The Elbow Blessen Abraham Jainy James Naved Patel

The Primary Elbow Extensors & Flexors Elbow flexors Biceps brachii Brachialis Brachioradialis Weak assistance from pronator teres Elbow extensor Triceps brachii Anconeus provides assistance

What type of joint is the elbow? The elbow is a Radioulnar joint It is a pivot-type joint The radial head rotates around the proximal Distal radius rotates around distal ulna The angular ligament maintains radial head in its joints

What is the degree of freedom for the elbow joint? In supination it is 80 – 90 degree’s from neutral In pronation its 70 – 90 degrees from neutral

Articulation of which bones make the elbow joint? The elbow is made up of the humerus, ulna, & radius

Draw diagram representing all the movement of elbow joint and name the plane and axis of each movement. All these movements take place in the saggital and frontal plane

In what plane does supination and pronation occur? Supination & pronation take place in the sagittal and coronal plane

What is tennis elbow? Tennis elbow is a common problem where the lateral epicondyle becomes painful and tender. Usually involving the extensor digitorum muscle near its origin on lateral epicondyle. It is also known as lateral epicondylitis and is associated with gripping & lifting activities

The ligaments of the elbow joint Ulnar collateral ligament Radial collateral ligament Annular ligament

Normal ranges: Elbow flexion (zero to 150 degrees) Elbow Extension (150 degrees to zero) Supination (zero to 80 or 90 degrees) Pronation (zero to 80 or 90 degrees)

The ligament injured in hyperextension of the elbow joint is: The ulnar collateral ligament

Elbow flexion is an example of Third class lever because the biceps brachii applies force at the insertion of the radial tuberosity, the resistance is the center of gravity and the elbow as the axis.

The Biceps brachialis muscle is The prime mover for flexion of the Elbow joint The biceps brachialis pulls at the insertion of the radial tuberosity as shown in the previous slide.

Elbow Flexors Muscle Origin Insertion Action Innervation Biceps Brachii Scapula – Supraglenoid Tuberosity; Coracoid Process Radius - Tubercle; Bicipital Aponeurosis Elbow flexion, forearm supination, shoulder flexion and transverse flexion Musculotaneous (C5 & C6) Brachialis Anterior Humerous Ulna -Coronoid Process Elbow flexion Brachioradialis Humerous – Lateral Condyle Radius (Lateral Distal) – Styloid Process Radial Nerve (C5, C6, C7 & C8)

Biceps Brachii Movement Elbow Flexion [1, 2 ] Forearm Supination [1, 2 ] Shoulder Flexion (Weak) [2 ] Transverse Flexion (Weak) [2 ] Attachments Origin Scapula Supraglenoid Tuberosity [1 ] Coracoid Process [2 ] Insertion Radius Tubercle [1, 2 ] Fascia of forearm Bicipital Aponeurosis [1, 2 ]

Brachialis Movement Attachments Elbow Flexion Origin Insertion Humerous (Anterior) Insertion Ulna Coronoid Process

Brachioradialis Movement Attachments Elbow Flexion Origin Insertion Humerous Lateral Condyle Insertion Radius (Lateral Distal) Styloid Process

Elbow Extensors, Pronators and Supinators Muscle Origin Insertion Action Innervation Triceps Brachii Scapula – Infraglenoid Tubercle, Humerous (Posterior) – Superior to radial groove; Inferior to radial groove Ulna (Proximal Posterior) – Olecranon Process Elbow Extension, Shoulder Extension and Adduction Radial Nerve (C5, C6, C7 & C8) Anconeous Humerus (Posterior)- Lateral condyle Ulna (Posterior, Proximal), Olecranon Elbow Extension Pronator Teres Humerus (Distal) – medial condyloid ridge, Poximal Ulna (medial) Middle third of Radius (lateral) Pronation of Forearm, weak elbow flexion Median Nerve (C6 & C7) Supinator Lateral epicondyle of humerus, Ulna (posterior) Proximal radius (lateral) surface below the head Supination of forearm Posterior Interosseous Nerve

Triceps Brachii Movement Elbow Extension [1, 2 , 3 ] Shoulder Adduction [1 ] Attachments Origin Scapula [1 ] Infraglenoid Turbercle Humerous (Posterior) Superior to Radial Groove [2 ] Inferior to Radial Groove [3 ] Insertion Ulna (Proximal Posterior) [1, 2 , 3 ] Olecranon Process

Anconeous Movement Elbow Extension Attachments Origin Humerus (Posterior) Lateral condyle Insertion Ulna (Posterior, Proximal) Olecranon

Pronator Teres Movement Weak flexion of elbow Attachments Origin Pronation of forearm Weak flexion of elbow Attachments Origin Humerus (Distal) medial condyloid ridge Poximal Ulna (medial) Insertion Middle third of Radius (lateral)

Supinator Attachments Movements Supination of the Forearm Origin Lateral epicondyle of humerus Ulna (posterior) Insertion Proximal radius (lateral) surface below the head