Transcript Elbow Humeroulnar Joint

ELBOW
HUMEROULNAR JOINT
BY: TAYLOR, JOREY AND VICTORIA
SURFACE ANATOMY
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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 & ULNAR
STYLOID 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 & ULNAR
STYLOID 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
Humerus
The Humerus is the bone that is most
proximal to the Upper
extremity
Contains-
• Capitulum,
• Trochlea
• Coronoid Fossa
• Medial Epicondyle
• Lateral epicondyle
• Olecranon Fossa
BONES OF THE HUMEROULNAR JOINT
CONT.
• Radius and Ulna
The 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;
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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
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Flexion: Biceps brachii, Brachialis, Brachioradialis
• A: Supination: Supinator, Biceps brachii
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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
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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
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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
ElbowOveruse of the elbow
joint in the use of sports
not limited to…Playing
Tennis
TREATMENT OPTIONS FOR TENNIS
ELBOW
Non 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