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20-September-2008 10:21:22 - Elbow For the band, see Elbow band. For other uses, see Elbow disambiguation. June 2008 Elbow-joint Elbow Left elbow-joint, showing anterior and ulnar collateral ligaments. Latin articulatio cubiti Gray's subject #84 321 MeSH Elbow+joint Dorlands/Elsevier a_64/12161185 The elbow-joint is a ginglymus or hinge joint. Three bones form the elbow joint: the humerus of the upper arm, and the paired radius and ulna of the forearm.1 The elbow is the region surrounding the elbow-joint.2 The bony prominence at the very tip of the elbow is the olecranon process of the ulna, and the inner aspect of the elbow is called the antecubital fossa. Contents 1 Movements 2 Muscles, arteries, and nerves 3 Portions of joint 4 Ligaments 5 Synovial membrane 6 Terminology: Elbow , Ell 7 Carrying angle 8 Elbow arthritis 9 Additional images 10 References Movements Two main movements are possible at the elbow: The hinge-like bending and straightening of the elbow flexion and extension happens at the articulation joint between the humerus and the ulna. The complex action of turning the forearm over pronation or supination happens at the articulation between the radius and the ulna this movement also occurs at the wrist joint. In the anatomical position with the forearm supine, the radius and ulna lie parallel to each other. During pronation, the ulna remains fixed, and the radius rolls around it at both the wrist and the elbow joints. In the prone position, the radius and ulna appear crossed. Most of the force through the elbow joint is transferred between the humerus and the ulna. Very little force is transmitted between the humerus and the radius. By contrast, at the wrist joint, most of the force is transferred between the radius and the carpus, with the ulna taking very little part in the wrist joint. Muscles, arteries, and nerves The muscles in relation with the joint are: in front, the Brachialis behind, the Triceps brachii and Anconæus laterally, the Supinator, and the common tendon of origin of the Extensor muscles medially, the common tendon of origin of the Flexor muscles, and the Flexor carpi ulnaris The arteries supplying the joint are derived from the anastomosis between the profunda and the superior and inferior ulnar collateral branches of the brachial, with the anterior, posterior, and interosseous recurrent branches of the ulnar, and the recurrent branch of the radial. These vessels form a complete anastomotic network around the joint. The nerves of the joint are a twig from the ulnar, as it passes between the medial condyle and the olecranon; a filament from the musculocutaneous, and two from the median. Portions of joint The elbow-joint comprises three different portions. All these articular surfaces are enveloped by a common synovial membrane, and the movements of the whole joint should be studied together. Joint From To Description humeroulnar joint trochlear notch of the ulna trochlea of humerus Is a simple hinge-joint, and allows of movements of flexion and extension only. humeroradial joint head of the radius capitulum of the humerus Is an arthrodial joint. proximal radioulnar joint head of the radius radial notch of the ulna In any position of flexion or extension, the radius, carrying the hand with it, can be rotated in it. This movement includes pronation and supination. The combination of the movements of flexion and extension of the forearm with those of pronation and supination of the hand, which is ensured by the two being performed at the same joint, is essential to the accuracy of the various minute movements of the hand. The hand is only directly articulated to the distal surface of the radius, and the ulnar notch on the lower end of the radius travels around the lower end of the ulna. The ulna is excluded from the wrist-joint by the articular disk. Thus, rotation of the head of the radius around an axis passing through the center of the radial head of the humerus imparts circular movement to the hand through a very considerable arc. Ligaments The trochlea of the humerus is received into the semilunar notch of the ulna, and the capitulum of the humerus articulates with the fovea on the head of the radius. The articular surfaces are connected together by a capsule, which is thickened medially and laterally, and, to a less extent, in front and behind. These thickened portions are usually described as distinct ligaments. The major ligaments are the ulnar collateral ligament, radial collateral ligament, and annular ligament. Synovial membrane The synovial membrane is very extensive. It extends from the margin of the articular surface of the humerus, and lines the coronoid, radial and olecranon fossæ on that bone; it is reflected over the deep surface of the capsule and forms a pouch between the radial notch, the deep surface of the annular ligament, and the circumference of the head of the radius. Projecting between the radius and ulna into the cavity is a crescentic fold of synovial membrane, suggesting the division of the joint into two; one the humeroradial, the other the humeroulnar. Between the capsule and the synovial membrane are three masses of fat: the largest, over the olecranon fossa, is pressed into the fossa by the Triceps brachii during the flexion; the second, over the coronoid fossa, and the third, over the radial fossa, are pressed by the Brachialis into their respective fossæ during extension. Terminology: Elbow , Ell The now obsolete length unit ell relates closely to the elbow. This becomes especially visible when considering the Germanic origins of both words, Elle ell, defined as the length of an arm from shoulder to fingertips and Ellbogen elbow. It is unknown when or why the second l was dropped from English usage of the word, but a more precise suggested spelling would be ellbow for the joint and ellbone for the ulna, the etymological originator of both unit and joint. Carrying angle Normal radiograph; right picture of the straightened arm shows the carrying angle of the elbow Normal radiograph; right picture of the straightened arm shows the carrying angle of the elbow When the arm is extended, with the palm facing forward or up, the bones of the humerus and forearm are not perfectly aligned. The deviation from a straight line generally on the order of 5-10°-men, 10-25°-women occurs in the direction of the thumb, and is referred to as the carrying angle visible in the right half of the picture, right. In females the carrying angle is greater than in males.3 Carrying angle is typically larger in women than in men, due to the wider pelvic girdle exhibited in women. The carrying angle can influence how objects are held by individuals - those with a more extreme carrying angle may be more likely to supinate the forearm when holding objects in the hand to keep the elbow closer to the body. Elbow arthritis Elbow arthritis is usually seen in individuals with rheumatoid arthritis or after severe articular fractures. When the damage to the joint is severe, fascial arthroplasty or elbow joint replacement may be considered.4 Additional images Medial Humerus Radius Ulna Articulated Left Human Posterior Distal Humerus Extended Left Human Posterior Distal Humerus Flexed Left elbow-joint, showing posterior and radial collateral ligaments. Capsule of elbow-joint distended. Anterior aspect. Capsule of elbow-joint distended. Posterior aspect. The Supinator. Posterior view. Diagram of the anastomosis around the elbow-joint. Back of right upper extremity. Close-up radiograph, right elbow-joint Left male elbow Pathological fusion of three bones at elbow. References ^ eMedicine/Stedman Medical Dictionary Lookup! ^ eMedicine/Stedman Medical Dictionary Lookup! ^ Steel, F; Tomlinson J 1958. The carrying angle in man. Journal of Anatomy 92 2: 315-7. PMID 13525245. ^ Summary - Total elbow joint replacement for elbow arthritis: Surgery with a dependable, time-tested prosthesis can lessen pain and improve function in elbows, especially those with rheumatoid arthritis Look up Elbow in Wiktionary, the free dictionary. This article was originally based on an entry from a public domain ion of Gray's Anatomy. As such, some of the information contained herein may be outdated. Please the article if this is the case, and feel free to remove this notice when it is no longer relevant. v d e Human anatomical features Head Skull · Forehead · Eye · Ear · Nose · Mouth · Tongue · Teeth · Jaw · Face · Cheek · Chin Neck Throat · Adam's apple Torso Shoulders · Spine · Breast Tail of Spence · Chest · Ribcage · Abdomen · Navel Sex organs Clitoris · Vagina · Penis · Scrotum · Testicle - Hip · Anus · Buttocks Limbs Arm · Elbow · Forearm · Wrist · Hand · Finger Thumb · Index · Middle · Ring · Little · Leg · Lap · Thigh · Knee · Calf · Heel · Ankle · Foot · Toe Hallux Skin Hair v d e Joints and ligaments of upper limbs Shoulder sternoclavicular: anterior sternoclavicular - posterior sternoclavicular - interclavicular - costoclavicular acromioclavicular: acromioclavicular - coracoclavicular trapezoid, conoid - coracoacromial - superior transverse scapular - inferior transverse of scapula glenohumeral: coracohumeral - glenohumeral superior, middle, and inferior - transverse humeral - glenoid labrum Elbow humeroradial: radial collateral humeroulnar: ulnar collateral proximal radioulnar: annular - oblique cord Forearm distal radioulnar: volar radioulnar - dorsal radioulnar wrist/radiocarpal: palmar radiocarpal - dorsal radiocarpal - palmar ulnocarpal - ulnar collateral - radial collateral Hand intercarpal, midcarpal: pisohamate - scapholunate carpometacarpal: dorsal carpometacarpal - palmar carpometacarpal pisometacarpal intermetacarpal: deep transverse metacarpal - superficial transverse metacarpal metacarpophalangeal: palmar - collateral interphalangeal: palmar - collateral Retrieved from http://en..org/wiki/Elbow Categories: Human anatomy | Upper limb anatomyHidden category: Articles needing additional references from June 2008 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية Aymar Brezhoneg Català Česky Dansk Deutsch Español Esperanto Français Gà idhlig Bahasa Indonesia Italiano עברית Latina Magyar Nederlands 日本語 ‪Norsk bokmÃ¥l‬ Polski Português Simple English SlovenÅ¡Ä?ina Suomi Svenska Tagalog తెలà±?à°—à±? ไทย Türkçe Võro ייִדיש This page was last modified on
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