The Elbow

Blessen Abraham Jainy JamesNaved Patel

The Primary Elbow Extensors & Flexors

Elbow flexors• Biceps brachii• Brachialis• Brachioradialis• Weak assistance from pronator teres

Elbow extensor• Triceps brachii• Anconeus provides assistance

What type of joint is the elbow?

The elbow is a Radioulnar joint

It is a pivot-type joint The radial head rotates around the

proximal Distal radius rotates around distal

ulna The angular ligament maintains

radial head in its joints

What is the degree of freedom for the elbow joint?

In supination it is 80 – 90 degree’s from neutral In pronation its 70 – 90 degrees from neutral

Articulation of which bones make the elbow joint?

The elbow is made up of the humerus, ulna, & radius

Draw diagram representing all the movement of

elbow joint and name the plane and axis of each movement.

All these movements take place in the saggital and frontal plane

In what plane does supination and pronation occur?

Supination & pronation take place in the sagittal and coronal plane

What is tennis elbow?

Tennis elbow is a common problem where the lateral epicondyle becomes

painful and tender. Usually involving the extensor digitorum muscle near its

origin on lateral epicondyle. It is also known as lateral epicondylitis and is

associated with gripping & lifting activities

The ligaments of the elbow joint

Ulnar collateral ligamentRadial collateral ligamentAnnular ligament

Normal ranges:Elbow flexion (zero to 150 degrees)Elbow Extension (150 degrees to zero)Supination (zero to 80 or 90 degrees)Pronation (zero to 80 or 90 degrees)

The ligament injured in hyperextension of the elbow

joint is:The ulnar collateral ligament

Elbow flexion is an example of

Third class lever because the biceps brachii applies force at the insertion of the radial tuberosity, the resistance is the center of gravity and the elbow as the axis.

The Biceps brachialis muscle isThe prime mover for flexion of the Elbow

jointThe biceps brachialis pulls at the insertion

of the radial tuberosity as shown in the previous slide.

Elbow Flexors Muscle Origin Insertion Action Innervation

Biceps Brachii

Scapula – Supraglenoid Tuberosity; Coracoid Process

Radius - Tubercle; Bicipital Aponeurosis

Elbow flexion, forearm supination, shoulder flexion and transverse flexion

Musculotaneous (C5 & C6)

BrachialisAnterior Humerous

Ulna -Coronoid Process

Elbow flexion Musculotaneous (C5 & C6)

Brachioradialis

Humerous – Lateral Condyle

Radius (Lateral Distal) – Styloid Process

Elbow flexion Radial Nerve (C5, C6, C7 & C8)

Biceps Brachii Movement Elbow Flexion [1, 2 ] Forearm Supination [1, 2 ] Shoulder

Flexion (Weak) [2 ] Transverse Flexion (Weak) [2 ]

Attachments Origin

Scapula Supraglenoid Tuberosity [1 ] Coracoid Process [2 ]

Insertion Radius

Tubercle [1, 2 ] Fascia of forearm

Bicipital Aponeurosis [1, 2 ]

BrachialisMovement

Elbow Flexion Attachments

OriginHumerous (Anterior)

InsertionUlna Coronoid Process

BrachioradialisMovement

Elbow Flexion Attachments

OriginHumerous

Lateral Condyle Insertion

Radius (Lateral Distal) Styloid Process

Elbow Extensors, Pronators and Supinators

Muscle Origin Insertion Action Innervation

Triceps Brachii

Scapula – Infraglenoid Tubercle, Humerous (Posterior) – Superior to radial groove; Inferior to radial groove

Ulna (Proximal Posterior) – Olecranon Process

Elbow Extension, Shoulder Extension and Adduction

Radial Nerve (C5, C6, C7 & C8)

Anconeous Humerus (Posterior)- Lateral condyle

Ulna (Posterior, Proximal), Olecranon

Elbow Extension

Radial Nerve (C5, C6, C7 & C8)

Pronator TeresHumerus (Distal) – medial condyloid ridge, Poximal Ulna (medial)

Middle third of Radius (lateral)

Pronation of Forearm, weak elbow flexion

Median Nerve (C6 & C7)

Supinator Lateral epicondyle of humerus, Ulna (posterior)

Proximal radius (lateral) surface below the head

Supination of forearm

Posterior Interosseous Nerve (C5, C6, C7 & C8)

Triceps Brachii Movement

Elbow Extension [1, 2 , 3 ] Shoulder

Extension [1 ] Adduction [1 ]

AttachmentsOrigin

Scapula [1 ] Infraglenoid Turbercle

Humerous (Posterior) Superior to Radial Groove [2 ] Inferior to Radial Groove [3 ]

InsertionUlna (Proximal Posterior) [1, 2 , 3 ]

Olecranon Process

Anconeous Movement

Elbow Extension

Attachments

OriginHumerus (Posterior)

Lateral condyle

Insertion Ulna (Posterior, Proximal)Olecranon

Pronator Teres

Movement Pronation of forearm Weak flexion of elbow

Attachments

OriginHumerus (Distal)

medial condyloid ridgePoximal Ulna (medial)

Insertion Middle third of Radius (lateral)

SupinatorMovements

Supination of the Forearm

AttachmentsOrigin

Lateral epicondyle of humerusUlna (posterior)

InsertionProximal radius (lateral) surface below the head