College of Allied Health Science ANATOMY MUSCULOSKELETAL  RADIUS & ULNA,  ELBOW AND RADIOULNAR JOINT HERMIZAN BIN HALIHANA...
Ulna <ul><li>Located on the medial aspect (the little finger side) of the forearm. </li></ul><ul><li>Longer than radius. <...
Ulna Anterior view Trochlear notch Olecranon Radial notch Coronoid process Lateral view
Cont…. <ul><li>The trochlear notch is a large curved area between the olecranon and coronoid process that forms part of th...
Ulnar Tuberosity
Radius <ul><li>Located on the lateral aspect (thumb side) of the forearm. </li></ul><ul><li>Proximal end of the radius has...
Cont… <ul><li>The shaft of the radius is widens distally to form a styloid process on the lateral side. </li></ul>
Ulnar Tuberosity
 
 
 
Radius and Ulna <ul><li>Ulna and radius articulate with the humerus at the elbow joint. </li></ul><ul><li>This articulatio...
Elbow Joint
Cont…. <ul><li>Ulna and radius connect with one another at three sites. </li></ul><ul><li>First, a broad, flat, fibrous co...
Elbow Joint Proximal Radioulnar Joint Distal  Radioulnar Joint Interosseous Membrane Radiocarpal Joint
Cont… <ul><li>Ulna and radius also articulates at their proximal and distal end. </li></ul><ul><li>Proximally, the head of...
Ulna and radius parallel each other Radius cross over the ulna
Cont…. <ul><li>Distally, the head of the ulna articulates with ulna notch of the radius. </li></ul><ul><li>This articulati...
 
Muscles of the Elbow
Muscles Move the Elbow Joint <ul><li>Most of the muscles that move the radius and ulna cause flexion and extension at elbo...
Flexor Muscles <ul><li>Biceps brachii </li></ul><ul><li>Brachialis </li></ul><ul><li>brachioradialis </li></ul>
Biceps brachii <ul><li>Origin </li></ul><ul><ul><li>Long head – supraglenoid tubercle of scapula. </li></ul></ul><ul><ul><...
Long Head of  Biceps Short head of Biceps
Brachialis <ul><li>Origin – distal, anterior surface of humerus </li></ul><ul><li>Insertion – ulnar tuberosity and coronoi...
Brachioradialis <ul><li>Origin – lateral border of distal end of humerus. </li></ul><ul><li>Insertion – superior to styloi...
Elbow Flexors
 
Extensor Muscles of Forearm <ul><li>Triceps brachii </li></ul><ul><li>Anconeus </li></ul>
Triceps brachii <ul><li>Origin </li></ul><ul><ul><li>Long head – infraglenoid tubercle of scapula </li></ul></ul><ul><ul><...
<ul><li>Action </li></ul><ul><ul><li>Extension forearm at elbow joint </li></ul></ul><ul><ul><li>Extension arm at shoulder...
Anconeus <ul><li>Origin – lateral epicondyle of humerus </li></ul><ul><li>Insertion – olecranon and superior portion of sh...
Triceps Brachii
Pronators Muscles of Forearm <ul><li>Pronator teres </li></ul><ul><li>Pronator quadratus </li></ul>
Pronator teres <ul><li>Origin – medial epicondyle of humerus and coracoid process of ulna </li></ul><ul><li>Insertion – mi...
Pronator quadratus <ul><li>Orgin – distal portion of shaft of ulna </li></ul><ul><li>Insertion – distal portion of shaft o...
Supinator Muscle of Forearm <ul><li>Supinator muscles </li></ul><ul><li>Origin – lateral epicondyle of humerus and ridge n...
Muscles of the Forearm Move the Wrist, Hand, Thumb and Fingers <ul><li>Group of muscles that act on the digits are known a...
Anterior view of forearm muscles
 
Anterior compartment of Forearm Muscles <ul><li>Muscle of the forearm originate on the  humerus </li></ul><ul><li>Insert o...
Posterior compartment of Forearm Muscles <ul><li>Muscle of the forearm originate on the  humerus </li></ul><ul><li>Insert ...
Forearm Muscles <ul><li>Superficial anterior compartment muscles </li></ul><ul><li>Deep  anterior compartment muscles </li...
Superficial Anterior Compartment Muscles <ul><li>Arrange in following order from lateral to medial: </li></ul><ul><ul><li>...
Deep Anterior Compartment Muscles <ul><li>Arrange in following order from lateral to medial: </li></ul><ul><ul><li>Flexor ...
Superficial Posterior Compartment Muscles <ul><li>Arrange in following order from lateral to medial: </li></ul><ul><ul><li...
Deep Posterior Compartment Muscles <ul><li>Arrange in following order from lateral to medial: </li></ul><ul><ul><li>Abduct...
Elbow Joint <ul><li>Ulna and radius articulates with the humerus </li></ul><ul><li>Occurs in 2 place </li></ul><ul><li>Hea...
Elbow Joint Head of Radius Trochlear notch Olecranon Coronoid Process
Radio-Ulnar Joint (Pivot Joint) <ul><li>Radius and ulna also articulates with one another in 2 places. </li></ul><ul><li>P...
<ul><li>Distally the head of ulna articulates with ulna notch of the radius. </li></ul><ul><li>This articulation is the di...
Proximal Radio-Ulnar Joint <ul><li>Head of radius articulate with radial notch of ulna. </li></ul>Annular Ligament
Distal Radio-Ulnar Joint <ul><li>Head of ulna articulate with ulnar notch of radius. </li></ul>
Elbow Joint <ul><li>Hinge joint (one way direction) </li></ul><ul><li>Articulations between the trochlea of the humerus wi...
Anatomical Components of Elbow joint <ul><li>Articular capsule </li></ul><ul><ul><li>Consist 2 parts; anterior and posteri...
<ul><li>Ulnar Collateral Ligament </li></ul><ul><ul><li>Thick </li></ul></ul><ul><ul><li>Triangular </li></ul></ul><ul><ul...
<ul><li>Radial Collateral Ligament </li></ul><ul><ul><li>Strong </li></ul></ul><ul><ul><li>Triangular </li></ul></ul><ul><...
 
 
 
Common Injuries  Associated With Elbow <ul><li>Tennis elbow / Lateral epicondylitis  </li></ul><ul><li>Compression of the ...
Cubital Fossa
Cubital Fossa <ul><li>Region of the upper limb in front of the elbow joint  </li></ul><ul><li>Triangular area with the fol...
Cubital Fossa
Bicipital Aponeurosis Median Nerve Pronator Teres Brachioradialis Brachial Artery Biceps Brachii Tendon
Venous Layer <ul><li>1 - cephalic vein  </li></ul><ul><li>2 - basilic vein  </li></ul><ul><li>3 - median cubital vein  </l...
<ul><li>1- bicipital aponeurosis (Grace of God tendon – protect median nerve and brachial artery) </li></ul><ul><li>2- bic...
Artery Nerve Layer <ul><li>1 - brachial artery  </li></ul><ul><li>2 - median nerve  </li></ul>
Muscular Floor <ul><li>1 - supinator  </li></ul><ul><li>2 - brachialis  </li></ul><ul><li>3 - biceps tendon  </li></ul>
Bony Floor <ul><li>1 - humerus  </li></ul><ul><li>2 - radius  </li></ul><ul><li>3 - ulna  </li></ul>
Clinical Importance <ul><li>Phlebotomy – venous blood drainage from median cubital vein </li></ul><ul><li>Blood pressure m...
Cubital Fossa
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Radius, Ulna, Elbow and Radioulnar Joint

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Radius, Ulna, Elbow and Radioulnar Joint

  1. 1. College of Allied Health Science ANATOMY MUSCULOSKELETAL RADIUS & ULNA, ELBOW AND RADIOULNAR JOINT HERMIZAN BIN HALIHANAFIAH Bsc Biomedicine (Hons) UKM
  2. 2. Ulna <ul><li>Located on the medial aspect (the little finger side) of the forearm. </li></ul><ul><li>Longer than radius. </li></ul><ul><li>At the proximal end is the olecranon, forms the prominence of the elbow. </li></ul><ul><li>The coronoid process is an anterior projection, together with the olecranon receive the trochlea of the humerus. </li></ul>
  3. 3. Ulna Anterior view Trochlear notch Olecranon Radial notch Coronoid process Lateral view
  4. 4. Cont…. <ul><li>The trochlear notch is a large curved area between the olecranon and coronoid process that forms part of the elbow joint. </li></ul><ul><li>Just inferior to the coronoid process is the ulnar tuberosity. </li></ul><ul><li>Distal end of the ulna consist of a head that is separated from the wrist by a fibrocartilage disc. </li></ul><ul><li>A styloid process is on the posterior side of the distal end. </li></ul>
  5. 5. Ulnar Tuberosity
  6. 6. Radius <ul><li>Located on the lateral aspect (thumb side) of the forearm. </li></ul><ul><li>Proximal end of the radius has a disc shaped head that articulates with capitulum of the humerus and the radial notch of the ulna. </li></ul><ul><li>Inferior to the head is the constricted neck. </li></ul><ul><li>A roughened area inferior to the neck on the medial side, called the radial tuberosity, is a point attachment for the tendons of the biceps brachii muscle. </li></ul>
  7. 7. Cont… <ul><li>The shaft of the radius is widens distally to form a styloid process on the lateral side. </li></ul>
  8. 8. Ulnar Tuberosity
  9. 12. Radius and Ulna <ul><li>Ulna and radius articulate with the humerus at the elbow joint. </li></ul><ul><li>This articulation occur in 2 places; head of radius articulate with capitulum of the humerus, and trochlear notch of the ulna articulates with trochlea of the humerus. </li></ul>
  10. 13. Elbow Joint
  11. 14. Cont…. <ul><li>Ulna and radius connect with one another at three sites. </li></ul><ul><li>First, a broad, flat, fibrous connective tissue called interosseous membrane joint the shaft of the two bones. </li></ul><ul><li>This membrane also provide a site of attachment for some tendons of deep muscles of the forearm. </li></ul>
  12. 15. Elbow Joint Proximal Radioulnar Joint Distal Radioulnar Joint Interosseous Membrane Radiocarpal Joint
  13. 16. Cont… <ul><li>Ulna and radius also articulates at their proximal and distal end. </li></ul><ul><li>Proximally, the head of radius articulates with the radial notch of ulna, depression that is lateral and inferior to the trochlear notch of ulna. </li></ul><ul><li>This articulation is the proximal radioulnar joint. </li></ul>
  14. 17. Ulna and radius parallel each other Radius cross over the ulna
  15. 18. Cont…. <ul><li>Distally, the head of the ulna articulates with ulna notch of the radius. </li></ul><ul><li>This articulation is the distal radioulnar joint. </li></ul><ul><li>Finally, the distal end of the radius articulates with three bones of the wrist, Lunate, Scaphoid and the Triquetrum to form radiocarpal joint (wrist joint). </li></ul>
  16. 20. Muscles of the Elbow
  17. 21. Muscles Move the Elbow Joint <ul><li>Most of the muscles that move the radius and ulna cause flexion and extension at elbow joint. </li></ul><ul><li>Is a hinge joint. </li></ul><ul><li>Muscles of the elbow can divide based on their action: </li></ul><ul><ul><li>Flexion (flexor muscles) </li></ul></ul><ul><ul><li>Extension (extensor muscles) </li></ul></ul><ul><ul><li>Pronation (pronators muscles) </li></ul></ul><ul><ul><li>Supination (supinators muscles) </li></ul></ul>
  18. 22. Flexor Muscles <ul><li>Biceps brachii </li></ul><ul><li>Brachialis </li></ul><ul><li>brachioradialis </li></ul>
  19. 23. Biceps brachii <ul><li>Origin </li></ul><ul><ul><li>Long head – supraglenoid tubercle of scapula. </li></ul></ul><ul><ul><li>Short head – coracoid process of scapula </li></ul></ul><ul><li>Insertion – radial tuberosity of radius and bicipital aponeurosis </li></ul><ul><li>Action </li></ul><ul><ul><li>Flexion forearm at elbow joint </li></ul></ul><ul><ul><li>Supinates forearm at radioulnar joint </li></ul></ul><ul><ul><li>Flexion arm at shoulder joint. </li></ul></ul><ul><li>Nerve supply – musculocutaneous nerve </li></ul>
  20. 24. Long Head of Biceps Short head of Biceps
  21. 25. Brachialis <ul><li>Origin – distal, anterior surface of humerus </li></ul><ul><li>Insertion – ulnar tuberosity and coronoid process of ulna. </li></ul><ul><li>Action - Flexion forearm at elbow joint </li></ul><ul><li>Nerve supply – musculocutaneous nerve </li></ul>
  22. 26. Brachioradialis <ul><li>Origin – lateral border of distal end of humerus. </li></ul><ul><li>Insertion – superior to styloid process of radius. </li></ul><ul><li>Action </li></ul><ul><ul><li>Flexion forearm at elbow joint </li></ul></ul><ul><ul><li>Supination and pronation forearm at radioulnar joint. (forearm in neutral position) </li></ul></ul><ul><li>Nerve supply – radial nerve </li></ul>
  23. 27. Elbow Flexors
  24. 29. Extensor Muscles of Forearm <ul><li>Triceps brachii </li></ul><ul><li>Anconeus </li></ul>
  25. 30. Triceps brachii <ul><li>Origin </li></ul><ul><ul><li>Long head – infraglenoid tubercle of scapula </li></ul></ul><ul><ul><li>Lateral head – lateral and posterior surface of humerus superior to radial groove. </li></ul></ul><ul><ul><li>Medial head – entire posterior surface of humerus inferior to a radial groove. </li></ul></ul><ul><li>Insertion – olecranon of ulna </li></ul>
  26. 31. <ul><li>Action </li></ul><ul><ul><li>Extension forearm at elbow joint </li></ul></ul><ul><ul><li>Extension arm at shoulder joint </li></ul></ul><ul><li>Nerve supply – radial nerve </li></ul>
  27. 32. Anconeus <ul><li>Origin – lateral epicondyle of humerus </li></ul><ul><li>Insertion – olecranon and superior portion of shaft of ulna. </li></ul><ul><li>Action - Extension forearm at elbow joint </li></ul><ul><li>Nerve supply – radial nerve </li></ul>
  28. 33. Triceps Brachii
  29. 34. Pronators Muscles of Forearm <ul><li>Pronator teres </li></ul><ul><li>Pronator quadratus </li></ul>
  30. 35. Pronator teres <ul><li>Origin – medial epicondyle of humerus and coracoid process of ulna </li></ul><ul><li>Insertion – midlateral surface of radius </li></ul><ul><li>Action- Pronates forearm at radioulnar joint , Weakly flexes forearm at elbow joint </li></ul><ul><li>Nerve supply – median nerve </li></ul>
  31. 36. Pronator quadratus <ul><li>Orgin – distal portion of shaft of ulna </li></ul><ul><li>Insertion – distal portion of shaft of radius </li></ul><ul><li>Action - Pronates forearm at radioulnar joint. </li></ul><ul><li>Nerve supply – median nerve </li></ul>
  32. 37. Supinator Muscle of Forearm <ul><li>Supinator muscles </li></ul><ul><li>Origin – lateral epicondyle of humerus and ridge near radial notch of ulna (supinator crest) </li></ul><ul><li>Insertion – lateral surface of proximal one-third of radius. </li></ul><ul><li>Action - Supinates forearm at radioulnar joints. </li></ul><ul><li>Nerve supply – deep radial nerve </li></ul>
  33. 38. Muscles of the Forearm Move the Wrist, Hand, Thumb and Fingers <ul><li>Group of muscles that act on the digits are known as extrinsic hand muscles because originate outside the hand and insert within it. </li></ul><ul><li>There is 2 groups of forearm muscles: </li></ul><ul><ul><li>Anterior compartment (flexor muscles) </li></ul></ul><ul><ul><li>Posterior compartment (extensor muscles) </li></ul></ul>
  34. 39. Anterior view of forearm muscles
  35. 41. Anterior compartment of Forearm Muscles <ul><li>Muscle of the forearm originate on the humerus </li></ul><ul><li>Insert on the carpals, metarcarpals, and phalanges </li></ul><ul><li>Act as flexor </li></ul><ul><li>Divide into superficial or deep muscles. </li></ul>
  36. 42. Posterior compartment of Forearm Muscles <ul><li>Muscle of the forearm originate on the humerus </li></ul><ul><li>Insert on the carpals, metarcarpals, and phalanges </li></ul><ul><li>Act as extensor </li></ul><ul><li>Divide into superficial or deep muscles. </li></ul>
  37. 43. Forearm Muscles <ul><li>Superficial anterior compartment muscles </li></ul><ul><li>Deep anterior compartment muscles </li></ul><ul><li>Superficial posterior compartment muscles </li></ul><ul><li>Deep posterior compartment muscles </li></ul>
  38. 44. Superficial Anterior Compartment Muscles <ul><li>Arrange in following order from lateral to medial: </li></ul><ul><ul><li>Flexor carpi radialis </li></ul></ul><ul><ul><li>Palmaris longus </li></ul></ul><ul><ul><li>Flexor carpi ulnaris </li></ul></ul><ul><ul><li>Flexor digitorum superficialis – deep to the other 3 muscles and is a largest superficial muscle in the forearm. </li></ul></ul>
  39. 45. Deep Anterior Compartment Muscles <ul><li>Arrange in following order from lateral to medial: </li></ul><ul><ul><li>Flexor pollicis longus </li></ul></ul><ul><ul><li>Flexor digitorum profundus </li></ul></ul>
  40. 46. Superficial Posterior Compartment Muscles <ul><li>Arrange in following order from lateral to medial: </li></ul><ul><ul><li>Extensor carpi radialis longus </li></ul></ul><ul><ul><li>Extensor carpi radialis brevis </li></ul></ul><ul><ul><li>Extensor digitorum </li></ul></ul><ul><ul><li>Extensor digiti minimi </li></ul></ul><ul><ul><li>Extensor carpi ulnaris </li></ul></ul>
  41. 47. Deep Posterior Compartment Muscles <ul><li>Arrange in following order from lateral to medial: </li></ul><ul><ul><li>Abductor pollicis longus </li></ul></ul><ul><ul><li>Extensor pollicis brevis </li></ul></ul><ul><ul><li>Extensor pollicis longus </li></ul></ul><ul><ul><li>Extensor indicis </li></ul></ul>
  42. 48. Elbow Joint <ul><li>Ulna and radius articulates with the humerus </li></ul><ul><li>Occurs in 2 place </li></ul><ul><li>Head of radius articulates with capitulum of the humerus , and </li></ul><ul><li>Trochlea of the humerus articulates with trochlear notch of the ulna. </li></ul>
  43. 49. Elbow Joint Head of Radius Trochlear notch Olecranon Coronoid Process
  44. 50. Radio-Ulnar Joint (Pivot Joint) <ul><li>Radius and ulna also articulates with one another in 2 places. </li></ul><ul><li>Proximally the head of radius articulates with the radial notch of ulna, a depression that is lateral and inferior to the trochlear notch. </li></ul><ul><li>This articulation called proximal radioulnar joint. </li></ul><ul><li>Head of radius retain contact with radial notch of ulna by annular ligament. </li></ul>
  45. 51. <ul><li>Distally the head of ulna articulates with ulna notch of the radius. </li></ul><ul><li>This articulation is the distal radioulnar joint. </li></ul><ul><li>the distal end of radius bone articulates with three bones of the wrist; lunate, scaphoid and the triquetrum to form radiocarpal join. </li></ul>Radio-Ulnar Joint (Pivot Joint)
  46. 52. Proximal Radio-Ulnar Joint <ul><li>Head of radius articulate with radial notch of ulna. </li></ul>Annular Ligament
  47. 53. Distal Radio-Ulnar Joint <ul><li>Head of ulna articulate with ulnar notch of radius. </li></ul>
  48. 54. Elbow Joint <ul><li>Hinge joint (one way direction) </li></ul><ul><li>Articulations between the trochlea of the humerus with the trochlea notch of ulna and </li></ul><ul><li>The capitulum of the humerus with the head of the radius comprise the joint. </li></ul><ul><li>Movements – flexion and extension of the forearm </li></ul>
  49. 55. Anatomical Components of Elbow joint <ul><li>Articular capsule </li></ul><ul><ul><li>Consist 2 parts; anterior and posterior parts </li></ul></ul><ul><ul><li>Anterior part – covers anterior part of the joint, from radial and coronoid fossa of the humerus to the coronoid process of the ulna and annular ligament of the radius. </li></ul></ul><ul><ul><li>Posterior part – from capitulum, olecranon fossa, and lateral epicondyle of the humerus to the annular ligament of the radius, olecranon process of ulna and posterior to the radial notch. </li></ul></ul>
  50. 56. <ul><li>Ulnar Collateral Ligament </li></ul><ul><ul><li>Thick </li></ul></ul><ul><ul><li>Triangular </li></ul></ul><ul><ul><li>Extends from the medial epicondyle of the humerus to the coronoid process and olecranon of the ulna. </li></ul></ul>
  51. 57. <ul><li>Radial Collateral Ligament </li></ul><ul><ul><li>Strong </li></ul></ul><ul><ul><li>Triangular </li></ul></ul><ul><ul><li>Extends from lateral epicondyle of the humerus to the annular ligaments of the radius and the radial notch of the ulna. </li></ul></ul>
  52. 61. Common Injuries Associated With Elbow <ul><li>Tennis elbow / Lateral epicondylitis </li></ul><ul><li>Compression of the ulnar nerve </li></ul><ul><li>Olecranon bursitis / student’s elbow </li></ul><ul><li>Golfers / Throwers Elbow (Medial Epicondylitis) </li></ul><ul><li>Elbow dislocation </li></ul>
  53. 62. Cubital Fossa
  54. 63. Cubital Fossa <ul><li>Region of the upper limb in front of the elbow joint </li></ul><ul><li>Triangular area with the following boundaries: </li></ul><ul><ul><li>laterally, brachioradialis muscle </li></ul></ul><ul><ul><li>medially, pronator teres muscle </li></ul></ul><ul><ul><li>superiorly, an imaginary line from the medial and lateral epicondyles. </li></ul></ul>
  55. 64. Cubital Fossa
  56. 65. Bicipital Aponeurosis Median Nerve Pronator Teres Brachioradialis Brachial Artery Biceps Brachii Tendon
  57. 66. Venous Layer <ul><li>1 - cephalic vein </li></ul><ul><li>2 - basilic vein </li></ul><ul><li>3 - median cubital vein </li></ul>
  58. 67. <ul><li>1- bicipital aponeurosis (Grace of God tendon – protect median nerve and brachial artery) </li></ul><ul><li>2- biceps tendon </li></ul>Aponeurotic layer
  59. 68. Artery Nerve Layer <ul><li>1 - brachial artery </li></ul><ul><li>2 - median nerve </li></ul>
  60. 69. Muscular Floor <ul><li>1 - supinator </li></ul><ul><li>2 - brachialis </li></ul><ul><li>3 - biceps tendon </li></ul>
  61. 70. Bony Floor <ul><li>1 - humerus </li></ul><ul><li>2 - radius </li></ul><ul><li>3 - ulna </li></ul>
  62. 71. Clinical Importance <ul><li>Phlebotomy – venous blood drainage from median cubital vein </li></ul><ul><li>Blood pressure measurement - stethoscope is placed over the brachial artery in the cubital fossa. The brachial pulse may be palpated in the cubital fossa. </li></ul>
  63. 72. Cubital Fossa
  64. 73. Thank You!!!
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