Kines Ch. 11 Elbow Joint
musculocutaneous, median, and radial
What nerves help in flexion?
soft
With flexion, the end feel is ____ because the muscle bulk of the arm and forearm compresses together and limits further motion.
proximal radioulnar joint; distal radioulnar joint
At the proximal end, the head of the radius pivots within the radial notch of the ulna, forming the superior or _____. Due to the shape of the radius, the distal end of the radius rotates around the distal end of the ulna, forming the inferior or _______.
radius
Because the radius moves and the ulna does not, a muscle must attach on the _____ to be able to pronate and supinate the forearm.
supracondylar fractures
____ are among the most common fractures in children and are caused by falling on the outstretched hand. This distal end of the humerus fractures just above the condyles.
lateral epicondylitis, aka tennis elbow
_____ is a very common overuse condition that affects the common extensor tendon where it inserts into the lateral epicondyle of the humerus. The extensor carpi radialis brevis is particularly affected.
medial epicondylitis, aka golfer's elbow
______ is an inflammation of the common flexor tendon that inserts into the medial epicondyle. It is an overuse condition that results in tenderness over the medial epicondyle and pain on resisted wrist flexion.
elbow dislocation
______ is caused when a great deal of force is applied to an elbow that is in a slightly flexed position. This causes the ulna to slide posterior to the distal end of the humerus.
145 degrees
Measured from the anatomical position, the elbow joint has approximately _____ degrees of flexion. Extension is the return to anatomical position from flexion.
90 degrees supination; 80 degrees pronation
Measured from the neutral or mid position, there are approximately ____ degrees of supination and _____ degrees of pronation.
humeroulnar and humeroradial articulations
On the humerus, the trochlea articulates with the trochlear notch of the ulna, and the capitulum articulates with the head of the radius. These articulations are sometimes referred to as the ______ and ______ articulations, respectively. However, they move together to produce the same joint motion; therefore, they are collectively called the elbow joint.
bony
Pronation has a ____ end feel due to the bony contact between the radius and the ulna. This end feel is more subtle than that felt during elbow extension.
triceps
elbow extension
biceps, brachialis, and brachioradialis
elbow flexion
radial tuberosity of radius
insertion of biceps brachii
coronoid process and ulnar tuberosity of the ulna
insertion of brachialis muscle
styloid process of the radius
insertion of brachioradialis
distal half of humerus, anterior surface
origin of brachialis muscle
lateral supracondylar ridge on the humerus
origin of brachioradialis muscle
True
T/F Functionally, the proximal and distal radioulnar joints are considered one joint as they move together to produce the same motions.
True
T/F The radius moves and the ulna does not.
False, the radius does move around the ulna, but the ulna does NOT rotate, as it is locked in place by its bony shape at the proximal end.
T/F When pronation and supination occur, the radius moves around the ulna as the ulna rotates.
coracoid process
The _____ is the projection on the anterior surface that provides attachment for the short head of the biceps muscle.
collateral ligaments
The _____ reinforce the joint capsule on the sides of the joint.
medial collateral ligament
The ______ is triangular and spans the medial side of the elbow. It attaches on the medial epicondyle of the humerus and runs obliquely to the medial sides of the coronoid process and olecranon process of the ulna.
lateral collateral ligament
The ______ is triangular. It attaches proximally on the lateral epicondyle of the humerus and distally on the annular ligament and the lateral side of ulna.
articulation of the humerus with the ulna and radius
The _______ is commonly called the elbow joint.
cork out of a bottle with a corkscrew ("corkscrew effect")
The action of the biceps as a forearm supinator and elbow flexor is used when pulling a _______.
median nerve with exception of the flexor carpi ulnaris
The anterior forearm is innervated by what nerve?
two
The biceps brachii muscle has one or two heads?
cubital fossa; brachial artery
The brachial pulse can be palpated in the _____, and during blood pressure measurement, the stethoscope is placed over the _____ in this location.
ROM
The brachialis is made for ______ not strength.
strength
The brachioradialis is made for _____ not ROM.
getting your hand to your mouth
The carrying angle is quite functional in ______.
active hyperextension
Unlike the shoulder joint, the elbow joint has no _____.
men= 5 degrees women= between 10 and 15 degrees
What is the normal carrying angle for men and women?
median nerve
pronator quadratus innervation
distal one-fourth of radius
pronator quadratus muscle insertion
distal one-fourth of ulna
pronator quadratus muscle origin
median nerve
pronator teres innervation
lateral aspect of radius at its midpoint
pronator teres insertion
medial epicondyle of humerus and coronoid process of ulna
pronator teres muscle origin
brachialis muscle
sometimes called the "workhorse of the elbow joint"
radial nerve
supinator innervation
anterior surface of the proximal radius
supinator insertion
lateral epicondyle of humerus and adjacent ulna
supinator muscle origin
long head: infraglenoid tubercle of scapula lateral head: inferior to greater tubercle on posterior humerus medial head: posterior surface of humerus
triceps brachii muscle origin
olecranon process of ulna
triceps insertion
elbow extension and neutralizer in flexion
triceps muscle action
radial nerve
triceps muscle innervation
women
Does the carrying angle tend to be greater in men or women?
radial
Every extensor from the elbow down to the hand is the ____ nerve.
olecranon process
Hyperextension of the elbow is blocked by the ______ of the ulna making bone-on-bone contact as it fits into the olecranon fossa of the humerus.
yes
If the musculocutaneous nerve is damaged can the patient still have flexion?
no
If the radial nerve is damaged can the patient still have extension?
interosseous membrane
In addition to the annular ligaments, the radioulnar articulations are held together by the ______. This broad, flat membrane is located between the radius and the ulna for most of their length.
firm
In supination, the end feel is ___ because of muscle and ligament tension.
carrying angle
In the anatomical position, the longitudinal axes of the humerus and forearm form an angle called the ____.
ulnar nerve compression
Pain from "hitting the funny bone" does not come from a bone, but from ________. It is very superficial where it crosses the medial elbow between the bony olecranon process and medial epicondyle. Any impact to the nerve can create pain, numbness, and tingling in the medial hand and fourth and fifth fingers innervated by this nerve.
1) medial collateral ligament 2) lateral collateral ligament 3) annular ligament
The 3 ligaments of the elbow:
supinator and biceps muscles
The ___ and ___ combine in a force couple action to move the radius around the ulna.
head
The ___ of the ulna is at the distal end, on the lateral surface; the ulnar notch of the radius pivots around it during pronation and supination.
joint capsule
The ____ attaches around the distal end of the humerus and encompasses the trochlea and capitulum and the fossas located above them. It attaches around the proximal end of the ulna, under the radial notch and coronoid process, and around the trochlear notch. It attaches around the radius, just under the head.
trochlear notch
The ____ is also called the semilunar notch; articulates with the trochlea of the humerus; makes up the anterior surface at the proximal end.
styloid process
The ____ is at the distal end of the ulna, on the posterior medial surface.
ulnar tuberosity
The ____ is located below the coronoid process; provides attachment for the brachialis muscle.
coronoid process
The ____ is located just below the trochlear notch; with the ulnar tuberosity, provides attachment for the brachialis muscle.
lateral epicondyle
The ____ is located on the lateral side of the distal end of the humerus, above the capitulum; provides attachment for the anconeus and supinator muscles.
trochlea
The ____ is located on the medial side of the distal end of the humerus; articulates with the ulna.
olecranon fossa
The ____ is located on the posterior surface between the medial and lateral epicondyles; articulates with the olecranon process of the ulna.
spiral groove
The ____ is the groove that the radial nerves runs through as it spirals around the midhumerus.
infraglenoid tubercle
The ____ is the raised portion of the inferior lip of the glenoid fossa that provides attachment of the long head of the triceps muscle.
supraglenoid tubercle
The ____ is the raised portion on the superior lip of the glenoid fossa that provides attachment for the long head of the biceps muscle.
interosseous membrane
The ____ keeps the radius and ulna from separating and provides most surface area for attachment of the forearm and wrist muscles.
annular ligament
The _____ attaches anteriorly and posteriorly to the radial notch of the ulna, encompassing the head of the radius and holding it against the ulna.
lateral supracondylar ridge
The _____ is located above the lateral epicondyle; provides attachment for the brachioradialis muscle.
olecranon process
The _____ is located at the proximal end of the ulna, on the posterior surface; forms the prominent point of the elbow and provides attachment for the triceps muscle.
radial notch
The _____ is located at the proximal end on the lateral side of the ulna, just distal to the trochlear notch; articulation point for the head of the radius.
medial epicondyle
The _____ is located on the medial side of the distal end of the humerus, above the trochlea; larger and more prominent than the lateral one. It provides attachment for the pronator teres muscle.
capitulum
The _____ is on the lateral side of the humerus, next to the trochlea; articulates with the head of the radius.
the distal end of the humerus is not level (The medial side [the trochlea] is lower than the lateral side [the capitulum] therefore, as the ulna and radius move around the trochlea and capitulum of the humerus, they do not move in a straight line like a typical hinge joint. Usually, the long axis of the lower segment is in line with the long axis of the upper segment.)
The carrying angle occurs because ________.
ulna; radius
The concave trochlear notch is at the proximal end of the _____, and the concave radial head is at the proximal end of the _____.
1) the trochlea articulating with the ulna 2) the capitulum articulating with the radius
The distal end of the humerus has two convex areas:
3 bones, 3 ligaments, two joints, one capsule
The elbow complex consists of:
flexion and extension
The elbow is a uniaxial joint that allows only ____ and _____, which occurs in a sagittal plane around the frontal axis.
bony end feel
The end feel for extension is the opposite as the end feel for flexion. It is described as hard due to bone-on-bone contact as the olecranon process of the ulna moves into the olecranon fossa of the humerus, limiting further joint motion. This is called ______.
brachial artery; Volkmann's ischemic contracture
The great danger of both elbow dislocation and supracondylar fracture is the potential damage to the ____ because of its close proximity. This can lead to ______, a rare but potentially devastating ischemic necrosis of the forearm muscles.
ulnar nerve
The hand is mostly innervated by what nerve?
capitulum of the humerus
The head of the radius articulates with the _______.
annular
The joint capsule is strengthened anteriorly and somewhat posteriorly by the ____ ligament.
stability
The medial and lateral collateral ligaments provide a great deal of ____ to the elbow.
radial nerve
The posterior forearm is innervated by what nerve?
biceps muscle
The radial tuberosity of the radius provides attachment for the _____.
pronation and supination
The radioulnar joint is a uniaxial pivot joint, allowing only ____ and _____ of the forearm. These motions occur in the transverse plane around the vertical axis.
radius and ulna; radioulnar joint
The second joint of the elbow complex involves articulations between the _____ and _____. This is known as the _____ joint and involves each bone articulating with the other at both ends of the forearm.
brachioradialis muscle
The styloid process of the radius provides attachment for the _______.
anteriorly during flexion; posteriorly during extension
The trochlear notch and the radial head glide anteriorly during _____ and posteriorly during _____.
pulled elbow, or nursemaid's elbow
______ is seen in young children under the age of 5 years who have experienced a sudden strong traction force on the arm. This often occurs when an adult suddenly pulls on the child's arm, or the child falls away from an adult while being held by the arm. This force causes the radial head to sublux out from under the annular ligament.
elbow flexion, forearm supination
action of biceps brachii
elbow flexion
action of brachialis
elbow flexion
action of brachioradialis
forearm pronation
action of pronator quadratus
forearm pronation, assistive in elbow flexion
action of pronator teres
forearm supination
action of supinator
musculocutaneous nerve
biceps brachii innervation
long head: supraglenoid tubercle of scapula short head: coracoid process of scapula
biceps brachii muscle (aka biceps muscle) origin
musculocutaneous nerve
brachialis muscle innervation
radial nerve
brachioradialis innervation
pronator teres, pronator quadratus
forearm pronation
biceps and supinator
forearm supination
