins here include• Cephalic • Brachial• Basilic• Median Antebrachial• Median Cubital• Dorsal Venous Arch
(Network)
CLINICAL CONCERNS OF HUMEROULNAR JOINT
• Lateral Epicondylitis- Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.
Causes of Tennis Elbow-Overuse of the elbow joint in the use of sports not limited to…Playing Tennis
TREATMENT OPTIONS FOR TENNIS
ELBOWNon Surgical options-• Physical Therapy• Braces• Non-Steroidal anti-inflammatory
medicines• Rest• Steroid Injections• Shock Wave Therapy
TREATMENT OPTIONS FOR TENNIS ELBOW
• Surgical options-• Open Surgery- The most common approach• Arthroscopic Surgery
RESOURCES
• Principles of Anatomy and Physiology Gerard J. Tortora and Bryan Derrickson 13th Edition • Essential Clinical Anatomy Keith L. Moore, Anne
M. R. Agur, Arthur F. Dalley. • Gary Blevins Muscle List 2014 • Trail Guide To The Body Andrew Biel 4th Edition