elbow and forearm regions

8/14/2019 Elbow and Forearm Regions

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Biceps + Triceps brachii

Olecrenon ProcessMedial Epicondyle

Cubital Fossa Anterior surface elbow

Contents Median Cubital Vein

Brachial Artery

Median Nerve

Boundaries Medial= Pronator teres

Lateral= Brachioradialis

Superior= Line between epicondyles


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During pronation,the radius rotatesover the ulna, and

the bones form anX

During supination,the radius and ulna

are parallel


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Bi = 2 Heads

Tri = 3 Heads

Brevis means there is a Longus

Digitorum/Digiti = insertion on fingers

Pollicis = insertion on pollex (thumb)


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Origin: Long head: Infraglenoid

tubercle of the scapula

Lateral head: inferior togreater tubercle of posterior

humerus Medial head: Posterior

surface of humerus

Insertion: Olecranon process

Action: Elbow extension

Innervation: Radial nerveVascular supply: Deep Brachialartery


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Origin:

Long head: Supraglenoidtubercle

Short head: coracoid process

Insertion: Radial tuberosity ofradius

Action: Elbow flexion, forearmsupination

Innervation: Musculocutaneousnerve

Vascular supply: Brachial artery


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Origin: Coracoidprocess

Insertion: Medial aspect

of humerusAction: Weak adductor

Innervation:Musculocutaneous,

nerves C6, C7Vascular: Brachialartery


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Origin: Distal ofhumerus, anteriorsurface

Insertion: Coronoidprocess and ulnartuberosity of the ulna

Action: Elbow flexion

Innervation:Musculocutaneousnerve

Vascular: Brachialartery


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Origin: Lateralsupracondylar ridgeof the humerus

Insertion: Styloidprocess of the radius

Action: Elbowflexion

Innervation: Radialnerve

Vascular: Radialartery


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Origin: Lateralepicondyle of humerusand adjacent ulna

Insertion: Anteriorsurface of the proximalradius

Action: Forearmsupination

Innervation: Radialnerve

Vascular: Recurrentinterosseous artery


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Origin: Medialepicondyle of humerusand coranoid process ofulna

Insertion: Lateral aspectof radius at its midpoint

Action: Forearmpronation, assistive in

elbow flexion

Innervation: Mediannerve

Vascular: Ulnar artery


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Origin: Distal ofulna

Insertion: Distal of

radiusAction: Forearmpronation

Innervation: Median

nerveVascular: Anteriorinterosseous artery


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Extensor CarpiUlnaris

O- lateral epicondyle ofhumerus

I- medial side of the base of

fifth metacarpal

A- wrist extension, ulnardeviation

N-Radial

V- Ulnar artery


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Extensor CarpiRadialis Brevis

O-lateral epicondyle ofhumerus

I-base of third metacarpal

A-wrist extension

N-Radial nerve

V-Radial artery


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Extensor CarpiRadialis Longus

O-supracondylar ridge ofhumerus

I-base of second metacarpal

A-wrist deviation, radialdeviation

N-Radial

V-Radial artery


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Extensor Digiti Minimi

O-lateral epicondyle of

humerus

I-base of distal phalanx offifth finger

A-extends all joints of fifthfinger

N-Radial

V-Recurrent interosseousartery


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Extensor PollicisLongus

O-middle posterior ulnaand interosseousmembrane

I-base of distal phalanx of

pollex (thumb)

A-extends MP and IP jts ofthumb

N-Radial

V-Posterior Interosseousartery


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Extensor PollicisBrevis

O-posterior distal radius

I-base of proximal phalanxof pollex (thumb)

A-extends MP jt of thumb

N-Radial

V-Posterier Interosseous

artery


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Abductor PollicisLongus

O-posterior radius,interosseous membrane,middle ulna

I-base of first metacarpal

A-abducts pollex (thumb)

N-Radial

V-Posterior interosseousartery


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Flexor Carpi Radialis

O-medial epicondyle of

humerus

I-base of second and thirdmetacarpals

A-wrist flexion, radialdeviation

N-Median

V-Radial and Ulnar arteries


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Flexor DigitorumProfundus

O-upper of ulna

I-distal phalanx of the fourfingers

A-flexes all three jts offingers

N-Median and Ulnar

V-Ulnar artery


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Flexor DigitorumSuperficialis

O-common flexor tendon,coronoid process and radius

-sides of the middle phalanx offour fingers

A-flexes MP and PIP jts of fingers

N-Median

V-Ulnar artery


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Flexor Pollicis Longus

O-anterior surface ofradius

I-distal phalanx of pollex(thumb)

A-flexes all jt of thumb

N-Median

V-Radial artery


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Clinical Concerns Cont.

Nursemaids Elbow (AKA Tennis Elbow)

Painful musculoskeletal condition developed from repetitive useof the superficial extensor muscles of the forearm

Pain radiates over the lateral epicondyle down the posteriorsurface of the forearm


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History

Observation Visually inspect, including wrsit and elbow

If no deformity present, observe while they supinateand pronate

Palpation

Special Tests


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Contusion Etiology:direct blow

Why more common to ulna?

Signs and Symptoms

ManagementForearm Splints Etiology: repeated severe static contraction Signs and Symptoms:dull ache between extensors,

interosseous membrane

Management: early season vs late in season? Note: Acute / Chronic exertional compartment syndrome:

deep compartment most common and associated withavulsions, distal radius fracture, or crushing injuries;management same as in lower leg


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Colles fracture Etiology: FOA, forces radius and ulna back and up =

hyperextension

Signs and Symptoms (posterior displacement)

Management Reverse Colles = fall on back of hand

Forearm Fractures Etiology

Signs and Symptoms: more common for radius and ulna tofracture simultaneously

Management


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http://catalog.cmsp.com/datav3/im040027.htm

elbow and forearm regions

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