Transcript Elbow(Humeroulnar) Joint

Elbow(Humeroulnar)
Joint
Presentation by Lindsey Bidleman and Linda McConnell
Components of the Elbow Joint Include…
Linda

Surface Anatomy

Bones

Articular Capsule

Cartilage

Bursae

Ligaments

Muscles

Nerves

Arteries

Veins
Surface Anatomy of the Elbow
Linda

Cubital Fossa

Medial Bicipital Groove

Biceps Tendon

Triceps Tendon

Olecranon

Lateral Epicondyle

Medial Epicondyle

Radial Styloid Process

Ulnar Styloid Process
Surface Anatomy of the Elbow Joint
Biceps Tendon
Medial Bicipital Groove
Cubital Fossa
Olecranon
Linda
Medial Epicondyle
Triceps Tendon
Lateral Epicondyle
Surface Anatomy of the Elbow Joint
Radial Styloid Process
Linda
Ulnar Styloid Process
Surface Anatomy of the Elbow Joint

Linda
Carrying angle

When arms are at your sides, palms facing forward, you hands and forearms
should be about 5-15 degrees away from your body.

This angle allows your forearms to clear you hips when swinging your arms
while walking. Also very important when carrying various objects.

The angle is more pronounced in women than men.
Surface Anatomy of the Elbow Joint
Carrying Angle: Male vs Female
Linda
Bones of the Elbow Joint Include…
Linda

Humerus- Largest bone in the
upper extremity. Articulates with
the radius and ulna.

Ulna- The stabilizing bone of the
forearm. The medial and longer
bone of the two forearms. (Pinky
side)

Radius- The lateral and shorter of
the two forearm bones. (Thumb
side)
Trochlear Notch
Ulna
Olecranon Process
Radial Notch
Coronoid Process

Olecranon Process- Big bony
projection on proximal end.

Coronoid Process-Prominant
elevation on anterior surface.

Trochlear Notch- Articulates with
the trochlea of the humerus.

Ulnar Tuberosity- Inferior to the
coronoid process.

Radial Notch- Smooth, rounded
curve that articulates with the
head of the radius.
Linda
Ulnar Tuberosity
Anterior Right
Posterior Right
Anterior Right
Posterior Right
Humerus

Capitulum- Articulates with the head
of the radius.

Olecranon Fossa- Big depression on
the posterior side of the humerus.

Medial Epicondyle- More prominent
than the lateral epicondyle.
Coronoid Fossa

Trochlea- Articulates with the
trochlear notch of the ulna.

Coronoid Fossa- Superior to the
Medial Epicondyle
trochlea, the smaller depression in
the anterior side of the humerus.

Lateral Epicondyle- Smaller than the
medial epicondyle.
Lateral Epicondyle
Capitulum
Olecranon Fossa
Trochlea
Linda
Radius
Neck

Head- Smooth, flat surface for
articulation with the capitulum of
the humerus.

Neck- Narrow part between the
head and the radial tuberosity.

Radial Tuberosity- Directly under
the head and neck, flat surface.
The attachment for the biceps
muscle.
Linda
Head
Radial Tuberosity
Anterior Right
Articular Capsule
Linda

Articular Capsule is “sleeve like”
and surrounds a synovial joint,
encloses the synovial cavity, and
unites articulating bone. Composed
of two layers…

Fibrous Membrane- usually
consisting of dense irregular
connective tissue that attaches to
the periosteum of the articulating
bones.

Synovial Membrane- Composed of
areolar connective tissue with
elastic fibers.
Cartilage
Linda

Cartilage is a solid, stretchable
type of connective tissue that
forms parts of the skeleton where
more flexibility and protection are
necessary.

Articular Cartilage provides a
smooth, low friction gliding surface
for free movement for the
humerus, radius, and ulna.

Its shiny surface also makes it kind
of pretty!
Bursae
Linda

Bursae are closed sacs containing
fluid , they prevent friction and
enable structures to move freely
over one another.

Intratendinous Olecranon BursaSometimes present in the tendon of
the triceps

Subtendinous Olecranon BursaLocated between the olecranon and
the triceps tendon, just proximal to
its attachment to the olecranon

Subcutaneous Olecranon BursaLocated in the subcutaneous
connective tissue over the olecranon
Clinical Awareness of Bursae
Linda

Injury can happen to the
subcutaneous olecranon bursa by
falls on the elbow, and from
infraction from abrasions of the skin
covering the olecranon, causing the
bursa to become inflamed.

Repeated excessive pressure and
friction produce a friction called
Subcutaneous olecranon bursitis.

Pain is severe during flexion of the
forearm

It is easy to treat if the patient
follows the “P.R.I.C.E”. Protection,
Rest, Ice, Compression, Elevation.
Ligaments: Connect bone to bone

Collateral ligaments of the elbow joint are
strong triangular bands that are medial
and lateral thickenings of the fibrous layer
of the joint capsule

Ulnar Collateral Ligament- Medial and
triangular ligament that extends from the
medial epicondyle of the humerus to the
coronoid process and olecranon of the
ulna consisting of three bands…
1. Anterior cord-like band is the strongest
2. Posterior fan-like band is the weakest
3. Slender oblique band that deepens the
socket for the trochlea of the humerus
Linda
Ligaments Cont…
Linda

Radial Annular Ligament- This
ligament encircles and holds the
head of the radius in the radial
notch of the ulna, and permits
pronation and supination of the Radial Collateral Ligament
forearm

Radial Collateral LigamentLateral fan-like ligament that
extends from the lateral
epicondyle of the humerus to
the annular ligament of the
radius and the radial notch of
the ulna.
Radial Annular Ligament
Ligaments
Continued
Interosseous Membrane- Fibrous
connective tissue that joins the shafts
of the radius and ulna.
Interosseous Membrane
Linda
#9 on classroom model
Origin
Long Head Supraglenoid tubercle
Short Head Coracoid process
Insertion
Radial Tuberosity of Radius
Innervation
Musculocutaneous Nerve
Vascular Supply
Brachial Artery
Action
Elbow Flexion, Forearm Supination
#11 on classroom model
Triceps
Origin
Long Head: infraglenoid tubercle of scapula
Lateral Head: Inferior to greater tubercle on posterior
humerus
Medial Head: Posterior surface of humerus
Insertion
Olecranon Process of Ulna
Innervation
Radial Nerve
Vascular Supply
Deep Brachial artery
Action
Elbow Extension
#25 on classroom model
Supinator
Origin
Insertion
Lateral epicondyle of humerus and adjacent ulna
Innervation
Vascular Supply
Action
Radial Nerve
Anterior Surface of the proximal radius
Recurrent interosseous artery
Forearm supination
#12 on classroom model
Pronator
Teres
Origin
Medial epicondyle of humerus and coranoid process of
ulna
Insertion
Innervation
Vascular Supply
Action
Lateral aspect of radius at its midpoint
Median Nerve
Ulnar artery
Forearm pronation, assistive in elbow flexion
Origin
Distal ¼ of Ulna
Insertion
Distal ¼ of Radius
Innervation
Median Nerve
Vascular Supply
Anterior interosseous artery
Action
Forearm pronation
Brachioradialis
#20 on classroom model
Origin
Insertion
Innervation
Lateral supracondylar ridge on the humerus
Vascular Supply
Action
Radial artery
Styloid process of the radius
Radial Nerve
Elbow flexion
#10 on classroom model
Origin
Insertion
Distal ½ of humerus, anterior surface
Innervation
Vascular Supply
Action
Musculotaneous Nerve
Coronoid process and ulnar tuberosity of the ulna
Brachial Artery
Elbow Flexion
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http://www.andpop.com/2012/10/02/10-funny-turkey-day-photos/
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Elbow Flexion – Passing Dishes
Forearm Pronation- Pouring Wine
Elbow Flexion – Forearm Pronation
http://admissions.vanderbilt.edu/insidedores/2011/11/thanksgiving-break-so-far/img_0358/
Elbow Extension – Forearm Supination
Nerve Supply to the Elbow
A. Brachial Plexus
RootsRandy
TrunksTravis
DivisionsDrinks
ChordsCold
BranchesBeer
B. Branches of Brachial Plexus
(Lateral to Medial)
MusculocutaneousMoms
AxillaryAre
RadialReally
MedianMad
UlnarUsually
The Musculocutaneous Nerve
 Supplies the elbow flexors EXCEPT the
brachioradialis
The Radial Nerve
 Supplies the elbow extensors
The Median Nerve
 Supplies all the pronators of the forearm
The Ulnar Nerve
 Runs posterior to the medial epicondyle
The Ulnar Nerve
• Known as the “Funny Bone”
• Largest nerve that is unprotected by deep tissues, ligaments, muscles, or
bones.
• The severity of the numbness or pain varies from person to person
• Can cause spontaneous paralysis of pinky and lateral ½ of ring finger.
• http://youtu.be/ZEcNgyIOO_E
Arteries of the Elbow
• Radial
• Recurent
interosseous
• Posterior
interosseous
• Brachial
• Anterior
interosseous
• Ulnar
• Superficial palmar
arch
http://www.papercards.com/sp/CD4934.asp
http://www.nowpublic.com/culture/pulse-rate

To control hemorrhage

Site where cuff compresses
artery against humerus to
obtain blood pressure
• Cepthalic
• Basilic
• Brachial
• Median antebrachial
• Median cubital
• Dorsal venous arch
Upper extremity veins provide best source to obtain blood

It is readily assessable

Veins can be visualized

Quickly cleaned

Does not impede with life activities
http://www.oneplaceforspecialneeds.com/main/library_blood_test.html
Tennis Elbow


Linda
Elbow tendinitis(tennis elbow) is
inflammation of the lateral
epicondyle.
Occurs most commonly in the
extensor carpi radialis brevis,
where there is an increase in pain
receptors in the area making the
region very tender!

Causes of tennis elbow…

The most common cause is the
overuse or repetitive strain caused
by repeated extension of the wrist
against resistance.

Gripping heavy objects

Tennis is also a cause, although the
above causes are more common.
Treatment for Tennis Elbow
Linda

Goals of treatment

Identify the cause of injury

Reduce pain and inflammation

Gradually return the patient to activity

Treatment

It may take several different types of
exercise to completely relieve pain caused
by tennis elbow…

Icing to reduce inflammation and pain.

Plenty of rest, but also with a few low
grade exercises such as…

Stretching Exercises

Strengthening Exercises

The Real Life Dangers of Tennis Elbow YouTube
References

You Tube Zach Thurow( April 4th, 2012) Retrieved on November 15th, 2013. The
Real Life Dangers of Tennis Elbow - YouTube

Sportsinjuryclinic.net (2013). Tennis Elbow/ Lateral Epicondylitis. Retrieved
November 15th, 2013 from http://www.sportsinjuryclinic.net/sportinjuries/elbow-pain/tennis-elbow

A.D.A.M. quality (1997-2013). Carrying Angle of the Elbow- excessive.
Retrieved November 15th, 2013. Carrying angle of the elbow - excessive:
MedlinePlus Medical Encyclopedia

Wikimedia Commons (April 23, 2013). File: Slide2xzxzxz.JPG. Retrieved on
November 16th, 2013. File:Slide2xzxzxz.JPG - Wikipedia, the free
encyclopedia

Tortora, G. & Derrickson, B. (2012). Principles of Anatomy & Physiology. (13th
ed.). Hoboken, NJ: John Wiley & Sons, Inc. Retrieved November 2013.
References

Moore, L., Agur, A., & Dalley, A. (2011). Essential Clinical Anatomy (4th ed.).
Baltimore, MD: Lippincott Williams & Wilkins. Retrieved November 2013.
Figures: SA6.3, SA6.4, 6.55, 6.56, 6.57, B6.21

Clemente, C. (2011). Anatomy A Regional Atlas of The Human Body (6th ed.).
Baltimore, MD: Lippincott Williams & Wilkins. Retrieved November 2013.
Figures: 88-1l, 88-3l
Linda
Quiz on Thursday
1.Biceps Brachii
2.Brachialis
3.Supinator
4.Brachioradialis
5.Pronator Quadratus