Elbow Joint Brian Martin

What is the elbow all about? -Complex hinge joint formed between the distal end of the humerus in the upper arm and the proximal ends of the ulna and radius in the forearm. -Allows for flexion and extension of the forearm relative to the upper arm, as well as the rotation of the forearm and wrist. -The rounded distal end of the humerus is divided into two joint processes. --The trochlea on the medial side. ---The pulley-shaped trochlea forms a tight joint with the trochlear notch of the ulna surrounding it on the concave end of the head of the radius meets the rounded, convex capitulum to complete the elbow joint --The capitulum on the lateral side. ---The loose union of the capitulum of the humerus and the head of the radius allows the radius to pivot as well as flex and extend. ---The pivoting of the radius allows for supination and pronation of the hand at the wrist.

What makes up the elbow? -An extensive network of ligaments surrounding the joint capsule helps the elbow joint maintain its stability and resist mechanical stresses. --The joint capsule of the elbow has sides that are thickened by ulnar and radial collateral ligaments. ---The front surface of the capsule is reinforced by fibers from a muscle (brachialis) in the upper arm. ---The three parts of the elbow joint include the humeroulnar, humeroradial, and proximal radioulnar joints. ----A common synovial membrane surrounds all of these.

What makes up the elbow? -The radial and ulnar collateral ligaments connect and maintain the position of the radius and ulna relative to the epicondyles of the humerus. --The radial collateral ligament of the elbow strengthens the side of the wall of the joint capsule of the elbow. ---It is composed of a fibrous band extending between the lateral epicondyle of the humerus and the annular ligament of the radius. --The ulnar collateral ligament of the elbow is made up of a thick band of fibrous connective tissue. ---It is located in the medial wall of the joint capsule. ---The front of the ligament connects the medial epicondyle of the humerus to the medial margin of the coronoid process of the ulna. ---The back portion is attached to the medial epicondyle of the humerus and to the olecranon process of the ulna. -The annular ligament of the elbow extends from the ulna around the head of the radius to hold the bones of the lower arm together. --The annular ligament of the elbow is attached to the margin of the trochlear notch of the ulna, and it encircles the head of the radius, functioning to keep the head in contact with the radial notch of the ulna.

What makes up the elbow? -These ligaments allow for movement and stretching of the elbow while resisting dislocation of the bones. -Being a hinge joint, the only movements allowed by the elbow are flexion and extension of the joint and rotation of the radius. -The range of motion of the elbow is limited by the olecranon of the ulna, so that the elbow can only extend around 180 degree. -Flexion of the elbow is limited only by the compression soft tissues surrounding the joint.

Muscles and Tendons -Several muscles surround the elbow, they make it possible to move the arm. --The two main muscles responsible for bending and straightening the arm at the elbow are; the triceps and biceps. ---Biceps are located at the front of the arm. ---Triceps are located at the back of the arm. --The main muscles of the elbow involved in wrist and finger movement are; the flexors and extensors. ---Flexors attach to the inside of the elbow and enable bending of the wrist and fingers. ---Extensors attach to the outside of the elbow and enable extension/straightening of the wrist and fingers. -Several tendons connect the muscles and bones of the elbow. --The primary tendons are the bicep and tricep tendons. ---The bicep tendon attaches the biceps on the front of the arm to the radius, enabling bending of the elbow. ---The tricep tendon attaches the triceps to the ulna, enabling straightening of the arm.

Tennis Elbow -So many muscles originate or insert near the elbow, it is a common site for injury. -Tennis Elbow (lateral epicondylitis) --Inflammation surrounding the lateral epicondyle of the humerus. ---6 muscles that control backward movement (extension) of the hand and fingers originate on the lateral epicondyle. --Repeated strenuous striking while the muscles are contracted and against force causes strain on the tendinous muscle attachments and can produce pain around the epicondyle. --Resting these muscles will usually bring recovery. ---Ice packs, aspirin, and anti-inflammatory medications are also all good treatments. ---Bracing the elbow can also help. --Pain is on the outside of the elbow and may be accompanied with warmth and swelling.

Tommy John Surgery -Tommy John Surgery --Repairs an injured elbow ligament. --Mostly common to collegiate and professional athletes. --Surgery is named after former LA Dodgers pitcher Tommy John. In 1974 he underwent the first surgery of this type. --Also called UCL reconstruction. ---UCL: Ulnar Collateral Ligament --During the surgery the surgeon replaces the injured UCL with a tendon taken from somewhere else in the patients body.