Download Elbow Presentation PTA

Elbow Joint
Chelsea, Robin, Carly, Jessica
Humerus
On distal end is the condyles.
Capitulum looks like lateral ball and
articulates with head of radius.
Trochlea looks like hourglass on its side
is medial and articulates with the Ulnar
trochlear notch.
The Medial epicondyle and Lateral
epicondyle are muscle attachment sites
that flank the trochlea.
Humerus
Olecranon Fossa on posterior surface superior to trochlear is placement
for the olecranon of the ulna.
Coronoid Fossa on anterior surface superior to trochlea, receives the ulna
coronoid process.
Ulna
Two prominent projections of the ulna are:
Olecranon process is posterior and the Coronoid
process is anterior. In between is the cupped area
called the Trochlear notch which articulates with the
trochlea of the humerus.
Radial notch is a depression
that articulates with the radius
head.
Ulnar Tuberosity is located
inferior to the coronoid process..
that
Radius
Head at proximal end, is a cylinder
shape
Neck inferior to radial head.
Radial Tuberosity medial surface
projection.
Surface Anatomy
Surface Anatomy
Cubital Fossa: Shallow Triangular
Depression on the anterior surface of elbow
●
●
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Superior line: connects medial and
lateral epicondyles
Medial Line: Pronator Teres muscle
Lateral Line: brachioradialis muscle
Surface Anatomy
Radial Styloid Process
Ulnar Styloid Process
Olecranon Process: Elbow
Surface Anatomy
Triceps Tendon: Descends
along posterior aspect of the
arm to the olecranon process.
Surface Anatomy
Biceps Tendon: Palpated in the Cubital Fossa immediately lateral to midline.
Medial Bicipital Groove: Groove between biceps and triceps
Surface Anatomy
Carrying angle: the ulna makes roughly a 170
degree angle with the humerus. It’s named for
the way the forearm angles away from the body
when something is carried.
*Angle More pronounced in Women
Ligaments
Articular Capsule: Extends from the
distal humerus to the proximal radius
and ulna. It surrounds the entire joint
Innerosseous Membrane: A flat fibrous
connective tissues that joins the radius
and ulna
Ligaments
Radial Anular Ligament: Attaches to
the ulna and encircles to holds the
head of the radius in the radial notch
Radial Collateral Ligament: Fan like
ligament that extends from the lateral
epicondyle and blends distally with the
annular ligament.
Ulnar Collateral Ligament: Triangular
shaped ligament that extends from the
medial epicondyle to the coronoid
process and olecranon process
Bursae
Subcutaneous Olecranon Bursa:
Located in the subcutaneous connective
tissue over the olecranon
Intratendinous Olecranon Bursa: Can
be seen in the tendon of the triceps
brachii
Subtendinous Olecranon Bursa: Sits in
between the olecranon and the triceps
tendon
Articular Cartilage
Articular cartilage prevents
friction of the bones by providing
a smooth gliding surface on the
distal end of the humerus and
the proximal ends of the radius
and ulna.
Articular Capsule
Synovial Membrane- inner
layer of loose connective tissue.
Lines fibrous layer, covers all
internal joint surfaces that are
not hyaline cartilage. Functionmakes synovial fluid. Cells in SM
secrete hyaluronic acid that
lubricates joint.
Fibrous layer- external layer of
dense connective tissue that is
continuous with the periosteum
of the articulating bones.
Arteries
Axillary- Subclavian artery becomes the axillary
after the artery passes the first rib. Branches
extend to shoulder, humerus and thoracic
regions.
Brachial- Continuation of axillary once past the
teres major muscle. Used for measuring blood
pressure.
Deep Brachial- Branches off the brachial.
Supplies blood to most arm muscles. Goes behind
the humerus.
Arteries
Ulnar- Supplies medial forearm, wrist
and hand.
Radial- Supplies the lateral forearm,
wrist and hand.
Arteries
Recurrent Interosseous- joins
common interosseous then
branches into anterior and
posterior.
Anterior Interosseous-Anterior
aspect of interosseous
membrane.
Posterior Interosseous- Passes
over posterior aspect of
interosseous membrane.
Veins
Cephalic- Off subclavian. On lateral
aspect of the arm
Brachial- Off axillary branch. Runs
down the midline of the arm.
Basilic- Off axillary branch. On
medial aspect of arm
Median Cubital- Joins cephalic and
basilic veins at the elbow.
Median Antebrachial- Mid forearm
Median Nerve
Median Nerve: C6-T1
The median nerve branches off
the brachial plexus and travels
down to supplies the flexor
muscles of the forearm and the
thenar eminence (palm of the
hand).
Musculocutaneous Nerve
Brachial Plexus- C5-C6 Innervates flexor muscles of biceps brachii, brachialis, coracobrachialis.
Radial Nerve
Root: C6-C8
Innervates Triceps,
Brachioradialis, Supinator
Ulnar Nerve
Root: C7-C8
Forearm Supination
● Biceps Brachii
● Supinator
Forearm Pronation
● Pronator Teres
● Pronator
Quadratus
Forearm Flexion
● Biceps Brachii
● Brachialis
● Brachioradialis
Forearm Extension
● Triceps Brachii
Arm Flexion
● Coracobrachialis
● Biceps Brachii
● Anterior Deltoid
● Pectoralis Major
Arm Extension
● Triceps Brachii
● Posterior Deltoid
● Latissimus Dorsi
● Teres Major
● Pectoralis Major
Biceps Brachii
Action of both: supination of forearm, when
supinated flexes elbow joint.
Long Head
Action: flexes arm
Origin is supraglenoid tuberosity of the
scapula.
Short Head
Action: resists dislocation of shoulder.
Origin: coracoid process
Insertion: radial tuberosity and bicipital
aponeurosis
Both innervated by the Musculocutaneous
nerve, roots C5-C6.
Triceps Brachii
Nerve: Radial
Roots: C6-C8
Long head:
O: Infraglenoid Tubercle
Action: Extension of forearm, and resists dislocation of shoulder
Lateral Head
O: Posterior surface of humerus superior to radial Groove
Action: Extension of Forearm
Medial Head:
O: Posterior surface of humerus inferior to radial groove
Action: Extension of forearm
All Insert: Proximal end of olecranon process
Brachialis
Is a fusiform muscle located
posterior to the biceps.
Action: the main elbow flexor,
flexing elbow in all positions.
Origin: Distal half of anterior
surface of humerus.
Insertion: coronoid process
and tuberosity of ulna.
Musculocutaneous Nerve,
C5-C6..
Brachioradialis
Nerve: Radial
Roots: C5-C7
Origin: Proximal ⅓ of lateral supra-epicondylar ridge
of humerus
Insertion: Lateral surface of distal end of radius
Action: Weak flexion of forearm
Pronator Teres
Origin: Ulnar Head - Coronoid Process,
Humeral Head - Medial Epicondyle of
humerus
Insertion: Middle of lateral surface of
radius
Action: Forearm pronation and flexion
Nerve: Median
Root: C6 & C7
Pronator Quadratus
Origin: Distal quarter of anterior
surface of ulna
Insertion: Distal quarter of anterior
surface of radius
Action: Pronates forearm and binds
radius and ulna together
Nerve: Anterior interosseous nerve
Root: C8 & T1
Supinator
Nerve: Radial
Root: C7-C8
Origin: Lateral epicondyle, radial collateral and
annular ligaments
Insertion: Lateral, posterior, and proximal ⅓ of
radius
Action: Supinates the forearm
Clinical Concerns: Tennis Elbow
(lateral Epicondylitis):
Inflammation of lateral
epicondyle
Occurs most commonly in the
extensor carpi radialis brevis,
making area very tender.
Causes: repeated extension of
the wrist against resistance
causing strain.
Questions?