Arm, Elbow, Forearm.

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Presentation transcript:

Arm, Elbow, Forearm

Two Compartments of Arm Arm = Shoulder to elbow; aka Brachium Anterior = flexors Innervated by Musculocutaneous Nerve Blood supply by brachial aa Posterior =extensors Innervated by Radial Nerve Blood supply by brachial profunda aa

Muscles of the Anterior Compartment Coracobrachialis Biceps brachii Brachialis

Anterior Muscles

Anterior muscles

Nerves

Muscles of the Posterior Compartment Triceps brachii Long head Lateral head Medial head Anconeus

Posterior Muscles

Posterior Nerve

Anconeus

Regional Blood Supply Brachial Brachial Profunda Superior Ulnar Collateral Inferior Ulnar Collateral Radial Collateral Middle Collateral

Blood Supply

Blood Supply

Veins

Elbow Complex Humero-Ulnar Joint – flexion/extension Olecranon Process and Olecranon Fossa (post.) Trochlea and Trochlear Notch (ant.) Joint Capsule ant. and post. Ulnar (Medial) collateral Radial (Lateral) collateral Anular Lateral Ulnar collateral – See Interactive Hand Carrying angle

Elbow Complex

Elbow Complex

Elbow Complex

Elbow Complex

Elbow Complex

Elbow Complex

Fill In the Blanks

Elbow complex

Elbow Complex

Elbow Use Interactive Elbow

Elbow Complex Humero-radial Head of radius with capitulum of humerus Accessory motion Not a direct articulation

Radio-Ulnar Joints – Supination and Pronation Superior Head of Radius in radial notch Anular ligament Inferior Head of Ulna in ulnar notch Anterior and Posterior radio-ulnar ligaments Interosseous Membrane

R-U Joints

R-U Joints

Supination and Pronation

Cubital Fossa

Cubital Fossa

Cubital Fossa

Cubital Fossa

Forearm AKA Antebrachium – Two Compartments Anterior = ventral Flexors All but 1 1/2 mm are innervated by median (or a branch called the anterior interosseous nerve), the other 1 1/2 innervated by the ulnar Three layers – superficial, intermediate and deep Most have 1 Point of origin on the medial epicondyle - CFT

Forearm Posterior = dorsal Extensors Innervated by the radial nerve (or one of two branches called either posterior interosseous nerve or deep radial) Three layers = superficial, intermediate and deep Most have 1 point of origin on the lateral epicondyle - CET

Anterior Surface Superficial P.Teres Flexor Carpi Radialis Flexor Carpi Ulnaris Palmaris Longus

Superficial Muscles

Anterior Surface Intermediate Flexor Digitorum Superficialis

Intermediate Layer -Origin

Intermediate Layer - Insertion

Anterior Surface Deep Layer Flexor digitorum profundus (anterior interosseous branch of median nerve Flexor pollicus longus Pronator quadratus (ant. Interosseous)

Deep Layer - Origins

Deep Layer - Insertions

Compare Insertions

Compare Insertions

Nerves of Anterior Forearm

Anterior Surface Transverse Carpal Ligament AKA Flexor Retinaculum Guyen’s Canal Carpal Tunnel Syndrome

TCL

TCL – Median N.

Guyens’ Tunnel – Ulnar N.

Posterior Surface Superficial Brachioradialis Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Extensor Carpi Ulnaris

Superficial Muscles

Posterior Surface Intermediate Layer Extensor Digitorum Communis Extensor Indicus Proprius Extensor Digit Minimi

Intermediate Muscles

EDC Insertion

EDC Insertion

Posterior Surface Deep Anatomical “Snuff” box Out-cropper muscles Supinator Abductor Pollicus Longus Extensor Pollicus Longus Extensor Pollicus Brevis Anatomical “Snuff” box Out-cropper muscles

Deep Muscles

Deep Muscles

Posterior Surface Extensor Retinaculum Compartments 1 epb and apl 2 ecrb, ecrl 3 epl 4 edc and eip 5 edm 6 ecu

Extensor Tendons

Extensor Tendons at Wrist

Nerves of Posterior Forearm

Nerves of Posterior Forearm

Common Injuries Radial Nerve Above wrist extensor innervation= “Dropped Wrist” Colle’s fracture Compression syndromes Epicondylitis – AKA “Tennis Elbow” “Golfer’s Elbow”

Regional Blood Supply Ulnar Radial Ant. Ulnar Recurrent Post. Ulnar Recurrent Radial Radial Recurrent Common Interosseous Interosseous Recurrent Ant. Interosseous Post. Interosseous

Blood Supply

Blood Supply

Blood Supply

Blood Supply