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Elbow Anatomy

Elbow Anatomy - bones Humerus Radius Ulna medial epicondyle lateral epicondyle Radius Ulna Olecranon

Elbow Joint

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Elbow Region Joints 3 Main Joints: Humeroulnar Joint = “true elbow joint” Humeroradial Joint Proximal Radioulnar Joint

Humeroulnar Joint Synovial Joint - Hinge Movements: Flexion Extension

Humeroradial Joint Synovial Joint - Gliding or Plane No real “true” movement

Proximal Radioulnar Joint Synovial Joint - Pivot Ligaments: Ulnar Collateral Ligament Radial Collateral Ligament Annular Ligament Movements: Supination Pronation

anterior

Distal anterior humerus

Posterior humeras

Ulna close up proximal lateral end

Radius l and right anterior view

Left and right posterior view of radius

Prox radius

Anterior elbow

Proximal Radio-Ulnar Joint

Annular Ligament

Posterior Medial Collateral Ligament Medial Collateral Ligament (MCL) Posterior Medial Collateral Ligament Resists valgus forces Limits extension UCL Anterior Medial Collateral Ligament Transverse ligament

Lateral Collateral Resists varus stress Weaker than MCL RCL

Elbow Movement & Limitations Elbow Extension Concavity (trochlear notch) of ulna moves on the trochlea of humerus Extension limited by olecranon process into olecranon fossa No articulartion between radius and humerus in elbow extension

Elbow Movement & Limitations Elbow Flexion Coronoid process of ulna moves into the coronoid fossa of the humerus The radial head slides over the capitulum and enters the radial fossa

Nerves All of the nerves that travel down the arm pass across the elbow Three main nerves begin together at the shoulder: the radial nerve, the ulnar nerve, and the median nerve. These nerves carry signals from the brain to the muscles that move the arm. The nerves also carry signals back to the brain about sensations such as touch, pain, and temperature.

Nerves Each nerve travels through its own tunnel as it crosses the elbow. Because the elbow must bend a great deal, the nerves must bend as well. Constant bending and straightening can lead to irritation or pressure on the nerves within their tunnels and cause problems such as pain, numbness, and weakness in the arm and hand.

Blood Vessels The largest artery is the brachial artery that travels across the front crease of the elbow. If you place your hand in the bend of your elbow, you may be able to feel the pulsing of this large artery. The brachial artery splits into two branches just below the elbow: the ulnar artery and the radial artery that continue into the hand. Damage to the brachial artery can be very serious because it is the only blood supply to the hand.

Blood Vessels basilic vein it unites with the Median antebrachial vein(s) to form the axillary v. basilic v. communicates with deep veins of the forearm through perforating veins, especially in the cubital region

Blood Vessels Cephalic Vein It drains into the Subclavin Vein median cubital vein usually pushes some of the blood collected by the cephalic v. to the basilic v.

Blood Vessels Median Cubital Vein Some Blood runs from the Cephalic Vein through the median Cubital into Basilic Vein The Most Common Vein for phlebotomists

Muscles

Anconeus Origin Lateral epicondyle of humerus Insertion Lateral surface of olecranon Action Assists triceps in extending forearm; stabilizes elbow joint; Innervation Radial nerve (C7, C8 and T1)

Anconeus

Biceps Brachii Origin Short head: tip of coracoid process of scapula Long head: supraglenoid tubercle of scapula Insertion Tuberosity of radius and fascia of forearm via bicipital aponeurosis Action Supinates forearm and, when it is supine, flexes forearm Innervation Musculocutaneous nerve (C5 and C6 )

Biceps Brachii

Brachialis Origin Distal half of anterior surface of humerus Insertion Coronoid process and tuberosity of ulna Action Major flexor of forearm -- flexes forearm in all positions primarily pronated Innervation Musculocutaneous nerve (C5 and C6)

Brachioradialis O: Proximal 2/3 of lateral supracondylar ridge of humerus I: Styloid process of radius N: Radial nerve A: Flexes forearm after flexion has been started by biceps, semipronator and semisupinator

Brachioradialis

Brachioradialis

Triceps Brachii Origin 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 Insertion Olecranon process of ulna and fascia of forearm Action Chief extensor of elbow Long head extends the shoulder as well Innervation Radial nerve (C6, C7 and C8)

Triceps Brachii

Triceps Brachii

Pronator Teres O: Humeral head- medial epicondylar ridge and common flexor tendon Ulnar head- coronoid process of ulna I: Middle of lateral surface of radius N: Median nerve A: Pronates forearm, assists in flexing forearm

Pronator Teres

Palmaris Longus O: Medial epicondyle of humerus I: Transverse carpal ligament and palmar aponeurosis N: Median nerve A: Flexes wrist, assists in pronation and flexion of forearm

Palmaris Longus

Flexor Carpi Radialis Origin Medial epicondyle of humerus Insertion Base of 2nd metacarpal Action Flexes and abducts hand (at wrist) Innervation Median nerve (C6 and C7) (C6, C7)

Flexor Carpi Radialis

Flexor Carpi Ulnaris O: medial epicondyle of humerus olecranon and dorsal border of ulna I: Pisiform, hamate, 5th metacarpal N: Ulnar nerve A: Flexes wrist and assists in ADD, assists in flexing forearm

Flexor Carpi Ulnaris

Flexor Digitorum Superficialis O: Humeral head- medial epicondyle of humerus Ulnar head- coronoid process Radial head- oblique line of radius I: Palmar surface of middle phalanx of medial 4 digits N: Median nerve A: Flex middle and proximal phalanges of medial 4 digits, aids wrist and forearm flexion

Flexor Digitorum Superficialis

Deep Layer of the Forearm

Flexor Pollicis Longus O: Volar surface of radius, interosseous membrane, coronoid process of ulna I: Base of distal phalanx of thumb on palmar surface N: median nerve A: Flexes thumb

Flexor Pollicis Longus

Pronator Quadratus O: Distal 4th volar surface of ulna I: Distal 4th of lateral border on volar surface of radius N: median nerve A: Pronates forearm

Pronator Quadratus

Extensor Carpi Radialis Longus O: Lateral supracondylar ridge of humerus I: Dorsal surface of base of 2nd metacarpal N: Radial nerve A: Wrist extension, ABD of hand

Extensor Carpi Radialis Longus

Extensor Carpi Radialis Brevis O: Lateral epicondyle of humerus, radial collateral ligament I: Dorsal surface of base of 3rd metacarpal N: Radial nerve A: Wrist extension, ABD hand

Extensor Carpi Radialis Brevis

Extensor Digitorum O: Lateral epicondyle of humerus I: Lateral and dorsal surface of phalanges of medial 4 digits N: Radial nerve A: Extends medial 4 digits, assists in wrist extension

Extensor Digitorum

Extensor Digiti Minimi O: Lateral epicondyle of humerus I: Dorsum of proximal phalanx of 5th digit N: Radial nerve A: 5th digit extension

Extensor Carpi Ulnaris O: Lateral epicondyle of humerus I: Medial side of base of 5th metacarpal N: Radial nerve A: Wrist extension, ADD hand

Extensor Carpi Ulnaris

Supinator O: Lateral epicondyle of humerus, lateral ligament of elbow and annular ligament, supinator crest and fossa of ulna I: Lateral and anterior surface of radius N: Radial nerve A: Supinates forearm