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Radius, Ulna, Elbow and Radioulnar Joint

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