Elbow Viva

Question 0

Names the bones involved in the elbow joint and classify the joint

Answer 0

Elbow joint: radius, ulna and humerus. Synovial hinge joint. Indicate an inferomedial line from 2cm below medial epicondyle to 1cm below lateral epicondyle.
Proximal radioulnar joint: radius and ulna. Synovial pivot joint.

Question 1

Bony points of the elbow

Answer 1

Medial and lateral epicondyles of the humerus.
Olecranon process and posterior border of the ulna down to ulnar head and ulnar styloid process.
Head of the radius.

Question 2

Give the attachments of some ligaments of the elbow joint

Answer 2

Ulnar collateral ligament: anterior band from medial epicondyle to the tubercle on the coronoid process.
Posterior band from medial epicondyle to the medial edge of the olecranon process.
Blends with the capsule, limits adduction.
Radial collateral ligament: lateral epicondyle, deep to the common extensor tendon. It blends with the annular ligament of the radius, radial notch and supinator crest of the ulna.

Question 3

Give the attachments and actions of Biceps Brachii

Answer 3

Proximal: long head- tendon runs through the intertubercular sulcus and attaches to the supraglenoid tubercle of the scapula. Short head- coracoid process of the scapula, lateral to the attachment of Coracobrachialis.
Distal: tendon attaches to radial tuberosity. Medial border gives off an aponeurosis to the posterior ulna and deep fascia of the forearm.
Actions: flexes the elbow, supinate at 90’ flexion. Weak flexor of the shoulder.
Passively insufficient when elbow and shoulder are both extended.

Question 4

Give the attachments and actions of Triceps Brachii

Answer 4

Proximal: long head- infraglenoid tubercle of the scapula. Medial head- below and medial to the spiral groove on the humerus. Lateral head- above and lateral to the spiral groove on the humerus.
Distal: posterior olecranon. A few fibres form the articularis cubiti and attach to the the capsule to pull it clear of the moving bones to prevent it becoming trapped.
Actions: extends the elbow. Long head extends the flexed elbow against resistance. Assists with adduction at the shoulder.
Passively insufficient when both elbow and shoulder are flexed.

Question 5

Give the nerve supply of Biceps Brachii and Triceps Brachii

Answer 5

Biceps Brachii: Musculocutaneous Nerve C5, C6.

Triceps Brachii: Radial Nerve C6, C7, C8 (lateral head C6, C7, C8; long and medial heads C7, C8).

Question 6

Give the attachments and actions of Brachioradialis

Answer 6

Proximal: lateral supracondylar ridge of the humerus.
Distal: lateral surface of radius just above styloid process.
Actions: flexes the elbow when the forearm is mid-prone. Returns the forearm to mid-prone position from the extremes of supination and pronation.

Question 7

Nerve supply of Brachioradialis

Answer 7

Radial Nerve C5, C6

Question 8

Describe the cubital fossa

Answer 8

Superior border: line between the medial and lateral epicondyles of the humerus.
Medial border: Pronator Teres.
Lateral border: Brachioradialis.
Floor: Brachialis medially; Supinator laterally.
Roof: skin and fascia.
Contents medial to lateral: median nerve, bifurcation of brachial artery into radial and ulnar artery, Biceps Brachii tendon, radial nerve and posterior interosseous branch. Also lymph vessels and lymph nodes.