clinical anatomy of the elbow and forearm Flashcards
what are the parts of the elbow joint
Humero-radial joint
humero-ulnar joint
radio-ulnar joint
what movement does the humero-radial joint do
flexion and extension
what movement does the humero-ulnar oint do
flexion and extension
movement of radioulnar joint
pronation and supination
what hold the radio-ulnar joint bones ?
anular ligament
interosseous membrane ‘
articular disc
interosseous membrane
sheet of dense CT that run obliquely
between radius and ulna
during pronation and supination the Proximal radio-ulnar
joint..
Radial head rotates on the capitulum in the radial notch of the ulnar
during pronation and supination distal radio-ulnar
joint..
Radius slides anteriorly
around the head of
ulna
Radiocapitellar line:
A line drawn down the neck of the
radius should intersect the capitulum
Anterior humeral line:
A line drawn down the anterior
surface of the humerus should intersect the middle third of
the capitulum
“Nursemaid’s” Elbow/ Pulled Elbow
• Subluxation of the
radial head
• Radial head slips out of
the annular ligament
Supracondylar fracture..Which neurovascular structures are at most risk in
displaced supracondylar fractures?
Median nerve and brachial
artery
Volkmann’s Ischemic Contracture
Consequence of supracondylar fracture if not recognized and
quickly repaired
what does an injury to the brachial artery lead to
ischemic flexor contracture of
the muscles of the anterior compartment
Posterior dislocation of
the elbow joint..What neurovascular
structures can be
damaged
Ulnar and median nerves,
brachial artery
Pronator teres
- Pronation
* Median nerve
Flexor carpi radialis
Flexes and ABduct the
wrist
• Median nerve
Palmaris longus
• Flexes the wrist
• Resist shearing forces
when gripping
• Median nerve
Flexor carpi ulnaris
- Flexes and ADduct the wrist
* Ulnar nerve
Flexor digitorum
superficialis(Middle layer )
• Flexes the wrist, flexes the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of digits 2-5 • Median nerve
Flexor pollicis longus (deep )
Flexes metacarpophalangeal (MCP) joint and interphalangeal (IP) joint of the thumb • Anterior interosseous nerve
Flexor digitorum profundus(deep) function :
• Flexes the wrist, flexes
metacarpophalangeal (MCP) joint,
proximal (PIP) and distal (DIP)
interphalangeal joints of digits 2-5
Flexor digitorum profundus innervation
Anterior interosseous nerve (lateral 2
tendons)
• Ulnar nerve (medial 2 tendons)
Pronator quadratus
Pronation of the
forearm
• Anterior interosseous
nerve
Borders of the cubital fossa
Line between the epicondyles • Pronator teres (medially) •Brachioradialis (laterally)
Contents of the cubital fossa
Median nerve
• Brachial artery
• Biceps tendon
Extensor carpi ulnaris(surface)
Extends and aDducts
the wrist
• Posterior interosseous
nerve
Extensor digiti minimi
Extends the metacarpophalangeal (MCP) joints, proximal (PIP) and distal (DIP) interphalangeal joints of the little finger • Posterior interosseous nerve
Brachioradialis
Accessory flexor when the
hand is midprone position
• Radial nerve
Extensor carpi radialis
longus
• Extends and aBducts
the wrist
• Radial nerve
Extensor carpi radialis
brevis
Extends and aBducts the
wrist
• Deep branch of the radial
nerve
Extensor digitorum
• Extends wrist, extends metacarpophalangeal (MCP) joints, proximal (PIP) and distal (DIP) interphalangeal joints of digits 2-5 • Posterior interosseous nerve
Extensor policis longus
Extends the carpometacarpal (CMC) joint, metacarpophalangeal (MCP) joint, and interphalangeal joint (IPJ) of thumb • Posterior interosseous
Extensor
indicis
• Extends the
index finger
• Posterior
interosseous
Supinator
Supination of
forearm
• Posterior
interosseous
Abductor policis
longus
Abducts carpometacarpal (CMC) joint of the thumb • Posterior interosseous
Extensor policis brevis
Extends the carpometacarpal (CMC) joint and metacarpophalangeal (MCP) joint of thumb • Posterior interosseous
Extensor policis brevis
Extends the carpometacarpal (CMC) joint and metacarpophalangeal (MCP) joint of thumb • Posterior interosseous
“Tennis elbow”
Lateral epicondylitis
Common extensor origin
“Golfer’s elbow”
Medial epicondylitis
Common flexor origin
venous drainage of the forearm -Superficial
basillic vein -axillary vein
cephalic vein empties into the axillary vein
venous drainage of the forearm :deep
Paired radial and ulnar veins run with
the radial and ulnar arteries in the
compartments
Colle’s Fracture:
-fracture of the distal radi
-May have injury to median and/ulnar nerves or acute carpal tunnel
syndrome
Smith’s fracture:(reverse Colles)
"garden spade" Anterior displacement of the distal fragment -May have injury to median and/ulnar nerves or acute carpal tunnel syndrome
