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Nicholas Presho, Brianna Saugen, & Rebecca Snyder Presenting the……… Ligaments Band of tissue, that connects bones & holds organs in place • Articular Capsule • Ulnar Collateral Ligament • Radial Anular Ligament • Radial Collateral Ligament • Interosseous Membrane Interosseous Membrane Articular Capsule Radial Collateral Ligament Articular Capsule Radial Anular Ligament Radial Anular Ligament Ulnar Collateral Ligament Bursae A pouch or sac that contains synovia, that facilitates motion. Olecranon Bursa Subcutaneous • Bursa between the olecranon process of the ulna and the skin. Subtendinous • Between the tendon and capsule Intratendinous • In the substance of the tendon Olecranon Bursa Subtendinous Olecranon Bursa Subcutaneous Olecranon Bursa Cartilage Firm, elastic, flexible type of connective tissue. • Articular Cartilage Articular Cartilage Articular Capsule • Synovial membrane Inner layer (Synovial Stratum) • Fibrous Layer Outer layer (Fibrous Stratum) Articular Capsule Synovial Membrane Articular Cartilage Bones Humerus • • • • • • Capitulum Trochlea Olecranon Fossa Coronoid Fossa Medial Epicondyle Lateral Epicondyle Humerus Medial Epicondyle Lateral Epicondyle Capitulum Trochlea Bones Ulna Olecranon Process Trochlear Notch Radial Notch • Olecranon Process • Coronoid Process • Trochlear Notch • Ulnar Tuberosity • Radial Notch Coronoid Process Ulnar Tuberosity Ulna Olecranon Fossa Coronoid Fossa Olecranon Lateral Epicondyle Medial Epicondyle Lateral Epicondyle Capitulum Trochlea Anterior View Posterior View Clinical Clinical Concerns Concerns Tennis Elbow (elbow tendinitis) Inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow. There may be a partial tear of the tendon fibers, which connect muscle to bone. The tear may be at or near where these fibers begin, on the outside of the elbow Cause The part of the muscle that attaches to a bone is called a tendon. Muscles in your forearm attach to the bone on the outside of your elbow. When you use these muscles over and over again, small tears develop in the tendon. Over time, this leads to irritation and pain where the tendon is attached to the bone Cure Put ice on the outside of your elbow 2 - 3 times a day. Take nonsteroidal anti-inflammatory medications An occupational therapist can show you exercises to stretch and strengthen the muscles of your forearm Surface Anatomy Lateral Epicondyle • A small, tuberculated eminence, curved a little forward, and giving attachment to the radial collateral ligament of the elbow-joint, Medial Epicondyle • • • Larger and more prominent than the lateral epicondyle, It gives attachment to the ulnar collateral ligament of elbow joint. The ulnar nerve runs in a groove on the back of this epicondyle Surface Anatomy Radial styloid process • A projection of bone on the lateral surface of the distal radius bone. It extends obliquely downward into a strong, conical projection. The radial collateral ligament of the wrist attaches at its apex. Ulnar styloid process • Projects from the medial and back part of the bone; it descends a little lower than the head, and its rounded end affords attachment to the ulnar collateral ligament of the wrist-joint. Surface Anatomy Cubital fossa The shallow triangular depression on the anterior surface of the elbow. • The cubital fossa contains four main vertical structures (from lateral to medial: Radial Nerve, Biceps brachii tendon, Brachial artery, Median nerve. Superficial dissection Olecranon • A large, thick, curved bony eminence of the forearm that projects behind the elbow. Deep dissection Surface Anatomy Carrying Angle The way the forearm angles away from the body when something is carried, such as a pail of water. More pronounced in women than men. Surface Anatomy Medial bicipital groove • On the surface anatomy of the upper arm. It is formed by the hollow between the biceps and triceps muscles Tendons are tough strips of tissue that connect muscles to bones and allow us to move our limbs. Triceps tendon • Attaches the ulnar bone at the elbow Biceps tendon • Attaches to the radius bone at the elbow Nerves • Median Nerve • Radial Nerve • Ulnar Nerve • Musculocutaneous Nerve Arteries Brachial artery • Provides the main arterial supply to the arm and is the continuation of the axillary artery. Ulnar artery • Decends through the anterior compartment of the forearm, deep to the pronator teres. Radial artery • Leaves the forearm by winding around the lateral aspect of the wrist and crossing the floor of the anatomical snuff box to reach the hand. Arteries Recurrent interosseous artery Anterior interosseous artery Posterior interosseous artery Superficial palmar arch • Formed predominantly by the ulnar artery with a contribution from the superficial palmar branch of the radial artery. Deep brachial artery (Profunda) • Largest branch of the brachial artery in the upper part of the arm . Veins • Cephalic vein • Basilic vein • Median antebrachial vein • Median cubital vein • Brachial vein • Dorsal venous arch (network) • Origin Scapula: Long head, supraglenoid tubercle, Short head, coracoid process • Insertion Radial tuberosity of radius • Action Elbow flexion, forearm supination • Innervation/Vascular Supply Musculocutaneous nerve; Brachial artery Biceps brachii Triceps Brachii • 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 • Action Elbow extension • Innervation/Vascular Supply Radial nerve Deep Brachial artery Triceps Brachii Triceps brachii Biceps brachii Brachialis • Origin Distal half of humerus, anterior surface • Insertion Coronoid process and ulnar tuberosity of the ulna • Action Elbow flexion • Innervation/Vascular Supply Musculocutaneous nerve Brachial artery Brachialis • Origin Lateral supracondylar ridge on the humerus • Insertion Styloid process of the radius • Action Elbow flexion • Innervation/Vascular Supply Radial nerve Radial artery Brachioradialis Supinator • Origin Lateral epicondyle of humerus and adjacent ulna • Insertion Anterior surface of the proximal radius • Action Forearm supination • Innervation/Vascular Supply Radial nerve Recurrent interosseous artery Pronator teres • Origin Medial epicondyle of humerus and coranoid process of ulna • Insertion Lateral aspect of radius at its midpoint • Action Forearm pronation, assistive in elbow flexion • Innervation/Vascular Supply Median nerve Ulnar artery • Origin Distal fourth of ulna Pronator quadratus • Insertion Distal fourth of radius • Action Forearm pronation • Innervation/Vascular Supply Median nerve Anterior interosseous artery Supinator Pronator teres Pronator quadratus • • • • • • • • http://www.joint-pain-expert.net/olecranon-bursitis.html http://www.keywordpictures.com/abuse/elbow%20anatomy%20diagram/// http://www2.ma.psu.edu/~pt/renee384/anatomy.htm http://www.daviddarling.info/encyclopedia/R/radius_arm.html http://www.kaboodle.com/reviews/female-tennis-player-silhouette-t-shirt-girls http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001485/ http://www.texasleaguers.com/medial-epicondyle/ http://chestofbooks.com/health/anatomy/Human-Body-Construction/Elbow-Joint.html