THE ELBOW

Overview Applied anatomy Patient history Observation Examination

Joints at the Elbow Humeroulnar

Ginglymus○ Hinge

Which plane/axis?Olecranon process of

ulna provides stability in extension, but does not “lock” into olecranon fossa of humerus

Joints at the Elbow Radioulnar

Trochoid○ Pivot

Which plane/axis?Annular ligament

encircles radial head but allows the radius to “spin” (pronate & supinate)

Movements at the Elbow Flexion and

extension at the humeroulnar joint

Movements at the Elbow Pronation and

supination at the radioulnar joints

Applied Anatomy Bony aspects

Humerus○ Head○ Diaphysis○ Medial condyle○ Medial epicondyle○ Lateral condyle○ Lateral epicondyle○ Coronoid fossa○ Olecranon fossa○ Capitulum○ Trochlea

Applied Anatomy Bony aspects

Radius○ Head○ Neck○ Radial tuberosity○ Diaphysis○ Radial styloid

Applied Anatomy Bony aspects

Ulna○ Olecranon process○ Coronoid process○ Raidal notch○ Diaphysis○ Head○ Ulnar styloid

Applied Anatomy Ligamentous

aspectsMedial

○ Ulnar or medial collateral ligamentProtects against

valgus forcesThe “Tommy John”

surgery

Applied Anatomy Ligamentous

aspectsLateral

○ Radial or lateral collateral ligamentProtects against

varus forcesAnterior

○ AnnularSupports PRUJ

Muscular Anatomy Anterior group

Biceps brachii Brachialis Brachioradialis Pronator teres Pronator quadratus Flexor carpi radialis Palmaris longus Flexor carpi ulnaris

Posterior group Triceps Anconeus Supinator Extensor carpi radialis Extensor carpi ulnaris

Anterior Group: Biceps Brachii O:

Long head: superior glenoid

Short head: coracoid I: Radial tuberosity A: Elbow flexion &

supination, shoulder flexion

N: Musculocutaneous

Anterior Group: Brachialis O: Distal humerus I: Proximal ulna A: Elbow flexion N:

Musculocutaneous

Anterior Group: Brachioradialis O: Lateral distal

humerus I: Distal radius at

the lateral styloid process

A: Elbow flexion N: Radial

Anterior Group: Pronator Teres O: Medial distal

humerus (condyle) & ulna

I: Lateral radius, middle 1/3

A: Elbow pronation & flexion

N: Median

Anterior Group: Pronator Quadratus O: Distal anterior

ulna I: Distal anterior

radius A: Pronation N: Median

Anterior Group: Flexor Carpi Radialis

O: medial epicondyle

I: palmar hand A: flexion,

abduction N: median

Anterior Group: Palmaris Longus O: Medial

epicondyle I: palmar hand A: flexion N: Median

Anterior Group: Flexor Carpi Ulnaris

O: medial epicondyle

I: palmar hand A: flexion,

adduction N: ulnar

Posterior Group: Triceps Brachii O:

Long head: infraglenoid lip of scapula

Lateral head: posterior humerus

Medial head: medial posterior humerus

I: Olecranon process A: Elbow extension,

shoulder extension N: Radial

Posterior Group: Anconeus

O: Posterior humerus, lateral condyle

I: Olecranon process

A: Elbow extension N: Radial

Posterior Group: Supinator O: Lateral

epicondyle of humerus

I: Lateral proximal radius

A: Supination N: Radial

Posterior Group Extensor Carpi

Radialis (ECR)O: lateral epicondyleI: dorsal handA: ext & abdN: radial

Posterior Group Extensor Carpi

Ulnaris (ECU)O: lateral

epicondyleI: dorsal handA: ext & addN: radial