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The Elbow & Radioulnar Joints

The Elbow & Radioulnar Joints. Describe the humeroulnar and humeroradial joints including joint structure, and factors influencing stability . Describe the ligaments supporting the humeroulnar , humeroradial and radioulnar joints. Describe the carrying angle and how it is formed.

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The Elbow & Radioulnar Joints

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  1. The Elbow & Radioulnar Joints • Describe the humeroulnar and humeroradial joints including joint structure, and factors influencing stability. • Describe the ligaments supporting the humeroulnar, humeroradial and radioulnar joints. • Describe the carrying angle and how it is formed. • Describe the movements of the humeroulnar, humeroradial and radioulnar joints including the muscles involved in these movements. • Describe the cubitalfossa and the structures that are located within this fossa Source: www.fysioweb.nl/.../ elleboog/page_01.htm

  2. Distal Humerus • Trochlea • Resembles rounded empty spool of thread • Almost complete circle, seperated by thin wall of bone • The groove runs as a spiral around the bone • Articulates with the trochlear notch of the ulna • Capitulum • Hemisphere of bone on anterior inferior surface of distal humerus • Medial border is truncated to form the capitulotrochlear groove • Radial fossa located proximal to capitulum

  3. Distal Humerus Posterior View Anterior View Source: mywebpages.comcast.net/ wnor/lesson4bonesofarm...

  4. Proximal Radius/Ulna • Proximal Ulna • Olecranon process forms the point of the elbow • Coronoid process projects sharply from anterior proximal ulna • Trochlear notch articulates with the trochlea of the humerus. It contains a curved longitudinal ridge that fits into the groove of the trochlea. • Radial notch – depression lateral to inferior edge of trochlear notch • Proximal Radius • Concave superior surface to articulate with capitulum • Cup like depression called the fovea • Distally to the head is the bicipitaltuberosity, it acts as attachment point for biceps

  5. The Carrying Angle • There is a lateral va’L’gus angle between the upper arm and forearm. • This L shaped angle allows the elbow to fit into the depression above the iliac crest (waistline) and aids in carrying heavy loads. • Usually 5° in Men / 10-15° in Women • It is due to the trochlea of the humerus (medial edge) projecting more distally and anteriorly than the lateral edge.

  6. Joint Capsule & Ligaments • A fibrous capsule encloses the elbow joint as well as the superior radioulnar joint. • It is strengthened at the sides by the radial (medial) and ulnar (lateral) collateral ligaments • Its is relatively weak anteriorly and posteriorly

  7. Elbow and R/U Ligaments Adapted from:www.orthogastonia.com/.../ elbow_anatomy.html

  8. Ligaments of the elbow joint Medial collateral Lig • Anterior, posterior and intermediate • Anterior is strongest and associated with common extensor tendon • Triangular Shaped • Protect against valgus stress Lateral Collateral Lig • Less defined than medial ligament • Divided into bundles • one binds with annular ligament • the other attaches to the superior crest of the ulna. • Protects against vargus stress Both are continuous with the joint capsule, are tense in flexion and extension, and strictly limit any abduction, adduction, axial rotation

  9. Ligaments of the Radioulnar Jt • Annular Ligament • Encircles 4/5’s of the radial head • Attached to the anterior and posterior margins of the radial notch. • Flexible – allows the head to rotate i.e. pronate/supinate • Strong – holds the radial head into the radial notch. • Upper fibres strengthened by the radial collateral ligament. • Interoseous Membrane • Strong fibrous sheet which stretches between the the inner surfaces of radius and ulna • Runs from proximal to distal • Helps to absorb forces transmitted from the hands, • Prevent displacement of the radius from the ulna and, • Provides a large surface for muscle attachments. • Also found between the tibia and fibula.

  10. Interosseous Membrane Source: web.sc.itc.keio.ac.jp/.../ A03506001-003.html

  11. Flexion: Biceps Brachii Brachialis Brachioradialis Pronator Teres Extension: Triceps brachii Anconeus Pronation: Pronator Teres Pronator Quadratus Brachioradialis Supination: Supinator Biceps brachii Brachioradialis Musculature

  12. Movements of the Humeroradial joint

  13. Movements of the Humeroradial joint

  14. Distal Radioulnar Joint • Head of ulna sits into ulnar notch on radius • Closed inferiorly by triangular articular disc • Stability due to articular disc, interosseous membrane and pronatorquatratus which overlies. • Main movement is supination85° /pronation75 ° • Describe process of supination…

  15. Cubital Fossa Triangular shaped space, bounded laterally by brachioradialis and medially by pronator teres. Main contents include: • Brachial artery • Cephalic and Median cubital veins • Median, radial and lateral cutaneous nerves • Biceps tendon

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