UPPER LIMBMUSCLES OF ARM, CUBITAL FOSSA,

AND ELBOW JOINT

Dr.Nivin Sharaf MD M.B.BCH

Objectives-Identify the following structures: humerus (medial & lateral epicondyles, lateral condyle (capitulum), medial condyle (trochlea), radius (head, styloid process, tuborosity), ulna (olecranon, coronoid process, styloid process) -Describe the movements of flexion and extension of the elbow joint. -Describe the articulation of the elbow joint with the radius and ulna. -Explain where you would aspirate a joint effusion. -Describe the course of neurovascular structures in the arm (brachial artery and vein, nerves - medial, ulnar and radial), and their relation in the cubital fossa-Name and identify the anatomical region of the cubital fossa (location, boundaries)

SurfaceAnatomy

Surface anatomy

• .

Bony Skeleton

Humerus and Scapula (Ant)

Humerus and Scapula (Post)

Supra scapularFossa

Infra scapularFossa

InferiorAngle

Humeral Head

Humeral NeckAnatomical

Humeral NeckSurgical

Radial groove

Medial epicondyle

Humerus and Scapula (Post)

Supra scapularFossa

Infra scapularFossa

InferiorAngle

Humeral Head

Humeral NeckAnatomical

Humeral NeckSurgical

Radial groove

Medial epicondyle

Elbow joint

http://www.joint-pain-expert.net/images/elbow_joint_anatomy001.jpg

Ligaments of Elbow

ELBOW= hinge jt.Humerus:-medial & lateral epicondyles,-lateral condyle (capitulum), -medial condyle (trochlea)-coronoid fossa -olecranon fossa

Radius:-head, -tuborosity (biceps insertion)

Ulna:-olecranon, -coronoid process- tuborosity (brachialis insertion)

Fibrous capsule of the elbow joint. -Strong collateral ligaments on each side.- Annular ligament encircles radial head

Triceps tendon

Cubital tunnel syndrome

Muscles

Anterior arm

Mainly Flexors BBCBrachialisBicepsCoraco brachialis

Nerve Supply!

Musculo Cutaneous Nerve

Posterior arm

Arm muscles

http://www.highfive.me.uk/Resources/Anatomy/UpperArm/All.JPG

Cubital Fossa

Surface Anatomy

Roof of cubital fossa. -superficial veins: Median Cubital v. Cephalic v. Basilic v.

Cubital fossa.– anterior to the elbow Boundaries:- Epicondyles * (medial & lateral)- Pronator Teres- Brachioradialis

Contents: - Brachial a (radial / ulnar aa)- Biceps tendon & aponeurosis- Median n

Floor of cubital fossa.- Brachialis m- Supinator m- Radial nerve: deep branch (muscular, articular) superficial branch (cutaneous)

Cubital Fossa

Identify the borders of the cubital fossa: Brachioradialis m. laterally, Pronator teres medially and Brachialis which forms the floor of the fossa.

Cubital Fossa

Contents

Lateral to medial, the Bicipital tendon, the Brachial artery, and the Median nerve. The Brachial veins may be removed. You should look for the branching of the Brachial a. into Radial and Ulnar aa. and the Superficial branch of the Radial nerve running underside Brachioradialis muscle

Course of nerves in anterior and posterior arm.

Brachial Plexus

Randy Travis Drinks Cold Tea

Axilallry N and Radial N

Radial Nerve

Axillary nerve

Posterior View

Axillary nerve suppliesDeltoid muscleTeres MinorSkin over deltoid

Radial NerveSupplies all the extensors+Brachio Radialis

Median Nerve

• Supplies all the flexors of the arm except

• Flexor Carpi Radialis (Radial N)

• Flexor Carpi Ulnaris (Ulnar N)

• Medial ½ of FDP

Radial Nerve

Brachial Plexus

Links

• http://www.bing.com/images/search?q=posterior+forarm&form=QBIR&qs=n#focal=703fca7fd9d811d3076749b41e801de4&furl=http%3A%2F%2Fwww.anatomyfacts.com%2FMuscle%2FMuscleBone_files%2Fimage019.gif

• http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/musculoskeletal_system/forearm_questions.html

• www.getbodysmart.com• http://www.becomehealthynow.com/body/muscles/atlas/anconeus.shtml

References

• Google images• Netter Anatomy Atlas• University of Washington website• Bing Images• Yahoo Images• http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/images/wrist_ant.jpg• http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/musculoskeletal_system/forearm_que

stions.html• http://iris3.med.tufts.edu/dentgross/labguide/SupHand2R.jpg• http://www.dasd.k12.pa.us/57592111818543/lib/57592111818543/Muscles_of_the_Posterior_Trunk,_

Shoulder_and_Arm_Numbered.jpg• http://www.yamli.com/#t=image&q=axillary%20nerve&s=120&safe=1&isz=all&sm=ltr

• 1. Deltoid: scapula/clavicle to humerus- abducts arm• 2. Levator scapulae: C-vertebrae to scapula- elevates scapula• 3. Infraspinatus: lower scapular spine to humeral head- lateral rotation of humerus• 4. Teres major: scapula to anterior humerus- medial rotation of humerus'• 5. Teres Minor: scapula to posterior humerus- lateral rotaion of humerus• 6. Supraspinatus: upper scapular spine to humeral head- abducts humerus• 7. Trapeziues: Vertebrae/Occipital to scapula/clavicle- abduct arm, rotate, abduct scapula• 8. Rhomboidius: T-vertebrae to scapula- raise/adduct scapula• 9. Latissimus Dorsi: T-, L-, S- vertebrae to humerus- extend/adduct arm• 10. Biceps: scapula to radius- flex elbow• 11. Triceps: scapula/humerus to ulna- extend elbow• 12. Pronator: Medial humerus to radius- medial rotation of forearm (pronation)• 13. Flexor carpi radialis: medial humerus to 2nd/3rd metacarpal- flex/abduct hand• 14. Flexor Digitorum: medial humerus/ulna to phalanges- flex fingers• 15. Extensor carpi ulnaris: lateral humerus to 5th metacarpal- extend/adduct hand • 16. Extensor digitorum: lateral humerus to phalanges- extend fingers• 17. Extensor carpi radialis: lateral humerus to 2nd/3rd metacarpal- extend/adduct hand