2 Distal Humerus Anatomy: Capitulum: rounded knob that articulates with the head of the radiusRadial fossa: anterior depression that receives the head of the radius when the forearm is flexedTrochlea: spool-shaped surface that articulates with the ulnaCoronoid fossa: anterior depression that receives the coronoid process when the forearm is flexedOlecranon fossa: posterior depression receiving the olecranon process of the ulna when the forearm is extendedMedial and lateral epicondyles: projections on either side for attachment of many forearm muscles.
4 Ulna Ulna located on the medial forearm Longer than the radius Anatomy:Olecranon process: large process on the proximal end of the elbowCoronoid process: an anterior projection of bone that with the olecranon receives the trochlea of the humerusUlnar tuberosity: ridge of bone inferior to the coronoid processTrochlear (semilunar) notch: large curved area between the olecranon and the coronoid processRadial notch: depression on the lateral humerus that receives the head of the radiusHead: rounded distal end of the ulnaStyloid process: small projection distal to the head of the ulna
5 Radius Located on the lateral side of the forearm Anatomy: Head: disc shaped proximal end of the radius which articulates with the capitulum of the humerus.Neck: constricted area distal to the headRadial tuberosity: roughened area on the proximal medial shaft for attachment of the biceps brachii muscleShaft: widens distally to articulate with the scaphoid and lunate bones of the wristStyloid process: small bony projection at the distal end of the radiusUlnar notch: depression on the medial side of the radius for articulation with the distal end of the ulna
7 Articular Anatomy of the Elbow Elbow is a hinge joint formed by the articulation of the distal humerus and proximal radius and ulnaMade up of three joints:Humeroradial: joint between the capitulum and the head of the radiusHumeroulnar: joint between the trochlea and the trochlear notch of the ulnaRadioulnar: joint between the head of the radius and the radial notch of the ulna
8 Soft Tissue of the Elbow Interosseous Membrane: A broad, flat fibrous connective tissue that joins the shafts of the radius and ulnaArticular Capsule: Extends from distal humerus to proximal radius and ulna (enveloping the entire joint)Ulnar Collateral Ligament: Thick triangular ligament extending from medial epicondyle of the humerus to the coronoid process and olecranon of the ulna
9 Soft Tissue of the Elbow Radial Collateral Ligament: Strongtriangular ligament extending fromthe lateral epicondyle of the humerusto the annular ligament of the radiusand radial notch of the ulnaRadial Annular Ligament: Ligamentencircling the head/neck of the radius andradial notch of the ulnaOlecranon Bursa: Fluid filled sac liningthe olecranon process. Lubricates thejoint
10 Elbow Ranges of MotionEach student should be able to describe and demonstrate the following movements:Elbow flexionElbow extensionPronationSupination
11 Palpation of the elbowOlecranon Process: Sitting; Shake hands with your partner and palpate large prominence of theelbow. Passively flex and extend the elbow observe how the olecranon moves.Olecranon Fossa: Sitting; Locate the olecranon process again. Roll your finger proximally aroundthe top of the process, pressing through the triceps tendon and into the fossa.Humeral epicondyles: Sitting; Again locate the olecranon process. Slide your fingers medially andlaterally off the olecranon feeling the prominences. Note that the medial is larger.Supracondylar ridges: Sitting; Locate the epicondyles, slide your fingers proximally toward theshoulder feeling the medial and lateral supracondylar ridges. Roll your fingers back and forth to feelthe edges.Shaft of the ulna: Sitting; Again, locate the olecranon process and then slide your hand distallyalong the shaft of the ulna (remember the ulna is medial). Follow it along the length of the forearm.Ulnar Head: Sitting; Slide your finger along the shaft of the ulna. Just proximal to the wrist the shaftwill bulge to become the ulnar head.Ulnar styloid process: Sitting; Find the posterior aspect of the ulnar head then slide distally off thehead and palpate the ulnar styloid process.
12 Palpation of the elbow (cont.) Radial Head: Sitting; Locate the lateral epicondyle and slide distally. Notice a small depressionbetween the humerus and radius. The distal side of the depression is the radial head. Have yourpartner pronate and supinate the forearm feeling the radial rotate.Radial Shaft: Sitting; Supinate and flex your partner’s elbow, find the radial head again and slideyour fingers distally along the radial shaft.Radial styloid process: Sitting: Find the distal radial shaft to the end feeling the lateral side of theradius to the tip of the styloid process.
13 Muscles that move the Elbow Biceps BrachiiBrachialisBrachioradialisTriceps BrachiiAnconeusPronator TeresPronator QuadratusSupinator
14 Biceps Brachii O: Long Head: Supraglenoid tubercle of the scapula Short Head: Corocoid process of the scapulaI: Radial tuberosityA: Shoulder: Flexes the armElbow: Flexes the elbow and assists in supination when power is required.**Note: the long head can cause abduction of the arm, while the short head can cause adductionN: Musculocutaneous nerve
15 Brachialis O: Anterior aspect of the humeral shaft I: Coronoid process of the ulnaA: Flexion of the forearmN: Musculocutaneous nerveBrachialis is located deep to thebiceps brachii
16 Brachioradialis O: Lateral supracondylar ridge of the humerus I: Styloid process of the radiusA: Flexion of the elbow in the neutralposition (shaking hands). Alsoassists in supination and pronationof the forearm.N: Radial nerve
17 Triceps Brachii O: Long Head: Infraglenoid tubercle of the scapula Lateral Head: Posterior aspect of the shaft of the humerus (proximal ½)Medial Head: Posterior aspect of the shaft of the humerus (distal ½)I: Olecranon Process of the UlnaA: Shoulder: Extends the armElbow: Extends the elbow** Note: the long head can cause adduction of the armN: Radial nerve
18 Anconeus O: Lateral epicondyle of the humerus I: Olecranon process of theulnaA: Extension of the elbow(weak)N: Radial nerve
19 Pronator TeresO:Humeral Head: medial epicondyle (via common flexor tendon) of the humerusUlnar Head: Coronoid process of the ulnaI: Lateral aspect of the shaft ofthe radiusA: Pronates the forearm and flexes the elbow. Assists in flexion of the elbowN: Median nerve
20 Pronator Quadratus O: Distal ¼ of the Ulna I: Distal ¼ of the Radius A: Pronation of the forearmN: Median nerve
21 Supinator O: Lateral epicondyle of the humerus and proximal ulna I: Proximal anterior radiusA: Supination of the forearm (for slow non-resisted supination the supinator is sufficient. When speed or resistance is required, the biceps brachii is recruited.N: Radial Nerve