Anatomy of elbow & radioulnar joints

1. Faculty of medicine
Department of anatomy
1

2. Elbow &
Radio-ulnar
joints
Dr. Nagwa Ebrahim
nagwaebrahim@hotmail.com

3. 3
Type
Articular surfaces
Capsule & synovial membrane
Supporting ligaments
Movements & muscles involved.
Stability
Nerve supply & blood supply
Clinical anatomy
Intended learning outcomes
ILOS

4. Elbow Joint 14

5. Articular Surfaces
3 bones:
Humerus
Ulna
Radius
15
1
2
3

6. Lower end humerus
Ant. S. Post. S.
TrochleaCapitulum
Only on ant. & inf. S.
Med. epicondyle
Lat. epicondyle
Coronoid
fossa Olecranon
fossa
Med.
Trochlea
radial
fossa

7. Dr. Nagwa Ebrahim
17Upper
end
radius
Ant.
Post.

8. 18
 Olecranon
process
 Coronoid
process
Trochlear
notch

9. 19
Trochlear
notch
TrochleaCapitulum
Sup. S. head
radius

10. 20
Joint type Synovial

11. Type Joint
Synovial
Hinge
Uni-axial
(horizontal Axis, Allow only
flexion & extension)
21

12. 22
Flexion:
Brachialis
Biceps brachii
(supinated forearm)
Brachioradialis
(midprone forearm)
Movements

13. 23

14. 24
Brachioradialis
midprone forearm
Biceps brachii
Supinated forearm

15. 25
Extension:
Triceps
Anconeus

16. 26
Anconeus:
O.: lat. Epicondyle
humerus
I.: Lat. S. olecranon

17. 27

18. 28

19. 29
Capsule
A) Proximal (upper) attachment :
Lower end humerus above
Coronoid, radial, olecranon fossae
-----------------------------------------------------------
B) Distal (lower) attachment :
margins of olecranon, coronoid processes
& annular ligament

20. 30

21. 31
Ant. Post.

22. ulna
32

23. 33

24. 34
Synovial membrane
oLines the capsule
o
oContinuous with
synovial memb. of
sup. radioulnar j.

25. 35
Supporting Ligaments
Radial collateral lig.
(Lat. Lig.)
Ulnar collateral lig.
(Med. Lig.)

26. 36
Ulnar collateral lig.
(Med. Lig.)
 Ant. band
 Post. band
 Oblique band
humerus
ulna

27. 37

28. 38
Radial collateral lig.
(Lat. Lig.)
Apex
base

29. Ulnar collateral lig.:
 Ant.
 Post.
 oblique
Radial collateral lig.:
 Apex
 base
A P
O
39

30. 40

31. 41
Carrying angle
165°
Supinated forearm

32. The carrying angle
• Between long axis of the arm and
extended , supinated forearm.
• It is directly laterally (165˚).
• Caused by:
a) downward projection of the med.
Edge of trochlea than the lat. Edge by
6mm.
B) Oblique sup. Articular S. of Coronoid
process of ulna.
42

33. 43

34. • Disappear IN:
a)Pronation
b)Midprone position
c) Flextion
• Importance:
Displace the UL away from the
trunk to help carrying objects.
44

35. Stability of Elbow Joint
Elbow joint is stable
Bec. Of:
Bony shape
Strong ligs.
45

36. Dislocations of the Elbow Joint 46

37. 47Usually post. in
children
Fall on outstretched
hands

38. 48
In flexion
the 3 bones form
equilateral triangle
In extension
the 3 bones one
line

39. Dislocations of the Elbow Joint
Ulnar n. injury common
50

40. 1/4/2017
51
Arthritis
arthritis is inflammation of a joint
inflammation is caused by many causes
Clinical note

41. 52

42. Tennis elbow
Over-use of
elbow extensors
Epicondylitis -
(Elbow Tendonitis)
An inflammation or
slight tearing of the
tendons or muscles
around the elbow
joint.
Lat.
epicondyle
53
Back strikes

43. Golf elbow
Over-use of
elbow flexors
Epicondylitis -
(Elbow Tendonitis)
An inflammation or
slight tearing of the
tendons or muscles
around the elbow
joint.
Med.
epicondyle
54

44. From
anastomosis
around the
elbow
55
Arterial Blood Supply

45. Radial nerves
Musculocutaneous
Ulnar
Median
Ant. interosseous
56
Nerve Supply

46. 57 Type: synovial hinge uniaxial
 Articular surfaces: humerus (trochlea –
capitulum) radius (sup. S. head) – ulna
(trochlear notch)
Capsule: above; Coronoid, radial,
olecranon fossae. Below; margins of
olecranon, coronoid processes & annular
ligament
 Supporting ligaments: radial collateral
(cone shaped)– ulnar collateral (3 bands)
 Movements: flexion - extension
 Stability: Stable
Summary

47. A 3 years old girl was admitted to the emergency dep.
With sever pain. History taking revealed that the girl was
violently lifted by her raised arm by her mother to save
her from a moving car. Which of the following is most
likely the cause of the pain?
A. Compression of median nerve
B. Separation of head of radius from its articulation with
trochlea of humerus
C. Separation of head of radius from its articulation with
ulna and capitulum of humerus
D. Separation of ulna from its articulation with trochlea of
humerus
E. Stretching of radial nerve as it passes behind medial
epicondyle of humerus
58

48. 59

49. 1/4/2017 60
Q. Which one of the following does
Not contribute to articular surface of
elbow joint.
A. Trochlea of humerus
B. Head of radius
C. Capitulum of humerus
D. Glenoid labrum

50. 61

51. Radio-ulnar joints
62
These joints permit
Rotation
Pronation & supination
radius
ulna

52. 63Superior
Synovial
Pivot
Inferior
Synovial
Pivot
Middle
Fibrous
Syndesmoses

53. 64

54. 65
supination pronation

55. Supination
Lat. Rotation forearm
1- Thumb directed lateraly
2- palm faces anteriorly

56. Muscles of supination
•In flexed
forearm
Biceps
brachii
•In extended
forearm
supinator
67

57. Pronation
1-Thumb directed medially
2-Palm faces backwards
3- body of radius lies
across ulna
68
Med. Rotation forearm

58. Muscles of pronation
 Pronator Quadratus
Principal pronator
 Pronator teres
In pronation against
resistance
69

59. For Sup. & inf. Radio-ulnar
joints (pronation&supination)
Range of movement
150 degree
Axis of movement
Line bet. Head radius &
base styloid process ulna
70

60. 71
Initiator of motion is
Brachioradialis
As it put forearm in
mid-prone position (neutral)

61. 72
Supination is more
powerful
than pronation
so……screwdriving…….

62. 73Superior Radio-ulnar joint
Joint Type
Synovial
Pivot
Uniaxial with
Vertical oblique axis

63. 74

64. 75
1. Circumference
of head of radius.
2. Radial notch
of ulna.
3. Inner surface
of annular
ligament
Articular s.

65. 76
o Annular lig.
o Quadrate lig.
bett. Neck radius
& lower margin of
radial notch
Ligaments

66. 77

67. 78

68. 79

69. Synovial
membrane is
continous with that
of elbow joint
80Synovial
membrane

70. 81Middle Radio-ulnar joint
Composed of :
 Oblique cord
 interosseous membrane
Type:
Fibrous
Syndesmoses

71. 82Oblique cord
• Directed infero-lat.
• Bet. Ulnar tuberosity &
area below radial
tuberosity
interosseous
membrane
• Directed infero-med.
• Bet. Interosseous
borders of radius &
ulna

72. 83Inferior Radio-ulnar joint
Inferior
Synovial
Pivot

73. This joint separated from wrist j.
by……….
Articular disc
 Triangular
 attached to lower edge of ulnar
notch & root of styloid process
of ulna
84Articular surface
 Ulnar head
 Ulnar notch of radius

74. 85
Articular disc
(fibrocartilage)
Articular disc
 Triangular
 attached to lower
edge of ulnar
notch & root of
styloid process of
ulna

75. Radio-ulnar joints
Superior
Synovial
Pivot
86
Middle
Fibrous
Syndesmoses
Inferior
Synovial
Pivot
Pronation & supination

76. 87