MMB [018]

Elbow joint
(practical)

Anatomy Division Staff

▪The muscles of the arm are divided into 2
compartments by means of 2 intermuscular septa
1.Anterior compartment → flexor muscles (Biceps,
coracobrachialis, Brachialis)
2.Posterior compartment→ extensor muscles
(Triceps)
Biceps brachii
•Long head
•Short head
• Insertion Tendon and
aponeurosis
•Action
• Supination of
Forearm Nerve supply:
• Flexion shoulder & musculocutaneous
elbow nerve
Biceps Tendon Reflex

Root value :
C5, C6
 Rupture of the long head of Biceps

Popeye’s Sign

• Common site
for rupture:
Intertubercul
ar groove
 • Coracobrachialis
➢ From coracoid process to
mid shaft humerus
➢ Flexion & adduction of arm
• Brachialis
➢ From front of lower half of
humerus to ulnar tuberosity
➢ Flexion of elbow
Nerve supply:
musculocutaneous nerve
Musculocutaneous Nerve
• Origin & Root Value:
Lateral cord: C5,6,7.
• Course & Relations.
• Branches:
1. Muscular---muscles of the
front of arm (flexor
compartment).
2. Cutaneous—lateral
cutaneous nerve of forearm.
• Injury (Applied).
Contents of the Posterior
Fascial Compartment of
the Upper Arm

• Muscle: The three

heads of the triceps
muscle
• Nerve supply :
Radial nerve.
• Blood supply:
Profunda brachii and
ulnar collateral
arteries
 Triceps brachii

• long head
(scapula)
• lateral head (back
It unable to of humerus above
extend the elbow spiral groove)
in case of ??
• Fracture of the • medial head
olecranon (back of humerus
process. below spiral
• Olecranon groove)
bursitis.
 Lateral head of
Triceps triceps from
posterior surface
Tendon of humerus
above spiral groove
reflex :
C7,8
Medial head of
Long head of triceps from
triceps from posterior surface
infraglenoid of humerus
tubercle below spiral
groove
 Radial Nerve
• Origin & Root Value:
Posterior cord, (C5,6,7,8,T1).
• Course & Relations.
• Branches:
• Muscular to the 3 heads of
triceps &anconeus.
• Post. Cutaneous of arm.
• Lower lat. cutaneous of arm.
• Post. Cut. Of forearm.
• Muscular to brachialis,
brachioradialis & ext. carpi rad.
longus.
• 2 terminal br. Injury (wrist drop).
 Cubital fossa
Boundaries:
•Medially: Pronator teres
•Laterally: Brachio-Radialis
•Base: Imaginary Line
•Roof
•Floor
Roof Floor
Veins:
• Basilic • Brachialis
• Cephalic • Supinator
• Median cubital
Contents: (From
medial to
lateral):
1. Median nerve
2. Brachial 4 1
2
artery
3
3. Tendon of
biceps brachii
4. Radial nerve
Clinical point: Blood pressure

Brachial artery just medial to the biceps tendon

 Clinical point: Venepuncture

Risk of injury to brachial artery and median nerve

Elbow region
Elbow joint

• synovial joint of
the hinge variety
(uni-axial)
Articular surfaces:

• lower end of
humerus with
upper ends of ulna
and radius

• All articular surfaces

are covered with a
layer of hyaline Ulna
cartilage.
 Articular surfaces
In 90° flexion: medial view

In 90° flexion: lateral view

Fibrous capsule
• Anteriorly and
posteriorly; it is weak to
allow flexion and
extension.

• Medially and laterally; it

is strong and reinforced
by collateral ligaments
to prevent adduction
and abduction.
 Synovial
membrane
• it lines the capsule and is
continuous with the synovial
membrane of the superior
radio-ulnar joint.
Ligaments:
Radial collateral Ulnar collateral
ligament ligament

anterior band

Annular ligament Anterior part

posterior band
Oblique part
Posterior part
Movements of
Elbow Joint
Flexion: Extension:
• Brachialis (principle • Triceps brachii
flexor) • Anconeus
• Biceps brachii • Extensor carpi
radialis longus
• Brachioradialis (flexes the • Muscles of the
mid-pronated forearm)
common
• Muscles of the common extensor origin;
flexor origin; pronator extensor carpi
teres, flexor carpi radialis, radialis brevis,
palmaris longus, flexor
carpi ulnaris, flexor extensor
digitorum superficialis digitorum,
extensor carpi
ulnaris
Elbow dislocation
Elbow region X-ray
X RAY
Supracondylar
fracture of humerus
Radio-Ulnar joints
elbow: proximal radio-ulnar joint
supination - pronation
Radio-ulnar
joints:

Superior radio-ulnar joint

Interosseous
membrane

Inferior radio-ulnar joint

 Radioulnar joints
The radius and ulna
articulate together at the

I. Superior radio-ulnar joints

II. Middle radio-ulnar joints
III. Inferior radio-ulnar joints
Annular
Ligament
Movements

Supination Pronation
Movements of the Radioulnar
joints
SUPINATION : PRONATION :
The radius lies lateral the radius crosses
&parallel with the obliquely over the
ulna. front of ulna .
It is produced by: It is produced by :
1- Supinator when 1- Pronator
the elbow is quadratus
extended. (mainly).
2-Biceps when the
2- Pronator teres
elbow is flexed.

• IN PRONATION & SUPINATION,

the RADIUS is the movable bone while the ULNA is nearly immobile.
Anastomosis around the elbow
Medial Epicondyle
➢ Front
1
• Anterior branch of
inferior ulnar collateral
artery (brachial artery)
2
• Anterior ulnar recurrent
artery (ulnar artery).
➢ Back
1. Superior ulnar
collateral
2. Posterior branch of
inferior ulnar collateral
(brachial artery)
3. Posterior ulnar
recurrent artery (ulnar
artery).
Anastomosis around the elbow
Lateral Epicondyle
➢ Front
• Radial collateral
artery (profunda)
• Radial recurrent
artery (radial artery).

➢ Back
• Posterior descending
branch (profunda
brachii artery)
• Posterior interosseous
recurrent artery (arises
from posterior
interosseous artery)
Thank you