Elbow Rajat Mathur

2,762 views

Published on

Elbow kinesiology

0 Comments
10 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,762
On SlideShare
0
From Embeds
0
Number of Embeds
15
Actions
Shares
0
Downloads
181
Comments
0
Likes
10
Embeds 0
No embeds

No notes for slide

Elbow Rajat Mathur

  1. 1. Elbow Anatomy and Kinesiology Rajat Mathur M.D. October 2013 PGY2
  2. 2. Elbow Overview ● Hinge joint made up of humerus, ulna and the radius bones ● Function: properly place hand in space by shortening and lengthening the upper limb ● Most upper extremity movements involve the elbow and radioulnar joints
  3. 3. Bones ● Ulna is much larger proximally than radius ● Radius is much larger distally than ulna ● Scapula and humerus serve as proximal attachments for muscles that flex and extend the elbow. ● Ulna and radius serve as distal attachments for these same muscles
  4. 4. Bones ● Scapula, humerus, and ulna serve as proximal attachments for muscles that pronate and supinate the radioulnar joints. ● Distal attachments of the radioulnar joint muscles are located on radius ● Bony Landmarks ○ Lateral and medial epicondyle ○ Olecranon process ○ Radial head
  5. 5. Joints ● 3 joints enveloped by common capsule Joint From To Description Humeroulnar joint trochlear notch of the ulna trochlea of humerus - simple hinge joint - allows movement of flexion & extension only Humeroradial joint head of the radius capitulum of the humerus - synovial ball and socket hinge type joint - allows flexion, extension, pronation and supination Proximal radioulnar joint head of the radius radial notch of the ulna - tochoid (pivot) joint - flexion or extension - pronation and supination
  6. 6. Ligaments ● Ulnar collateral ligament ○ medial side of the elbow ○ extends from medial epicondyle of humerus to proximal portion of ulna ○ function is to prevent excessive abduction of elbow joint ● Radial collateral ligament ○ lateral side of the elbow ○ extends from lateral epicondyle of humerus to head of radius ○ function is to prevent excessive adduction of elbow joint
  7. 7. Ligaments ● Ulnar collateral ligament is critical in providing medial support to prevent the elbow from abducting when stressed in physical activity. ○ Many contact sports and throwing activities place stress on the medial aspect of the joint, resulting in injury.
  8. 8. Ligaments ● Radial collateral ligament provides lateral stability and is rarely injured ● Annular ligament provides stability for radial head during pronation and supination ○ commonly injured in children when arm pulled forcefully
  9. 9. Interosseous Membrane The joint between shafts of radius & ulna held tightly together between proximal and distal articulations by an interosseous membrane
  10. 10. Kinesiology of the elbow ● The elbow moves from 0 degrees of extension to 145-150 degrees of flexion.
  11. 11. Elbow motions ● Primarily involve movement between articular surfaces of humerus and ulna ● The humeral trochlea fits into the ulna trochlea notch ● Radial head has a relatively small amount of contact with humerus ● As the elbow reaches full extension, the olecranon process fits into the olecranon fossa ○ allows increased joint stability when fully extended
  12. 12. Elbow motions ● As the elbow flexes 20 degrees or more, its bony stability is unlocked, allowing for more side to side laxity. ● Stability in flexion is more dependent on the lateral (radial collateral ligament) and the medial (ulnar collateral ligament).
  13. 13. Movements ● Flexion ○ movement of forearm to shoulder by bending the elbow to decrease its angle ● Extension ○ movement of forearm away from shoulder by straightening the elbow to increase its angle
  14. 14. Movements ● Pronation ○ internal rotary movement of radius on ulna that results in hand moving from palm-up to palm- down position ● Supination ○ external rotary movement of radius on ulna that results in hand moving from
  15. 15. Pronation/Supination ● Radioulnar joint ○ trochoid or pivot joint ○ radial head rotates around proximal ulna ○ distal radius rotates around distal ulna ○ annular ligament maintains radial head in its joint ○ Supinate: 80-90 degrees from neutral ○ Pronate 70-90
  16. 16. Nerves ● All elbow and radioulnar joints muscles are innervated from median, musculocutaneous, and radial nerves of brachial plexus
  17. 17. Radial Nerve ● Radial nerve: originates from C5, C6, C7, & C8 ○ Triceps brachii ○ Brachioradialis ○ Supinator (posterior interosseous nerve) ○ Anconeus ○ Sensation to posterolateral arm, forearm, & hand
  18. 18. Median Nerve ● Median nerve - originates from C6 & C7 ○ Pronator teres ○ Pronator quadratus (anterior interosseus nerve) ○ Sensation to palmar aspect of hand & first three phalanges, palmar aspect of radial side of fourth finger, dorsal aspect of index & long
  19. 19. Musculocutaneous Nerve ● Musculocutaneous nerve - Originates from C5 & C6 ○ Biceps brachii ○ Brachialis
  20. 20. Muscles overview ● Elbow flexors ○ Biceps brachii ○ Brachialis ○ Brachioradialis ○ Weak assistance from pronator teres ● Elbow Extensor ○ Triceps brachii ○ Anconeus provides assistance ● Radioulnar pronators ○ Pronator teres ○ Pronator quadratus ○ Brachioradialis ● Radioulnar supinators ○ Biceps brachii ○ Supinator muscle ○ Brachioradialis
  21. 21. Muscles ● Anteriorly ○ Primarily flexion and pronation ■ Biceps brachii ■ Brachialis ■ Brachioradialis ■ Pronator teres ■ Pronator quadratus
  22. 22. Muscles ● Posterior ○ Primarily extension & supination ■ Triceps brachii ■ Anconeus ■ Supinator
  23. 23. Biceps Brachii ● Flexion of elbow ● Supination of forearm ● Weak flexion of shoulder joint ● Weak abduction of shoulder joint when externally rotated
  24. 24. Brachialis ● True flexion of the elbow
  25. 25. Brachioradialis Muscle ● Flexion of elbow ● Pronation from supinated position to neutral ● Supination from pronated position to neutral
  26. 26. Triceps Brachii ● All heads: extension of elbow ● Long head: extension of shoulder joint; adduction of shoulder joint, horizontal abduction
  27. 27. Anconeus ● Small contribution towards extension of elbow
  28. 28. Pronator Teres ● Pronation of forearm ● Weak flexion of elbow
  29. 29. Pronator Quadratus ● Pronation of forearm
  30. 30. Supinator ● Supination of forearm
  31. 31. MRI Anatomy of the Elbow http://gme.bridgeporthospital. com/portals/7/cchip_client/anatomywiz/awiz. aspx?TID=1
  32. 32. Thank you

×