Elbow Nathan Duncan & Katelyn Maley

Surface Anatomy

Cubital fossa Lateral epicondyle

Surface Anatomy ●Radial Styloid Process ●Ulnar Styloid Process ●Carrying angle: ○10-15 degrees Olecranon

Humerus -The largest bone in UE -Articulates with scapula at glenohumeral jt -Articulates with radius & ulna at the elbow jt

Humerus

Ulna -Medial & Longer of the two forearm bones -”Stabilizing” bones of forearm

Radius -Lateral & Shorter of the two forearm bones

Bone Landmarks of Radius & Ulna

Biceps Brachii Origin: Short head: Corocoid process Long Head: supraglenoid tubercle of scapula Insertion: Radial tuberosity and bicipital aponeurosis Nerve: Musculocutaneous Roots: C5-C6

Biceps Brachii: Synergists, Antagonists and ACTION ACTION Synergists: Supination: SupinatorForearm Flexion: Brachialis, Brachioradialis Arm Flexion: Coracobrachialis, Anterior Deltoid Antagonists: Pronation: Pronator Teres and Quadratus Forearm Extension: Triceps Brachii Arm Extension: Long Head of Triceps, Posterior Deltoid, Latissimus Dorsi Action: Supinates forearm, with forearm supinated flexes forearm, long head flexes arm

Triceps Brachii Origin: Long Head: Infraglenoid tubercleLateral Head: Posterior Surface of Humerus superior to radial grooveMedial Head: Posterior surface of humerus inferior to radial groove Insertion: Proximal end of olecranon process Nerve: Radial Nerve Roots: C6-C8

Triceps Brachii Synergist: Forearm Extension: AnconeusArm extension: Posterior Deltoid Antagonist: Forearm Flexion: Brachialis, Brachioradialis, Biceps Brachii Arm Flexion: Biceps Brachii, Anterior Deltoid Action: Extension of the forearm, Long head extends arm, resists dislocation

Brachialis Origin: Distal ½ of anterior surface of humerus Insertion: Coronoid process and ulnar tuberosity Nerve: Musculocutaneous Roots: C5-C6

Brachialis Action: Flexes forearm Synergist: Forearm Flexion: Biceps brachii, Brachioradialis Antagonist: Forearm extension: Triceps brachii

Brachioradialis Origin: Lateral supra-epicondylar ridge of humerus Insertion: Lateral surface of distal end of radius Nerve: Radial Roots: C5-C7 Synergists: Biceps brachii, brachialis Antagonist: Triceps Brachii

Supinator Origin: Lateral epicondyle, radial collateral and annular ligament Insertion: Lateral, posterior, and proximal ⅓ of radius Action: Supinates forearm Nerve: Radial nerve Roots: C7 and C8 Synergist: Supination: Biceps brachial Antagonist: Pronation: Pronator teres,Pronator quadratus

Pronator teres Origin: Ulnar head: Coronoid process of Ulna Humeral head: Medial epicondyle of humerus Insertion: Middle of lateral surface of radius Action: Forearm pronation and flexion Nerve: Median nerve Roots: C6 & C7 Synergist: Pronation: Pronator quadratus Flexion: Biceps brachii, brachialis, Brachioradialis Antagonist: Supination: Supinator, Biceps brachii Extension: Triceps brachii

Pronator quadratus Origin: Distal quarter of anterior surface of ulna Insertion: Distal quarter of anterior surface of radius Action: Pronates forearm, binds ulna and radius together Nerve: Anterior intereousseous nerve Roots: C8, T1 Synergist: Pronation: Pronator teres Antagonist: Supination: Supinator, Biceps brachii

Radial Collateral Ligament -Lateral, fan-like -Extends from lateral epicondyle of humerus & blends distally w/ annular ligament

Ulnar Collateral Ligament -Consists of three bands: Anterior, Posterior, Oblique -Extends from medial epicondylitis of humerus to corocoid process & olecranon

Ulnar Collateral Ligament

Interosseous Membrane -Fibrous sheet between radius & ulna -Serves as attachment site for muscles

Articular Cartilage -Smooth, white tissue that covers the ends of bones where they come together to form joints -Covers the end of the ulna, radius & humerus

Articular Capsule -Fibrous capsule which completely lines joint -Synovial membrane underneath

Bursae -Subcutaneous Olecranon -Subtendinous Olecranon -Intratendinous Olecranon

NERVES Median Nerve Radial Nerve Ulnar Nerve Musculocutaneous Nerve

ARTERIES Brachial artery Radial artery Ulnar artery

Arteries (continued) Posterior Interosseous artery Anterior Interosseous artery Recurrent Interosseous artery?

Veins of the Elbow -Cephalic -Basilic -Median Antebrachial -Median Cubital -Brachial

CLINICAL CONCERN Tennis Elbow (Lateral Epicondylitis): Is a general term for pain caused to the outside of the elbow. The most common cause is overuse or repetitive strain caused by repeated extension or bending back of the wrist against resistance. Gripping heavy objects like a manual screwdriver, weight training or handling bricks will also cause tennis elbow. Treatment: Ice and Rest Tennis elbow brace Exercises/Stretching E stim Massage Ultrasound Surgery/CastingCasting