1. Medial Epicondyle 2. Lateral Epicondyle 3. Trochlea 4. Capitellum 5. Olecranon Fossa 6. Ulna 7. Radius

Elbow Anatomy Flashcards by Natalie Hirst

Elbow Bony Anatomy

Medial Epicondyle
Lateral Epicondyle
Trochlea
Capitellum
Olecranon Fossa
Ulna
Radius

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Radius Anatomy

Proximal:
-Radial Head 
-Radial Tuberosity
-Radial Neck
Distal:
-Ulnar Notch
-Radial styloid process

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Ulna Anatomy

Proximal:
-Olecranon 
-Olecranon process
-Coronoid process
-Trochlear notch
-Radial notch
-Ulnar tuberosity
Distal:
-Ulnar styloid process

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Elbow articulations

Humeroulnar joint: flexion and extension
Humeroradial joint: flexion and extension
Proximal radioulnar joint: pronation and supination

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Humeroulnar Joint

Synovial Joint: hinge
Ligaments: Ulnar collateral ligament (3 bundles) -resist values stress
-Anterior
-Posterior
-Transverse (Oblique)
Movements: flexion and extension

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Humeroradial Joint

Synovial joint: gliding/planar
Ligaments: radial collateral ligament (resists various movement)
Small amount of gliding movement only

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Proximal Radioulnar Joint

Synovial Joint: pivot
Ligaments: annular ligament
Movements: supination and pronation

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Carrying Angle

Normal valgus: 10 degree in men, 13 degree in women

evidence of prior trauma

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Biceps Brachii (Long Head)

O: Supraglenoid tubercle
I: Radial tuberosity
A: Elbow flexion, forearm supination, and shoulder flexion
IN: Musculocutaneous nerve

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Biceps Brachii (short head)

O: Coracoid process of scapula
I: Radial tuberosity
A: elbow flexion, forearm supination, and shoulder flexion
IN: Muscuolocutaneous nerve

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Brachialis

O: Lower 2/3 of the anterior side of the surface of the humerus
I: corned process of the ulna
A: Elbow flexion
IN: Muscuolocutaneous nerve

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Brachialis v. Biceps Brachii

Insertions:
Brachialis: coronoid process (ulna)
Biceps Brachii: radial tuberosity (radius)
Radius “crosses-over” the ulna in forearm pronation/supination
Brachialis force production unaffected by the forearm rotation

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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
A: forearm pronation; assists in elbow flexion
IN: Median nerve

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Cubital fossa

Borders: Brachioradialis, pronator teres, lines connecting medial and lateral epicondyle
Contents (from lateral to medial) : biceps tendon, brachial artery, median nerve

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Triceps (Long head)

O: Infraglenoid tubercle of scapula
I: Olecranon process
A: elbow extension and shoulder extension
IN: Radial nerve

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Triceps (Lateral head)

O: posterior surface of lateral border of humerus
I: posterior part of olecranon
A: elbow extension
IN: radial nerve

Triceps (Medial head)

O: posterior lower shaft of humerus
I: olecranon process
A: elbow extension
IN: radial nerve

Triceps Brachii Kinesiology

Long head of the triceps crosses elbow and shoulder joint

The long head becomes actively insufficient when full elbow extension is attempted w/ shoulder hyperextension

Supinator

O: Lateral epicondyle of humerus; lateral proximal ulna
I: lateral surface of radius
A: forearm supination
IN: radial nerve

Flexion

movement of forearm to shoulder by bending the elbow to decrease its angle

Extension

movement of forearm away from shoulder by straightening the elbow to increase its angle

Pronation

internal rotary movement of radius on ulna that results in hand moving from palm up to palm down position

Supination

external rotary movement of radius to ulna that results in hand moving form palm down to palm up position

Brachial Plexus

Lateral, medial, and posterior cords are named in relation to the axillary artery
Lateral cord: lateral to the axillary artery
Medial cord: medial to the axillary artery
Posterior cord: posterior to the axillary artery

Major nerve braces in arm

Musculocutaneous Nerve: elbow flexors Radial Nerve: elbow, wrist, and finger extensors / forearm supinators Median Nerve: wrist, thumb, and finger flexors / forearm pronators Ulnar nerve: wrist and finger flexors

UCL - Anterior Bundle

Anterior portion of the anterior bundle tightening in elbow extension Posterior portion of the anterior bundle tightening in elbow flexion At 90 degrees of flexion, it provides 55% of the resistance to values stress at the elbow. -UCL is composed of 3 bands: anterior, posterior, and transverse UCL injury: injured as the result of a valves force from repetitive trauma

UCL Sprain

Common injury is overhead athletes, particularly baseball pitchers and javelin throwers Anterior bundle most susceptible High values torque (64-120 NM) is experienced at the elbow during baseball pitching UCL has been shown to fail under 34 Nm in laboratory conditions Importance of muscles

Tommy John Surgery

1974, 13-3 record Ruptured ulnar collateral ligament in pitching arm Asked team physician Frank Jobe to "make up something" to salvage career Reconstruction using graft from non-pitching arm

Post Tommy John Surgery

13 more years 164 more wins Three more all-stars never missed a start

Donor tendons:

Palmaris longus Plantaris or if both absent, -33mm x 15 mm strip of achilles tendon

Medial Epicondylitis

aka golfers elbow/throwers elbow Cause: repeated forceful flexion of wrist and extreme values torque of elbow Signs of injury: pain produced w/ revisited flexion and pronation Point tenderness and mild swelling Passive movement of wrist seldom elicits pain, but active movement does

Little League Elbow

Medial Epicondylitis is a portion of this If caught early, this is the only problem, if not.. -Avulsion of medial epicondyle -UCL tear -Fractures on lateral epicondyle -Compression fractures of olecranon

Lateral Epicondylitis

Tennis elbow Cause: excessive wrist extension, especially with clenched fist Sign: pain over outer part of the elbow Pain with resisted extension and supination

Humeral fractures

``` Radial nerve palsy: -most at risk- distal 1/3 fractures -occurs up to 18% of fractures 90% neurapraxis and heal in 3-4 mos -Exploration indicated: no more recovery in 3-4 mos (clinical or EMG), loss of function with closed reduction, open fractures ```

Elbow dislocation

Cause: high incidence in sports cause by fall on outstretched hand with elbow (hyper) extended or severe twist while flexed Signs: swelling, severe pain, disability -may be displaced backwards, forward, or laterally -complication with median and radial nerves and blood vessels -rupture and tearing of stabilizing ligaments will usually accompany the injury