ELBOW JOINT

Nicholas Presho, Brianna Saugen, & Rebecca SnyderPresenting the………

Band of tissue, that connects bones & holds organs in place

• Articular Capsule

• Ulnar Collateral Ligament

• Radial Anular Ligament

• Radial Collateral Ligament

• Interosseous Membrane

Interosseous Membrane

Ligaments

Radial Anular Ligament

Radial Anular Ligament

Articular Capsule Articular Capsule

Ulnar Collateral Ligament

Radial Collateral Ligament

A pouch or sac that contains synovia, that facilitates motion.

Olecranon BursaSubcutaneous• Bursa between the olecranon process of the ulna and the skin.

Subtendinous• Between the tendon and capsule

Intratendinous• In the substance of the tendon

Olecranon Bursa

Bursae

Subcutaneous Olecranon Bursa

Subtendinous Olecranon Bursa

Firm, elastic, flexible type of connective tissue.

• Articular CartilageArticular Cartilage

Cartilage

• Synovial membraneInner layer (Synovial Stratum)• Fibrous LayerOuter layer (Fibrous Stratum) Synovial Membrane

Articular Cartilage

Articular Capsule

Articular Capsule

Humerus • Capitulum• Trochlea• Olecranon Fossa• Coronoid Fossa• Medial Epicondyle• Lateral Epicondyle

Humerus

Trochlea

Capitulum

Medial EpicondyleLateral Epicondyle

Bones

Ulna • Olecranon Process• Coronoid Process• Trochlear Notch• Ulnar Tuberosity• Radial Notch

Trochlear NotchOlecranon Process

Ulnar Tuberosity

Ulna

Radial Notch

Coronoid Process

Bones

Trochlea

Olecranon

Medial Epicondyle

Coronoid Fossa

Olecranon Fossa

Lateral Epicondyle

Capitulum

Lateral Epicondyle

Anterior ViewPosterior View

Clinical ConcernsTennis Elbow

Clinical ConcernsTennis Elbow (elbow tendinitis) Inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow.There may be a partial tear of the tendon fibers, which connect muscle to bone. The tear may be at or near where these fibers begin, on the outside of the elbow

CurePut ice on the outside of your elbow 2 - 3 times a day.Take nonsteroidal anti-inflammatory medications An occupational therapist can show you exercises to stretch and strengthen the muscles of your forearm

CauseThe part of the muscle that attaches to a bone is called a tendon. Muscles in your forearm attach to the bone on the outside of your elbow. When you use these muscles over and over again, small tears develop in the tendon. Over time, this leads to irritation and pain where the tendon is attached to the bone

Surface AnatomyLateral Epicondyle• A small, tuberculated eminence, curved a little

forward, and giving attachment to the radial collateral ligament of the elbow-joint,

Medial Epicondyle• Larger and more prominent than the lateral

epicondyle,• It gives attachment to the ulnar collateral

ligament of elbow joint.• The ulnar nerve runs in a groove on the back of

this epicondyle

Surface AnatomyRadial styloid process• A projection of bone on the lateral

surface of the distal radius bone. It extends obliquely downward into a strong, conical projection. The radial collateral ligament of the wrist attaches at its apex.

Ulnar styloid process• Projects from the medial and back part

of the bone; it descends a little lower than the head, and its rounded end affords attachment to the ulnar collateral ligament of the wrist-joint.

Cubital fossa The shallow triangular depression on the anterior surface of the elbow.• The cubital fossa contains four main vertical

structures (from lateral to medial: Radial Nerve, Biceps brachii tendon, Brachial artery, Median nerve.

Superficial dissection

Deep dissection

Surface Anatomy

Olecranon• A large, thick, curved

bony eminence of the forearm that projects behind the elbow.

The way the forearm angles away from the body when something is carried, such as a pail of water. More

pronounced in women than men.

Carrying Angle

Surface Anatomy

Medial bicipital groove• On the surface anatomy of the upper

arm. It is formed by the hollow between the biceps and triceps muscles

Tendons are tough strips of tissue that connect

muscles to bones and allow us to move our limbs.

Triceps tendon• Attaches the ulnar bone at the elbowBiceps tendon• Attaches to the radius bone at the elbow

Surface Anatomy

Nerves

• Median Nerve• Radial Nerve• Ulnar Nerve

• Musculocutaneous Nerve

Brachial artery • Provides the main arterial supply to

the arm and is the continuation of the axillary artery.

Ulnar artery • Decends through the anterior

compartment of the forearm, deep to the pronator teres.

Radial artery• Leaves the forearm by winding around

the lateral aspect of the wrist and crossing the floor of the anatomical snuff box to reach the hand.

Arteries

Recurrent interosseous arteryAnterior interosseous arteryPosterior interosseous artery

Superficial palmar arch• Formed predominantly by the ulnar artery

with a contribution from the superficial palmar branch of the radial artery.

Deep brachial artery(Profunda)• Largest branch of the brachial artery in the

upper part of the arm .

Arteries

• Cephalic vein• Basilic vein• Median antebrachial

vein• Median cubital vein• Brachial vein• Dorsal venous arch

(network)

Veins

• Origin Scapula: Long head, supraglenoid tubercle, Short head, coracoid process

• Insertion Radial tuberosity of radius

• Action Elbow flexion, forearm supination

• Innervation/Vascular Supply Musculocutaneous nerve; Brachial artery

Biceps brachii

• Origin Long head: infraglenoid tubercle of scapula Lateral head: Inferior to greater tubercle on posterior humerus Medial head: Posterior surface of humerus

• Insertion Olecranon process of ulna

• Action Elbow extension

• Innervation/Vascular Supply Radial nerve

Deep Brachial artery

Triceps Brachii

Triceps Brachii

Biceps brachiiTriceps brachii

Brachialis

• Origin Distal half of humerus, anterior surface

• Insertion Coronoid process and ulnar tuberosity of the ulna

• Action Elbow flexion

• Innervation/Vascular Supply Musculocutaneous nerve

Brachial artery

Brachialis

Brachioradialis• Origin Lateral supracondylar ridge on the humerus

• Insertion Styloid process of the radius

• Action Elbow flexion

• Innervation/Vascular Supply Radial nerve Radial artery

Supinator • Origin Lateral epicondyle of humerus and adjacent ulna

• Insertion Anterior surface of the proximal radius

• Action Forearm supination

• Innervation/Vascular Supply Radial nerve Recurrent interosseous artery

Pronator teres• Origin Medial epicondyle of humerus and coranoid process of ulna

• Insertion Lateral aspect of radius at its midpoint

• Action Forearm pronation, assistive in elbow flexion

• Innervation/Vascular Supply Median nerve Ulnar artery

• Origin Distal fourth of ulna

• Insertion Distal fourth of radius

• Action Forearm pronation

• Innervation/Vascular Supply Median nerve Anterior interosseous artery

Pronator quadratus

Pronator teres

Pronator quadratus

Supinator

• http://www.joint-pain-expert.net/olecranon-bursitis.html• http://www.keywordpictures.com/abuse/elbow%20anatomy%20diagram///• http://www2.ma.psu.edu/~pt/renee384/anatomy.htm• http://www.daviddarling.info/encyclopedia/R/radius_arm.html• http://www.kaboodle.com/reviews/female-tennis-player-silhouette-t-shirt-girls• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001485/• http://www.texasleaguers.com/medial-epicondyle/• http://chestofbooks.com/health/anatomy/Human-Body-Construction/Elbow-Joint.html