Elbow Joint: Anatomy

Parts of the Elbow Joint

The elbow joint consists of 3 separate articulations enclosed in a single capsule Capsule An envelope of loose gel surrounding a bacterial cell which is associated with the virulence of pathogenic bacteria. Some capsules have a well-defined border, whereas others form a slime layer that trails off into the medium. Most capsules consist of relatively simple polysaccharides but there are some bacteria whose capsules are made of polypeptides. Bacteroides:

Ligaments of the Elbow Joint

The elbow capsule Capsule An envelope of loose gel surrounding a bacterial cell which is associated with the virulence of pathogenic bacteria. Some capsules have a well-defined border, whereas others form a slime layer that trails off into the medium. Most capsules consist of relatively simple polysaccharides but there are some bacteria whose capsules are made of polypeptides. Bacteroides is supported by the ligaments of the elbow, especially the radial (lateral) and ulnar (medial) collateral ligaments.

Functional Anatomy and Movements of the Elbow Joint

The functional anatomy of the elbow is unique secondary to the orientation Orientation Awareness of oneself in relation to time, place and person. Psychiatric Assessment and multiple articulations. The main function of the elbow is to link the shoulder and the hand Hand The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves. Hand: Anatomy and position and stabilize the hand Hand The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves. Hand: Anatomy during activities.

Carrying angle:

• Normal valgus carrying angle: 5–15 degrees
• Prevents arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy from contacting hips
• Women > men, greater in dominant limb (both sexes)

Muscles of the Elbow Joint

The muscles of the elbow originate in the upper arm Upper Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy and insert into the forearm Forearm The forearm is the region of the upper limb between the elbow and the wrist. The term “forearm” is used in anatomy to distinguish this area from the arm, a term that is commonly used to describe the entire upper limb. The forearm consists of 2 long bones (the radius and the ulna), the interosseous membrane, and multiple arteries, nerves, and muscles. Forearm: Anatomy, producing flexion-extension of the elbow as well as supination-pronation of the forearm Forearm The forearm is the region of the upper limb between the elbow and the wrist. The term “forearm” is used in anatomy to distinguish this area from the arm, a term that is commonly used to describe the entire upper limb. The forearm consists of 2 long bones (the radius and the ulna), the interosseous membrane, and multiple arteries, nerves, and muscles. Forearm: Anatomy. The muscles also provide dynamic stabilization to the elbow joint.

Neurovascular and Lymphatic Supply of the Elbow

Innervation

• Anteriorly: The musculocutaneous, median, and radial nerves pass anterior to the elbow and innervate the anterior capsule Capsule An envelope of loose gel surrounding a bacterial cell which is associated with the virulence of pathogenic bacteria. Some capsules have a well-defined border, whereas others form a slime layer that trails off into the medium. Most capsules consist of relatively simple polysaccharides but there are some bacteria whose capsules are made of polypeptides. Bacteroides.
• Posteriorly: The ulnar nerve Ulnar Nerve A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm. Axilla and Brachial Plexus: Anatomy passes posteriorly and medially at the elbow and innervates the posterior capsule Capsule An envelope of loose gel surrounding a bacterial cell which is associated with the virulence of pathogenic bacteria. Some capsules have a well-defined border, whereas others form a slime layer that trails off into the medium. Most capsules consist of relatively simple polysaccharides but there are some bacteria whose capsules are made of polypeptides. Bacteroides.

Arterial supply

• Brachial artery Brachial Artery The continuation of the axillary artery; it branches into the radial and ulnar arteries. Cubital Fossa: Anatomy
  • Courses down the anterior surface of the arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy into the cubital fossa Cubital Fossa The cubital fossa is the region anterior to the elbow joint. The cubital fossa is seen as the triangular depression between the brachioradialis and pronator teres muscles. The 4 important structures of the cubital fossa (from lateral to medial) are the radial nerve, tendon of the biceps brachii muscle, brachial artery, and median nerve. Cubital Fossa: Anatomy
  • Bifurcates into the radial and ulnar artery Ulnar Artery The larger of the two terminal branches of the brachial artery, beginning about one centimeter distal to the bend of the elbow. Like the radial artery, its branches may be divided into three groups corresponding to their locations in the forearm, wrist, and hand. Forearm: Anatomy in the proximal forearm Forearm The forearm is the region of the upper limb between the elbow and the wrist. The term “forearm” is used in anatomy to distinguish this area from the arm, a term that is commonly used to describe the entire upper limb. The forearm consists of 2 long bones (the radius and the ulna), the interosseous membrane, and multiple arteries, nerves, and muscles. Forearm: Anatomy
• The cubital anastomosis is an extensive circulatory system surrounding the elbow, formed from branches of the brachial, radial, and ulnar arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries: Histology.

Venous drainage

• Basilic and cephalic vein: the primary superficial veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins: Histology of the upper arm Upper Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy
• Connected at the elbow anteriorly by the median cubital vein

Lymphatic drainage

Epitrochlear or cubital lymph nodes Cubital lymph nodes Cubital Fossa: Anatomy are found at the elbow and drain proximally to the axillary lymph nodes Lymph Nodes They are oval or bean shaped bodies (1 – 30 mm in diameter) located along the lymphatic system. Lymphatic Drainage System: Anatomy.

Clinical Relevance

The following are common conditions related to the elbow:

• Humerus Humerus Bone in humans and primates extending from the shoulder joint to the elbow joint. Arm: Anatomy fracture Fracture A fracture is a disruption of the cortex of any bone and periosteum and is commonly due to mechanical stress after an injury or accident. Open fractures due to trauma can be a medical emergency. Fractures are frequently associated with automobile accidents, workplace injuries, and trauma. Overview of Bone Fractures: A distal humerus fracture Distal Humerus Fracture Supracondylar Fracture primarily occurs from falling on the outstretched arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy. Humerus Humerus Bone in humans and primates extending from the shoulder joint to the elbow joint. Arm: Anatomy fractures are classified into supra-, trans-, or intercondylar fractures. Depending on the location and the extent of the fractures, these injuries may need to be reduced and addressed surgically. 
• Supracondylar fracture Supracondylar fracture Supracondylar fractures are the most common elbow fractures in the pediatric population. The most common mechanism of injury involves a fall on an outstretched hand, resulting in a fracture of the distal humerus. Patients frequently present with pain, visible deformity, and limited range of motion of the injured elbow. Supracondylar Fracture: a common traumatic fracture Fracture A fracture is a disruption of the cortex of any bone and periosteum and is commonly due to mechanical stress after an injury or accident. Open fractures due to trauma can be a medical emergency. Fractures are frequently associated with automobile accidents, workplace injuries, and trauma. Overview of Bone Fractures in children that occurs from a fall on an outstretched arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy or hand Hand The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves. Hand: Anatomy. Treatment often includes closed reduction Closed Reduction Radial Head Subluxation (Nursemaid’s Elbow) and percutaneous pinning, which may be urgent if the neurovascular system is compromised.
• Olecranon Olecranon A prominent projection of the ulna that articulates with the humerus and forms the outer protuberance of the elbow joint. Arm: Anatomy fracture Fracture A fracture is a disruption of the cortex of any bone and periosteum and is commonly due to mechanical stress after an injury or accident. Open fractures due to trauma can be a medical emergency. Fractures are frequently associated with automobile accidents, workplace injuries, and trauma. Overview of Bone Fractures: occurs secondary to falling on the flexed arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy. Depending on the complexity of the fracture Fracture A fracture is a disruption of the cortex of any bone and periosteum and is commonly due to mechanical stress after an injury or accident. Open fractures due to trauma can be a medical emergency. Fractures are frequently associated with automobile accidents, workplace injuries, and trauma. Overview of Bone Fractures, the fracture Fracture A fracture is a disruption of the cortex of any bone and periosteum and is commonly due to mechanical stress after an injury or accident. Open fractures due to trauma can be a medical emergency. Fractures are frequently associated with automobile accidents, workplace injuries, and trauma. Overview of Bone Fractures may be treated surgically with a tension band osteosynthesis.
• Radial head fracture Fracture A fracture is a disruption of the cortex of any bone and periosteum and is commonly due to mechanical stress after an injury or accident. Open fractures due to trauma can be a medical emergency. Fractures are frequently associated with automobile accidents, workplace injuries, and trauma. Overview of Bone Fractures: One of the most common fractures in adults; occurs secondary to falling on the extended arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy. Can occur with or without dislocation and may include multiple fragments. May require surgical management.
• Elbow dislocation Elbow dislocation Elbow dislocation is the displacement of either the radius or the ulna relative to the humerus. The most common mechanism of injury is falling on an outstretched hand. Elbow dislocation presents with joint swelling, pain, and restricted range of motion. Elbow Dislocation: 2nd-most common joint dislocation after the shoulder. A fall on an outstretched hand Hand The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves. Hand: Anatomy is the usual mode of injury. Complex elbow dislocations have an associated fracture Fracture A fracture is a disruption of the cortex of any bone and periosteum and is commonly due to mechanical stress after an injury or accident. Open fractures due to trauma can be a medical emergency. Fractures are frequently associated with automobile accidents, workplace injuries, and trauma. Overview of Bone Fractures or neurovascular injury.
• Nursemaid’s elbow (radial head subluxation): also called “babysitter’s elbow.” Common injury of young children that occurs secondary to longitudinal traction on the hand Hand The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves. Hand: Anatomy and forearm Forearm The forearm is the region of the upper limb between the elbow and the wrist. The term “forearm” is used in anatomy to distinguish this area from the arm, a term that is commonly used to describe the entire upper limb. The forearm consists of 2 long bones (the radius and the ulna), the interosseous membrane, and multiple arteries, nerves, and muscles. Forearm: Anatomy. Causes a subluxation Subluxation Radial Head Subluxation (Nursemaid’s Elbow) of the annular ligament Annular Ligament Radial Head Subluxation (Nursemaid’s Elbow) from the normal location surrounding the radial head. Treatment is usually closed reduction Closed Reduction Radial Head Subluxation (Nursemaid’s Elbow) using a supination technique Supination Technique Radial Head Subluxation (Nursemaid’s Elbow).
• Medial/lateral epicondylitis or flexor/extensor tendinosis: a common problem of the elbow, with localized pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways at either the lateral (extensor) or medial (flexor) epicondyle. Associated with inflammation Inflammation Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body’s defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function. Inflammation or degeneration of the tendons of the area due to repetitive microtrauma Microtrauma Small injuries caused by external force applied to the body including bones, muscles, nerves and tendons. Osgood-Schlatter Disease/overuse. Medial epicondylitis or flexor tendinosis is also known as “golfer’s elbow,” while lateral epicondylitis or extensor tendinosis is known as “ tennis elbow Tennis elbow A condition characterized by pain in or near the lateral humeral epicondyle or in the forearm extensor muscle mass as a result of unusual strain. It occurs due repetitive stresses on the elbow from activities such as tennis playing. Examination of the Upper Limbs.”
• Ulnar nerve compression Nerve Compression Brachial Plexus Injuries syndrome: also called cubital tunnel syndrome. Usually due to a direct trauma Direct Trauma Toddler’s Fractures of the ulnar nerve Ulnar Nerve A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm. Axilla and Brachial Plexus: Anatomy or repetitive/prolonged elbow flexion Flexion Examination of the Upper Limbs. Less commonly secondary to hypermobility of the ulnar nerve Ulnar Nerve A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm. Axilla and Brachial Plexus: Anatomy or osteophytes in the cubital tunnel.