1. Elbow(Humeroulnar) Joint
Presentation by Lindsey Bidleman and Linda McConnell

2. Components of the Elbow Joint Include…
Surface Anatomy
Bones
Articular Capsule
Cartilage
Bursae
Ligaments
Muscles
Nerves
Arteries
Veins
Linda

3. Surface Anatomy of the Elbow
Cubital Fossa
Medial Bicipital Groove
Biceps Tendon
Triceps Tendon
Olecranon
Lateral Epicondyle
Medial Epicondyle
Radial Styloid Process
Ulnar Styloid Process
Linda

4. Surface Anatomy of the Elbow Joint
Medial Bicipital Groove
Biceps Tendon
Cubital Fossa
Lateral Epicondyle
Medial Epicondyle
Olecranon
Triceps Tendon
Linda

5. Surface Anatomy of the Elbow Joint
Radial Styloid Process
Ulnar Styloid Process
Linda

6. Surface Anatomy of the Elbow Joint
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.
Linda

7. Surface Anatomy of the Elbow Joint Carrying Angle: Male vs Female
Linda

8. Bones of the Elbow Joint Include…
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)
Linda

9. Ulna Trochlear Notch Olecranon Process Coronoid Process Radial Notch
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.
Ulnar Tuberosity
Anterior Right
Linda
Posterior Right

10. Humerus Anterior Right Posterior Right Coronoid Fossa
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.
Trochlea- Articulates with the trochlear notch of the ulna.
Coronoid Fossa- Superior to the trochlea, the smaller depression in the anterior side of the humerus.
Lateral Epicondyle- Smaller than the medial epicondyle.
Coronoid Fossa
Medial Epicondyle
Lateral Epicondyle
Capitulum
Olecranon Fossa
Trochlea
Linda

11. Radius Head Neck Radial Tuberosity
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
Anterior Right

12. Articular Capsule
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.
Linda

13. Cartilage
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!
Linda

14. Bursae
Bursae are closed sacs containing fluid , they prevent friction and enable structures to move freely over one another.
Intratendinous Olecranon Bursa- Sometimes present in the tendon of the triceps
Subtendinous Olecranon Bursa- Located between the olecranon and the triceps tendon, just proximal to its attachment to the olecranon
Subcutaneous Olecranon Bursa- Located in the subcutaneous connective tissue over the olecranon
Linda

15. Clinical Awareness of Bursae
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.
Linda

16. 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

17. Ligaments Cont…
Radial Annular Ligament
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 forearm
Radial Collateral Ligament- Lateral 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 Collateral Ligament
Linda

18. Ligaments Continued
Interosseous Membrane- Fibrous connective tissue that joins the shafts of the radius and ulna.
Interosseous Membrane
Linda

19. Myology of the Elbow and Forearm
Biceps Brachii
#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

20. Myology of the Elbow and Forearm
Triceps
#11 on classroom model
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

21. Myology of the Elbow and Forearm
Supinator
#25 on classroom model
Origin
Lateral epicondyle of humerus and adjacent ulna
Insertion
Anterior Surface of the proximal radius
Innervation
Radial Nerve
Vascular Supply
Recurrent interosseous artery
Action
Forearm supination

22. Myology of the Elbow and Forearm
Pronator Teres
#12 on classroom model
Origin
Medial epicondyle of humerus and coranoid process of ulna
Insertion
Lateral aspect of radius at its midpoint
Innervation
Median Nerve
Vascular Supply
Ulnar artery
Action
Forearm pronation, assistive in elbow flexion

23. Myology of the Elbow and Forearm
Pronator Quadratus
Origin
Distal ¼ of Ulna
Insertion
Distal ¼ of Radius
Innervation
Median Nerve
Vascular Supply
Anterior interosseous artery
Action
Forearm pronation

24. Myology of the Elbow and Forearm
Brachioradialis
#20 on classroom model
Origin
Lateral supracondylar ridge on the humerus
Insertion
Styloid process of the radius
Innervation
Radial Nerve
Vascular Supply
Radial artery
Action
Elbow flexion

25. Myology of the Elbow and Forearm
Brachialis
#10 on classroom model
Origin
Distal ½ of humerus, anterior surface
Insertion
Coronoid process and ulnar tuberosity of the ulna
Innervation
Musculotaneous Nerve
Vascular Supply
Brachial Artery
Action
Elbow Flexion

26. Summary of Muscle Innervation

27. Prime Movers of the Elbow

28. Tis’ the Season

29. Actions of Thanksgiving

30. Elbow Flexion – Passing Dishes

31. Forearm Pronation- Pouring Wine

32. Elbow Flexion – Forearm Pronation

34. Elbow Extension – Forearm Supination

35. Nerve Supply to the Elbow
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

36. Innervations of Elbow 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

37. 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.

38. Arteries of the Elbow Brachial Radial Anterior interosseous
Ulnar
Superficial palmar arch
Radial
Recurent interosseous
Posterior interosseous

39. Organization of Arteries

40. Upper Extremity vascular site significance

41. Location of Brachial Artery
To control hemorrhage
Site where cuff compresses artery against humerus to obtain blood pressure

42. Veins of the Elbow Cepthalic Basilic Brachial Median antebrachial
Median cubital
Dorsal venous arch

43. Upper extremity veins provide best source to obtain blood
Venipuncture
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

44. Tennis Elbow
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.
Linda

45. Treatment for Tennis Elbow
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
Linda

46. References
You Tube Zach Thurow( April 4th, 2012) Retrieved on November 15th, The Real Life Dangers of Tennis Elbow - YouTube
Sportsinjuryclinic.net (2013). Tennis Elbow/ Lateral Epicondylitis. Retrieved November 15th, 2013 from injuries/elbow-pain/tennis-elbow
A.D.A.M. quality ( ). Carrying Angle of the Elbow- excessive. Retrieved November 15th, Carrying angle of the elbow - excessive: MedlinePlus Medical Encyclopedia
Wikimedia Commons (April 23, 2013). File: Slide2xzxzxz.JPG. Retrieved on November 16th, 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.

47. References
Moore, L., Agur, A., & Dalley, A. (2011). Essential Clinical Anatomy (4th ed.). Baltimore, MD: Lippincott Williams & Wilkins. Retrieved November 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 Figures: 88-1l, 88-3l
Linda

48. Quiz on Thursday 1.Biceps Brachii 2.Brachialis 3.Supinator
4.Brachioradialis
5.Pronator Quadratus