Elbow Joint Anatomy Quiz
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Questions and Answers

What is the main function of the bicipital tuberosity?

  • Stabilization of the radial head
  • Flexion of the elbow
  • Attachment of the biceps tendon (correct)
  • Formation of the cubital fossa

    • What is the structural composition of the proximal radio-ulnar joint?

  • Fibrous joint
  • Pivot synovial joint (correct)
  • Hinge joint
  • Cartilaginous joint

    • Which nerve is primarily involved in the flexion of the elbow by the biceps and brachialis muscles?

  • Median nerve
  • Musculocutaneous nerve (correct)
  • Ulnar nerve
  • Radial nerve

    • What is the anatomical significance of the styloid process of the ulna?

    <p>Pivot point for forearm rotation</p> Signup and view all the answers

    What muscles are responsible for the pronation of the forearm?

    <p>Pronator teres and pronator quadratus</p> Signup and view all the answers

    Which structure forms a fibro-osseous ring in the proximal radio-ulnar joint?

    <p>Anular ligament and ulnar facet</p> Signup and view all the answers

    What happens during radial head subluxation?

    <p>Distal pull on the radius</p> Signup and view all the answers

    Which of the following nerves is injured in median nerve injuries at the elbow, affecting the thenar muscles?

    <p>Median nerve</p> Signup and view all the answers

    Where is the cubital fossa located?

    <p>Anterior and distal to the elbow</p> Signup and view all the answers

    Which veins are considered superficial contents of the cubital fossa?

    <p>Basilic, cephalic, and median cubital veins</p> Signup and view all the answers

    What forms the synovial cavity in the elbow joint?

    <p>Trochlear notch of the ulna and trochlea of the humerus</p> Signup and view all the answers

    Which joint is responsible for the pronation and supination of the forearm?

    <p>Superior radio-ulnar joint</p> Signup and view all the answers

    What is the carrying angle in the forearm?

    <p>Angle less than 165° in supine position</p> Signup and view all the answers

    Which of the following statements is true regarding the proximal ulna?

    <p>It contains both the olecranon and coronoid processes</p> Signup and view all the answers

    Which structure in the elbow joint serves as the anterior recess for the coronoid process?

    <p>Coronoid fossa</p> Signup and view all the answers

    Which landmark on the proximal radius is crucial for articulation with the humerus?

    <p>Head</p> Signup and view all the answers

    What contributes to the smaller carrying angle observed in females compared to males?

    <p>Wider female pelvis</p> Signup and view all the answers

    Which action does the capitulum of the humerus facilitate?

    <p>Flexion of the elbow</p> Signup and view all the answers

    Which aspect of the elbow joint is the interosseous border associated with?

    <p>Articular surface of the proximal ulna</p> Signup and view all the answers

    What happens to the arm and forearm in the pronated position?

    <p>They are in a straight line</p> Signup and view all the answers

    What anatomical feature allows the ulna and radius to shift laterally, creating the carrying angle?

    <p>Trochlear notch</p> Signup and view all the answers

    Which structure acts as the rounded articular surface for the ulna within the elbow joint?

    <p>Trochlea</p> Signup and view all the answers

    The superior radio-ulnar joint allows for which specific movements?

    <p>Pronation and supination</p> Signup and view all the answers

    In the elbow joint, which fossa accommodates the olecranon process during extension?

    <p>Olecranon fossa</p> Signup and view all the answers

    What is the primary role of the brachialis muscle related to the elbow joint?

    <p>Flexion of the forearm</p> Signup and view all the answers

    What occurs to the carrying angle when the forearm is in the supine position?

    <p>It decreases to less than 165°</p> Signup and view all the answers

    Which statement best describes the head of the radius in relation to the capitulum of the humerus?

    <p>It articulates with the capitulum for flexion and extension</p> Signup and view all the answers

    What is represented by the interosseous border of the proximal ulna?

    <p>Articular surface for the radius</p> Signup and view all the answers

    What anatomical feature primarily contributes to preventing injury to the deep branch of the radial nerve?

    <p>Neck of the radius</p> Signup and view all the answers

    Why is the angle in the carrying angle less significant in females compared to males?

    <p>Females possess wider pelvises</p> Signup and view all the answers

    What is the primary role of the anular ligament in the elbow joint?

    <p>Allowing rotation of the radius during pronation and supination</p> Signup and view all the answers

    Which muscles are responsible for extending the elbow joint?

    <p>Triceps and anconeus</p> Signup and view all the answers

    In children, what anatomical feature makes radial head subluxation more likely?

    <p>The cartilaginous nature of the radial head</p> Signup and view all the answers

    Which of the following statements correctly describes the blood supply to the elbow?

    <p>An arterial anastomosis involving multiple arteries supplies the elbow</p> Signup and view all the answers

    What characterizes the cubital fossa?

    <p>It is formed by the junction of the muscles around the elbow</p> Signup and view all the answers

    Which of the following is true regarding median nerve injury at the elbow?

    <p>It impairs functionality of the thenar muscles and affects certain finger flexion</p> Signup and view all the answers

    Which anatomical landmark is considered the apex of an almost isosceles triangle formed in the elbow region?

    <p>Olecranon</p> Signup and view all the answers

    What role do superficial veins in the cubital fossa play in medical procedures?

    <p>Their interconnections allow for IV injections without compromising blood flow</p> Signup and view all the answers

    What happens to the radial nerve in cases of radial head subluxation?

    <p>It becomes compressed by the annular ligament</p> Signup and view all the answers

    Which of the following options describes the movements of the elbow joint?

    <p>Supination is facilitated by both the biceps and supinator muscles</p> Signup and view all the answers

    What is the primary function of the trochlear notch of the ulna?

    <p>To articulate with the trochlea of the humerus</p> Signup and view all the answers

    Which feature of the carrying angle is true?

    <p>It allows the thighs to clear when the forearm is supine</p> Signup and view all the answers

    Which joint at the elbow allows for both flexion and pronation/supination?

    <p>Superior radio-ulnar joint</p> Signup and view all the answers

    What aspect does the olecranon fossa accommodate during elbow extension?

    <p>Olecranon process</p> Signup and view all the answers

    What anatomical landmark on the radius is closely associated with the deep branch of the radial nerve?

    <p>Neck</p> Signup and view all the answers

    What is the role of the coronoid fossa in the elbow?

    <p>To accommodate the coronoid process of the ulna during flexion</p> Signup and view all the answers

    Which is a true statement regarding the radius and ulna in the context of the carrying angle?

    <p>The ulna and radius shift laterally to form the angle</p> Signup and view all the answers

    Which statement correctly describes the role of the triceps muscle at the elbow joint?

    <p>It inserts at the olecranon process</p> Signup and view all the answers

    What happens to the carrying angle when the forearm is pronated?

    <p>It decreases significantly</p> Signup and view all the answers

    What role does the bicipital tuberosity play in the anatomy of the elbow?

    <p>Attachment site for biceps tendon</p> Signup and view all the answers

    Which ligaments and structures form the fibro-osseous ring around the radial head?

    <p>Anular ligament and radial notch</p> Signup and view all the answers

    Which muscles are responsible for supination of the forearm?

    <p>Biceps and supinator</p> Signup and view all the answers

    What is likely to occur when the head of the radius is pulled distally?

    <p>Radial head subluxation</p> Signup and view all the answers

    What clinical assessment technique can be used to test biceps reflexes?

    <p>Tap tendon in the cubital fossa</p> Signup and view all the answers

    Which statement accurately describes the function of the median nerve at the elbow?

    <p>Impairs thenar muscle function</p> Signup and view all the answers

    What anatomical feature is located at the apex of the triangular arrangement of structures in the elbow?

    <p>Olecranon</p> Signup and view all the answers

    Which arteries contribute to the blood supply of the elbow through anastomosis?

    <p>Recurrent branches of radial and ulnar arteries</p> Signup and view all the answers

    What is characteristic of the superficial veins in the cubital fossa?

    <p>They form significant interconnections.</p> Signup and view all the answers

    Which muscle plays a primary role in elbow flexion alongside the biceps?

    <p>Brachialis</p> Signup and view all the answers

    Which structures are involved in the extension of the elbow joint?

    <p>Triceps and anconeus</p> Signup and view all the answers

    What is the role of the anular ligament in relation to the elbow joint?

    <p>It enables the rotation of the radius during forearm movements.</p> Signup and view all the answers

    Which condition is characterized by the head of the radius being pulled distally?

    <p>Radial head subluxation</p> Signup and view all the answers

    Which of the following nerves is responsible for testing reflexes in the biceps?

    <p>Musculocutaneous nerve</p> Signup and view all the answers

    Which muscle primarily prevents lateral shift during the carrying angle of the forearm?

    <p>Triceps</p> Signup and view all the answers

    What is the main consequence of a median nerve injury at the elbow?

    <p>Loss of function in the thenar muscles</p> Signup and view all the answers

    What supplies blood to the elbow joint?

    <p>Radial and ulnar arteries</p> Signup and view all the answers

    In the cubital fossa, which structure is found at the floor?

    <p>Brachialis muscle</p> Signup and view all the answers

    What anatomical feature of the ulna can be palpated at the elbow?

    <p>Olecranon</p> Signup and view all the answers

    What is a characteristic of the cubital fossa's roof?

    <p>Composed of skin and bicipital aponeurosis</p> Signup and view all the answers

    Which structure serves as the primary articulating surface for the radius in the elbow joint?

    <p>Capitulum</p> Signup and view all the answers

    What anatomical feature is primarily responsible for the articulation of the ulna with the humerus?

    <p>Trochlear notch</p> Signup and view all the answers

    During elbow extension, which fossa accommodates the olecranon process?

    <p>Olecranon fossa</p> Signup and view all the answers

    Which part of the radius is primarily associated with the deep branch of the radial nerve?

    <p>Neck</p> Signup and view all the answers

    What type of joint connects the head of the radius with the capitulum of the humerus?

    <p>Hinge joint</p> Signup and view all the answers

    Which aspect of the elbow joint allows the forearm to be moved into a straight line during pronation?

    <p>Superior radio-ulnar joint</p> Signup and view all the answers

    What is the approximate carrying angle in a supine position?

    <p>165°</p> Signup and view all the answers

    Which structure is primarily at risk during a fracture or dislocation at the neck of the radius?

    <p>Deep branch of the radial nerve</p> Signup and view all the answers

    What is the carrying angle primarily created by?

    <p>Angled displacement of the radius and ulna</p> Signup and view all the answers

    What function does the coronoid fossa serve in relation to the elbow joint?

    <p>Fitting point for the coronoid process</p> Signup and view all the answers

    Which joint in the elbow is primarily responsible for flexion and extension?

    <p>Trochlear joint</p> Signup and view all the answers

    What anatomical structure allows the forearm to be supinated?

    <p>Radial notch of the ulna</p> Signup and view all the answers

    Which of the following describes the carrying angle in relation to the humerus?

    <p>The angle enhances forearm clearance in a supine position.</p> Signup and view all the answers

    Which part of the ulna contributes to the hinge-like function of the elbow joint?

    <p>Trochlear notch</p> Signup and view all the answers

    What anatomical structure articulates with the capitulum of the humerus?

    <p>Head of the radius</p> Signup and view all the answers

    Which fossa accommodates the olecranon process during elbow extension?

    <p>Olecranon fossa</p> Signup and view all the answers

    What is the significance of the interosseous border in the anatomy of the forearm?

    <p>It separates the radius from the ulna.</p> Signup and view all the answers

    In which position is the carrying angle normally less than 165°?

    <p>When the elbow is flexed</p> Signup and view all the answers

    What is true about the head of the ulna in relation to other structures?

    <p>It articulates with the articular disc of the radio-ulnar joint.</p> Signup and view all the answers

    Which anatomical feature primarily protects the deep branch of the radial nerve?

    <p>Neck of the radius</p> Signup and view all the answers

    What is the primary structure that attaches the head of the radius to the ulna in the proximal radio-ulnar joint?

    <p>Anular ligament</p> Signup and view all the answers

    What is the role of the bicipital aponeurosis in the cubital fossa?

    <p>It acts as a protective layer for underlying structures.</p> Signup and view all the answers

    Which muscles are primarily responsible for supination of the forearm?

    <p>Biceps and supinator</p> Signup and view all the answers

    What complication is often associated with median nerve injuries at the elbow?

    <p>Inability to flex distal interphalangeal joints of the 2nd-3rd fingers</p> Signup and view all the answers

    Where is the radial head in relation to the lateral epicondyle during examination?

    <p>2cm distal</p> Signup and view all the answers

    What structure serves as the primary blood supply to the elbow joint?

    <p>Arterial anastomosis</p> Signup and view all the answers

    In the cubital fossa, which nerves are found within the superficial fascia?

    <p>Medial and lateral cutaneous nerves of the forearm</p> Signup and view all the answers

    What type of joint is the proximal radio-ulnar joint classified as?

    <p>Pivot synovial joint</p> Signup and view all the answers

    Which statement best describes the effect of radial head subluxation in children?

    <p>It is more common due to the cartilaginous head of the radius.</p> Signup and view all the answers

    Which anatomical feature is the apex of the triangle formed by the olecranon, medial, and lateral epicondyles?

    <p>Olecranon</p> Signup and view all the answers

    Study Notes

    Elbow Joint

    • The elbow joint comprises 3 joints but has 1 synovial cavity.
    • The elbow joint's synovial hinge joints are modified for flexion and extension.
    • The trochlear notch of the ulna articulates with the trochlea of the humerus.
    • The head of the radius articulates with the capitulum of the humerus.
    • The superior radio-ulnar (pivot) joint allows pronation and supination.
    • The joint between the head of the radius and radial notch of the ulna allows pronation and supination.

    Elbow Joint Landmarks

    • The trochlea (pulley) is a rounded articular surface for the ulna.
    • The capitulum is a rounded articular surface for the radius.
    • The coronoid fossa (anterior) accommodates the coronoid process of the ulna.
    • The olecranon fossa (posterior) accommodates the olecranon process of the ulna.

    Radius and Ulna

    • The head of the radius is proximal and articulates with the capitulum and radial notch.
    • The head of the ulna is distal and articulates with the articular disc of the radio-ulnar joint.
    • The proximal part of the ulna contains the olecranon process, where the triceps inserts.
    • The proximal part of the ulna also contains the coronoid process, where the brachialis inserts.
    • The articular surface of the proximal ulna articulates with the radius.
    • The interosseous border between the ulna and radius is observable.
    • The carrying angle is created by the ulna and radius shifting laterally:
      • It's the angle between the shaft of the humerus and the middle of the forearm.
      • If aligned, the angle would be 180°.
      • In the supine position, the carrying angle is less than 165°.
      • It's smaller in females than males due to wider female pelvises.
      • The carrying angle helps clear the thighs when the forearm is supine.
      • Pronation aligns the arm and forearm in a straight line.

    Proximal Radius

    • The head of the radius articulates with the capitulum of the humerus (flexion/extension) and the ulna (pronation/supination).
    • The neck contains a deep branch of the radial nerve, vulnerable to fracture/dislocation.
    • The bicipital tuberosity serves as an attachment site for the biceps tendon.

    Proximal Radio-Ulnar Joint

    • This is a pivot synovial joint.
    • The anular ligament attaches to the upper and lower margins of the ulnar facet.
    • During pronation and supination, the head of the radius rotates within the anular ligament.
    • A fibro-osseous ring is formed by the anular ligament and radial notch.
    • The radius and ulna are united distally by the triangular articular disc.
    • The styloid process of the ulna acts as a pivot point.

    Elbow Palpation

    • The olecranon, medial and lateral epicondyles are palpable.
    • These form an almost isosceles triangle, with the olecranon at the apex.
    • Disruption of this arrangement indicates elbow dislocation.
    • The head of the radius is palpable 2 cm distal to the lateral epicondyle and rotates during pronation and supination.

    Elbow Muscles

    • Flexion: brachialis and biceps (MCN, C5-C6); brachioradialis (radial nerve, C5-C6)
    • Extension: triceps and anconeus (radial nerve, C7-C8)
    • Pronation: pronator teres and quadratus (median nerve, C6)
    • Supination: biceps and supinator (MCN, radial nerve, C5-C6)

    Elbow Reflexes

    • Biceps: tap tendon in cubital fossa (C5, C6)
    • Triceps: tap tendon just above olecranon (C7, C8)
    • Supinator: tap tendon of brachioradialis (old name = supinator longus)

    Radial Head Subluxation

    • This occurs when the head of the radius is pulled distally with/without damage to the annular ligament.
    • It is more common in children because the head is still cartilaginous.
    • The annular ligament is not a tight fit, and the deep branch of the radial nerve is vulnerable here.

    Median Nerve Injury at the Elbow

    • Impairs thenar muscle function.
    • The proximal interphalangeal joints of the 1st-3rd fingers cannot be flexed.
    • The proximal interphalangeal joints of the 4th and 5th fingers are weak.
    • The distal interphalangeal joints of the 2nd-3rd fingers cannot be flexed.
    • The distal interphalangeal joints of the 4th and 5th fingers are spared because they are innervated by the ulnar nerve.
    • The metacarpophalangeal joints of the 2nd-3rd fingers cannot be flexed (1st-2nd lumbricals).

    Elbow Blood Supply

    • The elbow's blood supply is via an arterial anastomosis.
    • The elbow is supplied by the recurrent branches of the radial and ulnar (anterior, posterior) arteries.
    • The superior and inferior ulnar collateral arteries also contribute to the anastomosis.
    • The radial and middle collateral arteries branch off the deep brachial artery and also supply the elbow.

    Cubital Fossa

    • It's a triangular area anteriorly distal to the elbow.
    • Its proximal boundary is an imaginary line between both epicondyles.
    • Its distal boundary is pronator teres (medial) and brachioradialis (lateral).
    • Brachialis forms the floor.
    • The roof of the cubital fossa is made up of skin, superficial and deep fascia, and the bicipital aponeurosis.
    • The superficial fascia contains the lateral and medial cutaneous nerves of the forearm, as well as the cephalic, basilic, and median cubital veins.
    • The floor contains brachialis medially and supinator laterally.
    • The veins of the roof comprise the superficial contents.
    • The aponeurotic layer contains the bicipital aponeurosis and biceps tendon.
    • Just inferior to it lie the brachial artery and median nerve.

    Superficial Veins

    • They form many interconnections.
    • This allows for removal without affecting blood flow back to the heart.
    • They are used for IV injections in clinical settings.
    • They are also abused by drug users.

    Elbow Joint

    • The elbow joint is made up of three joints with a single synovial cavity
    • It includes the synovial hinge joint of the ulna with the trochlea of the humerus, the head of the radius with the capitulum of the humerus, and the superior radio-ulnar joint which allows for pronation and supination
    • The head of the radius articulates with the capitulum and radial notch
    • The head of the ulna articulates with the articular disc of the radio-ulnar joint
    • The carrying angle is created by the ulna and radius shifting laterally, forming an angle between the shaft of the humerus and the middle of the forearm
    • The carrying angle is smaller in females than in males
    • The carrying angle allows the thighs to be cleared when the forearm is supine
    • The proximal radius articulates with the capitulum of the humerus (flexion/extension) and the ulna (pronation/supination)
    • The proximal radio-ulnar joint is a pivot synovial joint where the radius rotates within the anular ligament during pronation and supination
    • The olecranon, medial and lateral epicondyles are all palpable
    • The head of the radius is palpable 2 cm distal to the lateral epicondyle
    • Flexion of the elbow joint is done by brachialis and biceps
    • Extension is done by triceps and anconeus
    • Pronation is done by pronator teres and quadratus
    • Supination is done by biceps and supinator
    • Reflexes can be tested by tapping the tendons of the biceps, triceps, and brachioradialis
    • Radial head subluxation occurs when the head of the radius is pulled distally with or without damage to the anular ligament
    • The elbow is supplied by the recurrent branches of the radial and ulnar (anterior, posterior) arteries, the superior and inferior ulnar collateral arteries, and the radial and middle collateral arteries
    • Median nerve injury at the elbow affects the function of the thenar muscle, proximal interphalangeal joints of the 1st-3rd fingers, distal interphalangeal joints of the 2nd-3rd fingers

    Cubital Fossa

    • The cubital fossa is a roughly triangular area located at the anterior distal portion of the elbow
    • The cubital fossa is bounded proximally by an imaginary line between both epicondyles, distally by pronator teres and brachioradialis, and floored by brachialis
    • The roof of the cubital fossa is comprised of skin, the superficial and deep fascia, and the bicipital aponeurosis
    • The superficial fascia contains the lateral and medial cutaneous nerves and the cephalic, basilic, and median cubital veins
    • The floor contains the brachialis medially and supinator laterally
    • The superficial contents include the veins within the roof
    • The aponeurotic layer contains the bicipital aponeurosis and biceps tendon with the brachial artery and median nerve running immediately inferior
    • Superficial veins can be removed without compromising blood flow back to the heart
    • Superficial veins are often used for IV injections and can be abused by drug users

    Elbow Joint

    • The elbow contains three joints with one synovial cavity
    • Synovial hinge joints allow for flexion and extension
    • Trochlear notch of the ulna articulates with the trochlea of the humerus
    • Head of the radius articulates with the capitulum of the humerus
    • Superior radio-ulnar (pivot) joint facilitates pronation and supination
    • Joint between the head of the radius and radial notch of the ulna allows for pronation and supination

    Elbow Joint Landmarks

    • Trochlea - rounded articular surface for the ulna
    • Capitulum - rounded articular surface for the radius
    • Coronoid fossa (anterior) - accommodates the coronoid process of the ulna
    • Olecranon fossa (posterior) - accommodates the olecranon process of the ulna

    Radius and Ulna

    • Head of the radius - proximal, articulates with capitulum and radial notch
    • Head of the ulna - distal, articulates with the articular disc of the radio-ulnar joint
    • Olecranon process - proximal part of the ulna, triceps inserts here
    • Coronoid process - proximal part of the ulna, brachialis inserts here to the tuberosity
    • Carrying angle - created by the ulna and radius shifted laterally, angle between the shaft of the humerus and the middle of the forearm.
    • Carrying angle - ensures clearance of the thighs when the forearm is supine.

    Radius

    • Head - articulates with capitulum of the humerus (flexion/extension) and ulna (pronation/supination).
    • Neck - vulnerable to fracture/dislocation due to the deep branch of the radial nerve.
    • Bicipital tuberosity - site for attachment of the tendon of biceps to posterior surface (insertion).

    Proximal Radio-Ulnar Joint

    • Pivot synovial joint.
    • Anular ligament - attaches to the upper and lower margins of the ulnar facet.
    • Head of the radius - rotates within the anular ligament during pronation and supination.
    • Fibro-osseous ring - formed by the anular ligament and radial notch.
    • Triangular articular disc - unites radius and ulna distally, anchored just in front of the process.
    • Styloid process of the ulna - serves as a pivot point.

    Palpable Landmarks

    • Olecranon, medial, and lateral epicondyles - form an isosceles triangle with the olecranon at the apex.
    • Head of the radius - palpable 2cm distal to the lateral epicondyle, can be felt rotating during pronation and supination.

    Elbow Joint Movements

    • Flexion - brachialis and biceps (MCN, C5-C6) and brachioradialis (radial nerve, C5-C6)
    • Extension - triceps and anconeus (radial nerve, C7-C8)
    • Pronation - pronator teres and quadratus (median nerve, C6)
    • Supination - biceps and supinator (MCN, radial nerve, C5-C6)

    Elbow Joint Reflexes

    • Biceps - tap tendon in cubital fossa (C5, C6)
    • Triceps - tap tendon just above olecranon (C7, C8)
    • Supinator - tap tendon of brachioradialis (old name = supinator longus)

    Radial Head Subluxation

    • Head of the radius is pulled distally with/without damage to the annular ligament.
    • More common in children due to cartilaginous head and less tight annular ligament.
    • Deep branch of the radial nerve is vulnerable.

    Median Nerve Injury

    • Impairs thenar muscle function.
    • Proximal interphalangeal joints of 1st-3rd fingers unable to flex.
    • Distal interphalangeal joints of 2nd-3rd fingers unable to flex.
    • 4th and 5th finger DIPs are spared as they are innervated by the ulnar nerve.
    • Metacarpophalangeal joints of 2nd-3rd fingers unable to flex (1st-2nd lumbricals).

    Elbow Blood Supply

    • Arterial anastomosis
    • Recurrent branches of the radial and ulnar (anterior, posterior) arteries.
    • Superior and inferior ulnar collateral arteries.
    • Radial and middle collateral arteries branch off the deep brachial artery.

    Cubital Fossa

    • Triangular area anteriorly distal to the elbow.
    • Proximal boundary - imaginary line between both epicondyles.
    • Distal boundary - pronator teres (medial) and brachioradialis (lateral).
    • Floor - brachialis.
    • Roof - skin, superficial and deep fascia, and the bicipital aponeurosis.
    • Superficial fascia - lateral and medial cutaneous nerves of the forearm, cephalic, basilic, and median cubital veins.
    • Floor - brachialis medially and supinator laterally.

    Cubital Fossa Contents

    • Superficial contents: veins of the roof.
    • Aponeurotic layer: bicipital aponeurosis and biceps tendon.
    • Just inferior to the aponeurotic layer: brachial artery and median nerve.

    Superficial Veins of the Cubital Fossa

    • Interconnected, allowing for removal without loss of blood flow to the heart.
    • Used for IV injections.
    • Abusable by drug users.

    Elbow Joint

    • The elbow houses three joints within a single synovial cavity.
    • The hinge joint is specifically designed for flexion and extension, formed by the ulna's trochlear notch articulating with the humerus' trochlea.
    • The head of the radius and the humerus' capitulum are also involved in this articulation.
    • Pronation and supination occur at the superior radio-ulnar joint (pivot joint).
    • The radius' head articulates with the ulna's radial notch for pronation and supination.
    • Key landmarks on the lower humerus include the trochlea (pulley) for ulna articulation, the capitulum for radius articulation, the coronoid fossa (anterior) for the ulna's coronoid process, and the olecranon fossa (posterior) for the ulna's olecranon process.

    Proximal Ulna

    • The proximal ulna features the olecranon process, the insertion point for the triceps muscle.
    • The coronoid process is also present, serving as the brachialis muscle's insertion point to the tuberosity.
    • The proximal ulna's articular surface interfaces with the radius.
    • The interosseous border can be observed between it and the radius.

    Proximal Radius

    • The proximal radius has distinctive landmarks.
    • The head articulates with the humerus' capitulum for flexion and extension, and with the ulna for pronation and supination.
    • The neck houses a deep branch of the radial nerve, vulnerable to injury from fracture or dislocation.
    • The bicipital tuberosity serves as the biceps tendon's insertion point on the posterior surface.

    Proximal Radio-ulnar Joint

    • The proximal radio-ulnar joint is a pivot synovial joint.
    • The anular ligament attaches to the ulnar facet's upper and lower margins.
    • During pronation and supination, the radius' head rotates within the anular ligament.
    • The anular ligament and radial notch form a fibro-osseous ring.
    • Distally, the triangular articular disc unites the radius and ulna (anchored anterior to the process).
    • The ulna's styloid process acts as a pivotal point.

    Palpation Landmarks

    • The olecranon, medial, and lateral epicondyles are all palpable, forming an almost isosceles triangle with the olecranon at the apex.
    • Disruption of this arrangement indicates an elbow dislocation.
    • Located 2 cm distal to the lateral epicondyle, the head of the radius can be palpated and observed rotating during pronation and supination.

    Muscle Actions

    • Flexion is achieved by the brachialis and biceps (MCN, C5-C6) as well as the brachioradialis (radial nerve, C5-C6).
    • Extension is performed by the triceps and anconeus (radial nerve, C7-C8).
    • Pronation is facilitated by the pronator teres and quadratus (median nerve, C6).
    • Supination involves biceps and supinator (MCN, radial nerve, C5-C6).

    Reflex Testing

    • Biceps reflex: tapping the tendon in the cubital fossa (C5, C6).
    • Triceps reflex: tapping the tendon just above the olecranon (C7, C8).
    • Supinator reflex: tapping the brachioradialis tendon (old name: supinator longus).

    Radial Head Subluxation

    • This occurs when the radius' head is pulled distally, potentially damaging the annular ligament.
    • More common in children due to the cartilaginous nature of the head.
    • The annular ligament is not a tight fit, making the deep branch of the radial nerve vulnerable.

    Median Nerve Injury at the Elbow

    • Impairs thenar muscle function.
    • The proximal interphalangeal joints of fingers 1-3 cannot flex.
    • The proximal interphalangeal joints of fingers 4 and 5 exhibit weakness.
    • The distal interphalangeal joints of fingers 2 and 3 cannot flex.
    • The distal interphalangeal joints of fingers 4 and 5 are spared, as they are innervated by the ulnar nerve.
    • The metacarpophalangeal joints of fingers 2 and 3 cannot flex (1st-2nd lumbricals).

    Elbow Blood Supply

    • An arterial anastomosis provides blood supply to the elbow.
    • The elbow receives supply from the recurrent branches of the radial and ulnar (anterior, posterior) arteries.
    • The anastomosis also includes the superior and inferior ulnar collateral arteries.
    • The radial and middle collateral arteries branch off the deep brachial artery, also supplying the elbow.

    Cubital Fossa

    • A triangular area anteriorly distal to the elbow.
    • Proximally: imaginary line between both epicondyles.
    • Distally: pronator teres (medial) and brachioradialis (lateral).
    • Floor: brachialis.
    • Roof: skin, superficial and deep fascia, and bicipital aponeurosis.
    • Superficial fascia contains lateral and medial cutaneous nerves of the forearm, cephalic, basilic, and median cubital veins.
    • Floor consists of brachialis medially and supinator laterally.

    Cubital Fossa Contents

    • Superficial contents are the veins of the roof.
    • The aponeurotic layer contains the bicipital aponeurosis and biceps tendon.
    • Just inferior to it lies the brachial artery and median nerve.

    Superficial Veins

    • Superficial veins form numerous interconnections.
    • Removal is possible without compromising blood flow back to the heart.
    • Used for IV injections in clinical settings.
    • Abused by drug users.

    Elbow Joint

    • Contains 3 joints, 1 synovial cavity
    • The synovial hinge joints are modified for flexion and extension.
    • Trochlear notch of the ulna articulates with the trochlea of the humerus
    • Head of the radius articulates with the capitulum of the humerus
    • Superior radio-ulnar (pivot) joint is for pronation and supination
    • Joint between head of the radius and radial notch of the ulna is for pronation and supination

    Elbow Joint Landmarks

    • Trochlea (pulley) is a rounded articular surface for the ulna
    • Capitulum is a rounded articular surface for the radius
    • Coronoid fossa (anterior) is for the coronoid process of the ulna
    • Olecranon fossa (posterior) is for the olecranon process of the ulna

    Proximal Ulna

    • Proximal part of the ulna contains the olecranon process.
    • Triceps inserts here.
    • It also contains the coronoid process.
    • Brachialis inserts here to the tuberosity.
    • The articular surface of the proximal ulna is for the radius.
    • The interosseous border between it and the radius can be observed.

    Carrying Angle

    • Created by the ulna and radius which are shifted laterally
    • An angle between the shaft of the humerus and the middle of the forearm
    • If they were aligned, the angle would be 180°
    • Angle in the supine position is less than c. 165°
    • Smaller in females than in males.
    • Allows the thighs to be cleared when the forearm is supine
    • In pronation, the arm and forearm are in a straight line

    Proximal Radius

    • Head articulates with the capitulum of the humerus (flexion/extension) and the ulna (pronation/supination).
    • Neck contains a deep branch of the radial nerve which is vulnerable from fracture/dislocation here.
    • Bicipital tuberosity serves as a site for attachment of the tendon of biceps to posterior surface (insertion).

    Proximal Radio-ulnar Joint

    • A pivot synovial joint.
    • Anular ligament attaches to the upper and lower margins of the ulnar facet.
    • Head of the radius rotates within the anular ligament during pronation and supination
    • A fibro-osseous ring is formed by the anular ligament and radial notch.
    • Radius and ulna are united distally by the triangular articular disc (anchored just in front of the process).
    • Styloid process of the ulna serves as a pivot point.

    Palpable Elbow Landmarks

    • Olecranon, medial and lateral epicondyles are all palpable.
    • Form an almost isosceles triangle, with the olecranon at the apex.
    • Arrangement is disrupted in elbow dislocation.
    • Head of the radius is palpable 2cm distal to the lateral epicondyle.
    • Can be felt rotating during pronation and supination.

    Elbow Movement

    • Flexion: done by brachialis and biceps (MCN, C5-C6) as well as brachioradialis (radial nerve, C5-C6).
    • Extension is done by triceps and anconeus (radial nerve, C7-C8).
    • Pronation is done by pronator teres and quadratus (median nerve, C6).
    • Supination is done by biceps and supinator (MCN, radial nerve, C5-C6).

    Elbow Reflexes Testing

    • Biceps: tap tendon in cubital fossa (C5, C6).
    • Triceps: tap tendon just above olecranon (C7, C8).
    • Supinator: tap tendon of brachioradialis (old name = supinator longus).

    Radial Head Subluxation

    • Occurs when the head of the radius is pulled distally with/without damage to the annular ligament.
    • More common in kids, as the head is still cartilaginous.
    • Annular ligament is not a tight fit, and the deep branch of the radial nerve is vulnerable here.

    Median Nerve Injury at the Elbow

    • Impairs thenar muscle function.
    • Proximal interphalangeal joints of the 1st-3rd fingers are unable to be flexed.
    • Those of the 4th and 5th fingers are weak.
    • Distal interphalangeal joints of the 2nd-3rd fingers are unable to be flexed.
    • Those of the 4th and 5th are spared as they are innervated by the ulnar nerve.
    • The metacarpophalangeal joints of the 2nd-3rd fingers are unable to be flexed (1st-2nd lumbricals).

    Elbow Blood Supply

    • Elbow’s blood supply is via an arterial anastomosis.
    • Supplied by the recurrent branches of the radial and ulnar (anterior, posterior) arteries.
    • The superior and inferior ulnar collateral arteries also from part of the anastomosis.
    • The radial and middle collateral arteries branch off the deep brachial artery and also supply the elbow.

    Cubital Fossa

    • Triangular area anteriorly distal to the elbow.
    • Proximal: imaginary line between both epicondyles.
    • Distal: pronator teres (medial) and brachioradialis (lateral).
    • Floor: Brachialis.
    • Roof: Made up of skin, superficial and deep fascia and the bicipital aponeurosis.
    • Superficial fascia: contains the lateral and medial cutaneous nerves of the forearm.
    • Superficial fascia: also contains the cephalic, basilic and median cubital veins.
    • Floor: contains the brachialis medially and supinator laterally.

    Cubital Fossa Contents

    • Veins in the roof: make up the superficial contents.
    • Aponeurotic layer: contains the bicipital aponeurosis and biceps tendon.
    • Inferior to the aponeurotic layer: lie the brachial artery and median nerve.

    Superficial Cubital Veins

    • Form many interconnections.
    • Can be removed without worrying about loss of blood flow back to the heart.
    • Used for IV injections in clinical settings.
    • Abused by drug users.

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    Description

    Test your knowledge on the anatomy of the elbow joint, including its structure and important landmarks. The quiz covers the synovial cavities, articulations, and specific features of the radius and ulna. Explore how these components function together for flexion, extension, pronation, and supination.

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