1. Elbow (HumeroUlnar) Joint and Hand
Created by: Kelsey, Vonna, Jolee and Andy

2. Bones of the Hand …

3. Bones of the Wrist Trapezoid Trapezium Capitate Scaphoid Hamate
Pisiform
Lunate
Triquetrum

4. Metacarpal Bones 4th Metacarpal (on ring finger) 3rd Metacarpal
(on middle finger)
1st Metacarpal
(on thumb)
2nd Metacarpal
(on index finger)
5th Metacarpal
(on little finger)

5. Phalange Bones Proximal Proximal Phalanx of the Thumb Proximal Phalanx
Middle Finger
Proximal Phalanx
of the
Ring Finger
Proximal Phalanx
of the
Index Finger
Proximal Phalanx
of the
Little Finger

6. Phalange Bones Intermediate Intermediate Phalanx of the Index Finger
the Ring Finger
Intermediate
Phalanx of
the Middle Finger
Intermediate
Phalanx of
the Little Finger

7. Phalange Bones Distal Distal Phalanx of the Index Finger
Ring Finger
Distal Phalanx
of the
Middle Finger
Distal Phalanx
of the
Little Finger

8. Radius Head of the Radius Neck of the Radius Styloid Process
Radial Tuberosity
Ulnar Notch
of the Radius

9. Ulna Tuberosity of the Ulna Olecranon Process of the Ulna
Styloid Process
of the Ulna
Trochlear Notch
of the Ulna
Coronoid Process
of the Ulna
Radial Notch
of the Ulna

10. Humerus Trochlea of the Humerus Capitulum Of the Humerus
Olecranon Fossa
of the
Humerus
Coronoid Fossa
of the
Humerus
Medial Epicondyle
of the
Humerus
Lateral Epicondyle
of the
Humerus

11. Muscles of the Elbow and Forearm
Biceps
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Scapula - Long head: supraglenoid tubercle; short head: coracoid process
Radial tuberosity of radius
Elbow flexion, forearm supination
Musculocutaneous nerve
Brachial artery

12. Muscles of the Elbow and Forearm
Triceps
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Long head: infraglenoid tubercle of scapula - lateral head: inferior to greater tubercle on posterior humerus - medial head: posterior surface of humerus
Olecranon process of ulna
Elbow extension
Radial nerve
Deep brachial artery

13. Muscles of the Elbow and Forearm
Brachialis
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Distal half of humerus, anterior surface
Coronoid process and ulnar tuberosity of ulna
Elbow flexion
Musculocutaneous nerve
Brachial artery

14. Muscles of the Elbow and Forearm
Brachioradialis
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Lateral supracondylar ridge on the humerus
Styloid process of radius
Elbow flexion
Radial nerve
Radial artery

15. Muscles of the Elbow and Forearm
Coracobrachialis
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Coracoid process
Medial aspect of humerus
Weakly adducts shoulder joint
Musculocutaneous nerves ; C6, C7
Brachial artery

16. Muscles of the Elbow and Forearm
Supinator
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Lateral epicondyle of humerus and adjacent ulna
Anterior surface of proximal radius
Forearm supination
Radial nerve
Recurrent interosseous artery

17. Muscles of the Elbow and Forearm
Pronator teres
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Medial epicondyle of humerus; coranoid process of ulna
Lateral aspect of radius at its midpoint
Forearm pronation, assistive in elbow flexion
Median nerve
Ulnar artery

18. Muscles of the Elbow and Forearm
Pronator quadratus
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Distal fourth of ulna
Distal fourth of radius
Forearm pronation
Median nerve
Anterior interosseous artery

19. Muscles of the Wrist and Hand
Flexor carpi radialis
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Medial epicondyle of humerus
Base of 2nd and 3rd metacarpals
Wrist flexion, radial deviation
Median nerve
Radial and ulnar arteries

20. Muscles of the Wrist and Hand
Flexor carpi ulnaris
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Medial epicondyle of humerus
Pisiform; base of 5th metacarpal
Wrist flexion, ulnar deviation
Ulnar nerve
Ulnar artery

21. Muscles of the Wrist and Hand
Extensor carpi radialis longus
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Supracondylar ridge of humerus
Base of 2nd metacarpal
Wrist extension, radial deviation
Radial nerve
Radial artery

22. Muscles of the Wrist and Hand
Extensor carpi radialis brevis
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Lateral epicondyle of humerus
Base of 3rd metacarpal
Wrist extension
Radial nerve
Radial artery

23. Muscles of the Wrist and Hand
Extensor digitorum
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Lateral epicondyle of humerus
Base of distal phalanx of the 2nd - 5th fingers
Extends all 3 joints of the fingers
Radial nerve
Recurrent interosseous artery

24. Muscles of the Wrist and Hand
Extensor carpi ulnaris
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Lateral epicondyle of humerus
Medial side of base of 5th metacarpal
Extends and adducts wrist
Deep radial nerve
Ulnar artery

25. Muscles of the Wrist and Hand
Flexor digitorum superficialis
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Common flexor tendon, coronoid process, radius
Sides of the middle phalanx of the 4 fingers
Flexes MP and PIP joints of the fingers
Median nerve
Ulnar artery

26. Muscles of the Wrist and Hand
Flexor digitorum profundus
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Upper ¾ of ulna
Distal phalanx of the 4 fingers
Flexes all 3 joints of the fingers
Median and ulnar nerves
Ulnar artery

27. Muscles of the Wrist and Hand
Flexor pollicis longus
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Anterior surface of radius
Distal phalanx of pollex (thumb)
Flexes all joints of the pollex (thumb)
Median nerve
Radial artery

28. Muscles of the Wrist and Hand
Abductor pollicis longus
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Posterior radius, interosseous membrane, middle ulna
Base of the 1st metacarpal
Abducts pollex
Radial nerve
Posterior interosseous artery

29. Muscles of the Wrist and Hand
Extensor digiti minimi
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Lateral epicondyle of humerus
Base of distal phalanx of 5th finger
Extends all joints of 5th finger
Radial nerve
Recurrent interosseous artery

30. Muscles of the Wrist and Hand
Extensor pollicis brevis
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Posterior distal radius
Base of proximal phalanx of pollex
Extends MP joint of pollex
Radial nerve
Posterior interosseous artery

31. Muscles of the Wrist and Hand
Extensor pollicis longus
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Middle posterior ulna, interosseous membrane
Base of distal phalanx of pollex
Extends MP and IP joints of pollex
Radial nerve
Posterior interosseous artery

32. Muscles of the Wrist and Hand
Palmaris longus
Origin:
Insertion:
Action:
Innervation:
Vascular supply:
Medial epicondyle of humerus
Palmar fascia
Assistive in wrist flexion
Median nerve
Ulnar artery

33. Our Elbow
and Hand
Allow Complex
Movement
Such as…

35. AND…

37. The Ligaments, Bursae, Cartilage, and
Articular Capsule of the Elbow Joint and Hand
Ligaments Of the Elbow
Ligaments of the Hand
Articular Capsule
Cartilage
Bursae
Articular Capsule
Synovial Membrane
Fibrous Layer
Subtendinous
Olecranon Bursa
Articular Cartilage…
Ulnar Collateral
Ligament
Radial Collateral
Ligament
Subcutaneous
Olecranon Bursa
Radial Annular
Ligament
Interosseous
Membrane
Palmar
Aponeurosis
Flexor Retinaculum
Common
Flexor Sheath

38. Site of the Median Nerve Tendon of Palmaris Longus
Surface Anatomy
Anatomical Snuff Box
Cubital Fossa
Hypothenar
Eminence
Lateral Epicondyle
Distal Wrist
Crease
Medial Epicondyle
Radial Styloid
Process
Ulnar Styloid
Process
Thenar Evidence
Olecranon Process
Tendon of Flexor
Carpi Radialis
Site of the Median Nerve
Tendon of Palmaris Longus

39. Clinical Concerns: Carpal Tunnel Syndrome:
Compression of the median nerve.
mixed nerve that provides sensation to thumb, index, middle and middle –finger side of the ring fingers.
Causes pain, tingling and numbness
Cause:
Swelling or thickening of lining of the tendons in your carpal tunnel.
Repetitive use or injury-keyboarding, use of powertools, pinching, gripping etc.
Fluid retention due to pregnancy
Other Risk Factors: Sex, Heredity, health conditions (ie: diabetes, obesity, arthritis)
Treatment:
Wrist splinting, Nonsteroidal anti-inflammatory drugs, corticosteroids, physical therapy
Surgery
Prevention: Reduce force and relax grip, frequent breaks, improve posture, watch form, keep your hands warm.

40. Clinical Concerns cont’:
Tennis Elbow (lateral epicondylitis)
Overuse injury caused by repeated contraction of the forearm muscles.
Causes:
Stress to tissue results in inflammation or tiny tears of the tendons that attach the forearm muscles to the bone outside your elbow.
Repeated use of backhand stroke with poor technique- common motions: hammering, painting, raking, weaving……..playing tennis.
Signs and Symptoms:
Pain that radiates from the outside of elbow to forearm and wrist.
Pain when you touch or bump the outside of elbow
Pain when you extend your wrist
A weak grip, painful grip when during certain activities like shaking hands or turning a doorknob
Treatment: anti-inflammatory drugs, ice, rest, PRICE, exercises, corticosteroids, braces.
Surgery: (1 in 10)- trimming inflammed tendon or re-attachment.