MUSCLES OF THE ELBOW REGION Dr Bronwen Ackermann COMMONWEALTH OF AUSTRALIA Copyright Regulation WARNING This material has been reproduced and communicated to you by or on behalf of the University of Sydney pursuant to PartVB of the Copyright Act 1968 (the Act) The material in this communication may be subject to copyright under the Act. Any further reproduction or communication of this material by you may be the subject of copyright protection under the Act. Do not remove this notice All figures are from the Palastanga textbook unless otherwise noted University of Sydney 1
ELBOW SURFACE ANATOMY & MOVEMENT REVIEW ELBOW SURFACE ANATOMY University of Sydney 2
Biceps Deltoid (post) Lateral head of triceps Long head of triceps Biceps brachii Anterior deltoid Biceps tendon University of Sydney 3
POSTERIOR FOREARM FOREARM SURFACE ANATOMY (POST) Lateral head of triceps Extensor carpi radialis longus Extensor carpi radialis brevis Abductor pollicis longus Anconeus Extensor carpi ulnaris Extensor digitorum University of Sydney 4
FOREARM SURFACE ANATOMY (ANT) Flexor carpi radialis Pronator teres Palmaris longus Flexor digitorum superficialis Flexor carpi ulnaris ANTERIOR FOREARM University of Sydney 5
3/20/11 CUBITAL FOSSA - BOUNDARIES Triangular hollow located on the anterior elbow Medial boundary: flexor/pronator muscle group (pronator teres) Lateral boundary: extensorsupinator muscle group (brachioradialis) Superior boundary: imaginary line from lateral epicondyle to medial epicondyle CUBITAL FOSSA - CONTENTS Biceps tendon Brachial artery Median nerve Superficial layer (roof): Skin fascia median cubital vein lateral and medial cutaneous nerve of forearm bicipital aponeurosis Deep Gray s anatomy Copyright 2011 Dr Bronwen Ackermann University of Sydney boundary(floor): Brachialis supinator 6
ELBOW FLEXORS AND EXTENSORS Elbow flexors Biceps Brachialis Brachioradialis Elbow extensors Triceps brachii Anconeus BICEPS BRACHII Actions & functions: supinator, elbow flexor (in supination), shoulder flexion Surface anatomy tendon at cubital fossa (supination and flexion at 90 degrees) Origin: Long head: suprageloid tubercle and adjacent glenoid labrum Short head: corocoid process Insertion: Radial tuberosity Nerve supply: Musculocutaneous (C5/6) http://www.davedraper.com Grays anatomy University of Sydney 7
BRACHIALIS Actions & functions: Elbow flexion Surface anatomy Either side biceps tendon Origin: Distal 2/3 shaft of humerus Insertion: Coronid process and tuberosity of ulna Nerve supply: Musculocutaneous nerve (C5/6) Figure 2.26 from Palastanga BRACHIORADIALIS " Actions & functions: Elbow flexion neutral forearm, elbow joint stabiliser (shunt) " Surface anatomy lateral supracondylar ridge " Origin: Upper 2/3 supracondylar ridge " Insertion: Distal lateral radius near styloid process " Nerve supply: radial nerve (C5/6) Picture modified from Gray s anatomy University of Sydney 8
GRAYS ANATOMY ANT VIEW brachialis Pronator teres brachioradialis Common flexor origin Common extensor origin TRICEPS BRACHII Action & function: extends elbow, long head can adduct arm and extend shoulder from a flexed position Surface anatomy Back of upper arm Origin: Long head: infraglenoid tubercle and adjacent labrum Lateral head: post humerus above and lateral to spiral groove Medial head: post humerus below and medial to spiral groove Insertion: Olecranon of ulna Nerve supply: Radial nerve (C6/7/8) University of Sydney 9
ANCONEUS Action & function: Elbow extension, stabilise ulna during rotary movements Origin: Posterior lateral epicondyle Insertion: Lateral surface olecranon and proximal ¼ of lateral ulna Nerve supply: Radial nerve (C7/8) Lateral head of triceps Grays anatomy- post view Medial head of triceps Anconeus University of Sydney 10
Biceps attachment Brachialis attachment Supinator attachment RADIUS AND ULNA ANTERIOR VIEW Grays anatomy Triceps attachment Olecranon bursa Anconeus attachment Supinator attachment RADIUS AND ULNA POSTERIOR VIEW Grays anatomy University of Sydney 11
FOREARM PRONATORS AND SUPINATORS Pronators Pronator teres Pronator quadratus Supinators Biceps Supinator PRONATOR TERES Actions & functions: Forearm pronation Origin: Medial supracondylar ridge and medial epicondyle and pronator ridge on ulna Insertion: Middle of lateral surface of radius Nerve supply: Median nerve (C6/7) University of Sydney 12
PRONATOR QUADRATUS Actions & functions: Initiates pronation, stabilises DRUJ Origin: Lower quarter anterior surface of ulna Insertion: Lower quarter anterior radius Nerve supply: Anterior interosseous branch median nerve (C8/T1) SUPINATOR Actions & functions: Supinates forearm (ext) Origin: Lat epicondyle, RCL ligament, supinator crest and fossa of ulna Insertion: Post, lat ant aspects of radius Nerve supply: posterior interosseous nerve of radial nerve (C5/6) University of Sydney 13
SUMMARY ACTION ELBOW FLEXION MUSCLES ELBOW EXTENSION FOREARM SUPINATION FOREARM PRONATION University of Sydney 14