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    Lec 17, Elbow1

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    Rabiaa Qureshi
    The elbow is a complex joint made up of four articulations between the humerus, ulna, and radius that allow for flexion, extension, pronation, and supination movements. Key bony landmarks like the medial and lateral epicondyles serve as attachment points for muscles that flex and extend the wrist and fingers. The elbow achieves a full range of motion through sliding of the trochlear surfaces of the ulna and radial head on the humerus during flexion and extension.

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    Lec 17, Elbow1

    Uploaded by

    Rabiaa Qureshi
    29 views29 pages
    The elbow is a complex joint made up of four articulations between the humerus, ulna, and radius that allow for flexion, extension, pronation, and supination movements. Key bony landmarks like the medial and lateral epicondyles serve as attachment points for muscles that flex and extend the wrist and fingers. The elbow achieves a full range of motion through sliding of the trochlear surfaces of the ulna and radial head on the humerus during flexion and extension.

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    The elbow is a complex joint made up of four articulations between the humerus, ulna, and radius that allow for flexion, extension, pronation, and supination movements. Key bony landmarks like the medial and lateral epicondyles serve as attachment points for muscles that flex and extend the wrist and fingers. The elbow achieves a full range of motion through sliding of the trochlear surfaces of the ulna and radial head on the humerus during flexion and extension.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    29 views29 pages

    Lec 17, Elbow1

    Uploaded by

    Rabiaa Qureshi
    The elbow is a complex joint made up of four articulations between the humerus, ulna, and radius that allow for flexion, extension, pronation, and supination movements. Key bony landmarks like the medial and lateral epicondyles serve as attachment points for muscles that flex and extend the wrist and fingers. The elbow achieves a full range of motion through sliding of the trochlear surfaces of the ulna and radial head on the humerus during flexion and extension.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 29

    Structure of ELBOW and Movements

    Elbow complex
    • A freely mobile but strong and stable elbow
    complex is required for normal upper
    extremity function.
    • The design of the elbow and forearm adds to
    the mobility of the hand in space By
    shortening and lengthening the upper
    extremity and by rotating the forearm.
    Bones
    • Ulna is much larger proximally
    than radius
    • Radius is much larger distally
    than ulna
    • Scapula & humerus serve as
    proximal attachments for
    muscles that flex & extend the
    elbow
    • Ulna & radius serve as distal
    attachments for these same
    muscles
    6-3
    Bones
    • Scapula, humerus, & ulna serve as proximal
    attachments for muscles that pronate &
    supinate the radioulnar joints
    • Distal attachments of radioulnar joint muscles
    are located on radius
    • Bony landmarks
    – medial condyloid ridge
    – olecranon process
    – coranoid process
    – radial tuberosity
    6-4
    Bones
    • Key bony landmarks for
    wrist & hand muscles
    – medial epicondyle
    – lateral epicondyle
    – lateral supracondylar
    ridge

    6-5
    • Most activities of daily living require a 100 arc
    of flexion and extension at the elbow,
    specifically between 30 and 130, as well as 100
    of forearm rotation, equally divided between
    pronation and supination.
    • Tasks such as drinking and eating primarily
    require elbow flexion, whereas a task such as
    reaching to tie shoelace requires substantial
    elbow extension
    JOINTS OF THE ELBOW
    AND FOREARM
    • There are four joints involved in elbow and
    forearm function:
    • humeroulnar,
    • humeroradial
    • proximal radioulnar,
    • and distal radial ulnar joints
    Elbow/ Forearm Anatomy
    Arthrology and Movements
    – Humeroulnar Humeroradial
    – Proximal & Distal Radioulnar
    Ligaments and Capsule:
    Joint Capsule
    Ulnar Collateral (UCL)
    3 bundles
    Lateral Ulnar Collateral (LUCL)
    Radial Collateral (RCL)
    Annular Interosseus Membrane
    Humeroulnar Articulation
    • The primary motion at this articulation
    • is flexion and extension
    • Arthrokinematics.
    During flexion/extension the concave fossa
    slides in the same direction in which the ulna
    • moves, so with elbow flexion the fossa slides
    around the trochlea in an anterior and distal
    direction. With elbow extension, the fossa
    slides in a posterior and proximal direction.
    • There is also slight medial and lateral sliding of the
    ulna, allowing for full elbow range of motion (ROM);
    • it results in a valgus angulation of the joint with
    elbow extension
    • a varus angulation with elbow flexion.
    • When the bone moves in a medial/lateral direction,
    the trochlear ridge provides a convex surface, and the
    trochlear groove provides a concave surface—so with
    varus the ulna slides in a lateral direction and with
    valgus the ulna slides in a medial direction
    Common elbow abnormalities
    Changes in Carrying Angle
    When your arms are held out at your sides and your
    palms are facing forward, your forearm and
    hands should normally be about 5 to 15 degrees
    away from your body. This is the normal
    "carrying angle" of the elbow.
    a) Cubitum Varum: abnormal decrease in
    carrying angle.
    b) Cubitum Valgum: abnormal
    increase in the angle.
    Humeroradial Articulation

    • Arthrokinematics. As the elbow flexes and


    extends,
    • The concave radial head slides in the same
    direction as the bone motion so with elbow flexion
    the concave head slides anteriorly
    • with elbow extension it slides posteriorly.
    • With pronation and supination of the forearm, the
    radial head spins on the capitulum
    Close-packed position

    • Humero-ulnar joint: the elbow extended


    and the forearm supinated

    • Humeroradial joint: the elbow flexed


    approximately 90° and the forearm
    supinated approximately 5°
    Forearm Joint Characteristics
    and Arthrokinematics

    • Both the proximal and distal radioulnar joints are


    uniaxial pivot joints that function together to
    produce pronation and supination (rotation) of the
    forearm
    Arthrokinematics.
    • As the forearm rotates into pronation
    • and supination, the convex rim of the radial
    head slides opposite the bone motion
    • with pronation the head slides posteriorly
    (dorsally) on the radial notch
    • with supination it slides anteriorly (volarly).
    Distal (Inferior) Radioulnar
    Articulation
    • Arthrokinematics
    • . As the forearm rotates, the concave
    • radius slides in the same direction as the
    physiological motion.
    • It slides anterior (volar) with pronation and
    posterior (dorsal) with supination
    Segments at the Elbow
    • Flexion and Extension
    – Muscles crossing anterior side of elbow are the
    flexors:
    • Brachialis, biceps brachii, brachioradialis
    – Muscles crossing posterior side of elbow are the
    extensors:
    • Triceps, anconeus muscle
    Segments at the Elbow
    • Pronation and Supination
    – Involves rotation of radius around ulna
    – Articulations:
    • Proximal and distal radioulnar joints (both pivot joints)
    • Middle radioulnar joint (syndesmosis)
    • Pronator quadratus
    • Supinator
    Relationship of Wrist and Hand Muscles to the
    Elbow

    • Wrist Flexor Muscles. Originating on the medial


    epicondyle
    • are the flexor carpi radialis, flexor carpi ulnaris,
    palmaris longus, and flexor digitorum superficialis
    and profundus.
    • Wrist Extensor Muscles. Originating on the
    lateral epicondyle
    • are the extensor carpi radialis longus and brevis,
    extensor carpi ulnaris, and extensor digitorum.

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