Elbow and Forearm

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Elbow and Forearm : 

Elbow and Forearm Tristan Boam

Osteology : 

3 Bones Humerus Radius Ulnar Osteology

Joints : 

3 Joints Humerus – Ulnar Proximal and Distal Radio-Ulnar Joints

Articulations : 

Articulations Anteriorly... Head of Radius with Capitulum of Humerus Trochlea of Humerus with Trochlear notch of Ulnar

Slide 5: 

Posteriorly... Olecranon of Ulnar with Olecranon Fossa of Humerus

Ligaments : 

Radial Ligament Ulnar Ligament Stability Annular Ligament Ligaments Anterior View

Pulled Elbow : 

Children (e.g. Being pulled up a kerb) Weak Annular Ligament and under-development of Head of Radius Subluxation of joint Gentle Supination and Compression Pulled Elbow

Blood Supply : 

Brachial Artery Radial and Ulnar Arteries Radial and Ulnar Collateral Allow Blood Flow if Brachial Artery is Damaged Blood Supply

Nerve Routes : 

Radial Nerve passes anterior to Lateral Epicondyle Median Nerve – anterior to Medial Epicondyle Ulnar Nerve – Posterior to Medial Epicondyle Funny Bone... Nerve Routes

The Cubital Fossa : 

Borders Superior – Line through Epicondyles Lateral – Brachioradialis Medial – Pronator Teres Floor – Brachialis Roof – Biceps Aponeurosis and Fascia The Cubital Fossa

Contents : 

From Lateral to Medial Roger – Radial Nerve The Beagle – Tendon Of Biceps Bit – Brachial Artery Me – Median Nerve Contents

Bicipital Aponeurosis : 

Protects Structures underneath Bicipital Aponeurosis

Venepuncture : 

Usually from Median Cubital vein 20% of people have Median Basilic and Cepahlic Veins Venepuncture

Muscles – Flexor Compartment : 

Split into 3 layers: Superficial Intermediate Deep Most have a Common attachment of Medial Epicondyle Innervated by Median Nerve except for Flexor Carpi Ulnaris and the Ulnar half of Flexor Digitorum Profundus Flexion of wrist and digits (also Pronators) Muscles – Flexor Compartment

Flexor Compartment - Superficial : 

From Lateral to Medial: Pronator Teres Flexor Carpi Radialis Palmaris Longus Flexor Carpi Ulnaris Flexor Compartment - Superficial

Flexor Compartment - Intermediate : 

Flexor Digitorum Superficialis Flexor Compartment - Intermediate

Flexor Compartment - Deep : 

From Lateral to Medial: Flexor Pollicis Longus Flexor Digitorum Profundus Pronator Quadratus (Over Distal Radio-Ulnar joint) Flexor Compartment - Deep

Medial Epicondylitis : 

Golfers Elbow Repeated use of Flexors Pulls on Periosteum of Medial Epicondyle Medial Epicondylitis

Muscles – Extensor Compartment : 

2 Layers: Superficial Deep Supplied by Radial Nerve Extension of wrist and Digits (also supination) ‘Wrist Drop’ – Damage to radial nerve Muscles – Extensor Compartment

Extensors - Superficial : 

Lateral to Medial: Brachioradialis – ‘Beer Raising’ Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Extensor Digitorum Extensor Digiti Minimi Extensor Carpi Ulnaris Common Attachment: Lateral Epicondyle – ‘Tennis Elbow’ Extensors - Superficial Lateral Medial

Extensors - Deep : 

Lateral to Medial: Attach to Ulnar Shaft Supinator Abductor Pollicis Longus Extensor Pollicis Longus Extensor Pollicis Brevis Extensor Indicis Extensors - Deep Medial Lateral

Slide 22: 

Anconeus Stabilises Elbow Joint during extension and supination Radial Nerve

Student’s Elbow : 

Repeated Pressure Inflammation of Olecranon Bursa Local Anaethetic, Drainage Steroids Surgical Excision Student’s Elbow

Fracture of the Olecranon : 

Fall on elbow Triceps pulls olecranon proximally Surgical intervention - Pin Fracture of the Olecranon