Elbow (HumeroUlnar)Elbow (HumeroUlnar)Joint and HandJoint and HandCreated by: Kelsey, Vonna, Jolee and AndyCreated by: Kelsey, Vonna, Jolee and Andy

Bones of the Bones of the Hand …Hand …

Bones of the WristBones of the Wrist

ScaphoidScaphoid

LunateLunate

TriquetrumTriquetrum

PisiformPisiform

HamateHamate

CapitateCapitate

TrapezoidTrapezoid

TrapeziumTrapezium

Metacarpal BonesMetacarpal Bones

11stst Metacarpal Metacarpal(on thumb)(on thumb)22ndnd Metacarpal Metacarpal

(on index finger)(on index finger)

33rdrd Metacarpal Metacarpal(on middle finger)(on middle finger)

44thth Metacarpal Metacarpal(on ring finger)(on ring finger)

55thth Metacarpal Metacarpal(on little finger)(on little finger)

Phalange BonesPhalange Bones

ProximalProximal Proximal PhalanxProximal Phalanxof the of the ThumbThumb

Proximal PhalanxProximal Phalanxof theof the

Index FingerIndex Finger

Proximal PhalanxProximal Phalanxof theof the

Middle FingerMiddle Finger

Proximal PhalanxProximal Phalanxof theof the

Ring FingerRing Finger

Proximal PhalanxProximal Phalanxof theof the

Little FingerLittle Finger

Phalange BonesPhalange Bones

IntermediateIntermediate IntermediateIntermediatePhalanx ofPhalanx of

the Index Fingerthe Index Finger

IntermediateIntermediatePhalanx ofPhalanx of

the Middle Fingerthe Middle Finger

IntermediateIntermediatePhalanx ofPhalanx of

the Ring Fingerthe Ring Finger

IntermediateIntermediatePhalanx ofPhalanx of

the Little Fingerthe Little Finger

Phalange BonesPhalange Bones

DistalDistalDistal PhalanxDistal Phalanxof the of the

Index FingerIndex Finger

Distal PhalanxDistal Phalanxof theof the

Middle FingerMiddle Finger

Distal PhalanxDistal Phalanxof theof the

Ring FingerRing Finger

Distal PhalanxDistal Phalanxof theof the

Little FingerLittle Finger

RadiusRadius

Head of theHead of theRadiusRadiusNeck of theNeck of the

RadiusRadius

Radial TuberosityRadial Tuberosity

Styloid ProcessStyloid Processof the Radiusof the Radius

Ulnar NotchUlnar Notchof the Radiusof the Radius

UlnaUlnaOlecranon ProcessOlecranon Process

of the Ulnaof the Ulna

Trochlear NotchTrochlear Notchof the Ulnaof the Ulna

Coronoid ProcessCoronoid Processof the Ulnaof the Ulna

Radial NotchRadial Notchof the Ulnaof the Ulna

Tuberosity of Tuberosity of the Ulnathe Ulna

Styloid ProcessStyloid Processof the Ulnaof the Ulna

HumerusHumerus

Capitulum Capitulum Of the Of the

HumerusHumerus

TrochleaTrochleaof theof the

HumerusHumerus

Olecranon FossaOlecranon Fossaof theof the

HumerusHumerusCoronoid FossaCoronoid Fossaof theof the

HumerusHumerus Medial EpicondyleMedial Epicondyleof theof the

HumerusHumerusLateral EpicondyleLateral Epicondyle

of theof theHumerusHumerus

Biceps

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Scapula - Long head: supraglenoid tubercle; short head: coracoid process

Radial tuberosity of radius

Elbow flexion, forearm supination

Musculocutaneous nerve

Brachial artery

Muscles of the Muscles of the Elbow and ForearmElbow and Forearm

Muscles of the Muscles of the Elbow and ForearmElbow and Forearm

Triceps

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Long head: infraglenoid tubercle of scapula - lateral head: inferior to greater tubercle on posterior humerus - medial head: posterior surface of humerus

Olecranon process of ulna

Elbow extension

Radial nerve

Deep brachial artery

Muscles of the Muscles of the Elbow and ForearmElbow and Forearm

Brachialis

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Distal half of humerus, anterior surface

Coronoid process and ulnar tuberosity of ulna

Elbow flexion

Musculocutaneous nerve

Brachial artery

Muscles of the Muscles of the Elbow and ForearmElbow and Forearm

Brachioradialis

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Lateral supracondylar ridge on the humerus

Styloid process of radius

Elbow flexion

Radial nerve

Radial artery

Muscles of the Muscles of the Elbow and ForearmElbow and Forearm

Coracobrachialis

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Coracoid process

Medial aspect of humerus

Weakly adducts shoulder joint

Musculocutaneous nerves ; C6, C7

Brachial artery

Muscles of the Muscles of the Elbow and ForearmElbow and Forearm

Supinator

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Lateral epicondyle of humerus and adjacent ulna

Anterior surface of proximal radius

Forearm supination

Radial nerve

Recurrent interosseous artery

Muscles of the Muscles of the Elbow and ForearmElbow and Forearm

Pronator teres

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Medial epicondyle of humerus; coranoid process of ulna

Lateral aspect of radius at its midpoint

Forearm pronation, assistive in elbow flexion

Median nerve

Ulnar artery

Muscles of the Muscles of the Elbow and ForearmElbow and Forearm

Pronator quadratus

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Distal fourth of ulna

Distal fourth of radius

Forearm pronation

Median nerve

Anterior interosseous artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Flexor carpi radialis

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Medial epicondyle of humerus

Base of 2nd and 3rd metacarpals

Wrist flexion, radial deviation

Median nerve

Radial and ulnar arteries

Muscles of the Muscles of the Wrist and HandWrist and Hand

Flexor carpi ulnaris

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Medial epicondyle of humerus

Pisiform; base of 5th metacarpal

Wrist flexion, ulnar deviation

Ulnar nerve

Ulnar artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Extensor carpi radialis longus

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Supracondylar ridge of humerus

Base of 2nd metacarpal

Wrist extension, radial deviation

Radial nerve

Radial artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Extensor carpi radialis brevis

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Lateral epicondyle of humerus

Base of 3rd metacarpal

Wrist extension

Radial nerve

Radial artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Extensor digitorum

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Lateral epicondyle of humerus

Base of distal phalanx of the 2nd - 5th fingers

Extends all 3 joints of the fingers

Radial nerve

Recurrent interosseous artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Extensor carpi ulnaris

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Lateral epicondyle of humerus

Medial side of base of 5th metacarpal

Extends and adducts wrist

Deep radial nerve

Ulnar artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Flexor digitorum superficialis

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Common flexor tendon, coronoid process, radius

Sides of the middle phalanx of the 4 fingers

Flexes MP and PIP joints of the fingers

Median nerve

Ulnar artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Flexor digitorum profundus

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Upper ¾ of ulna

Distal phalanx of the 4 fingers

Flexes all 3 joints of the fingers

Median and ulnar nerves

Ulnar artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Flexor pollicis longus

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Anterior surface of radius

Distal phalanx of pollex (thumb)

Flexes all joints of the pollex (thumb)

Median nerve

Radial artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Abductor pollicis longus

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Posterior radius, interosseous membrane, middle ulna

Base of the 1st metacarpal

Abducts pollex

Radial nerve

Posterior interosseous artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Extensor digiti minimi

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Lateral epicondyle of humerus

Base of distal phalanx of 5th finger

Extends all joints of 5th finger

Radial nerve

Recurrent interosseous artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Extensor pollicis brevis

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Posterior distal radius

Base of proximal phalanx of pollex

Extends MP joint of pollex

Radial nerve

Posterior interosseous artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Extensor pollicis longus

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Middle posterior ulna, interosseous membrane

Base of distal phalanx of pollex

Extends MP and IP joints of pollex

Radial nerve

Posterior interosseous artery

Muscles of the Muscles of the Wrist and HandWrist and Hand

Palmaris longus

Origin:

Insertion:

Action:

Innervation:

Vascular supply:

Medial epicondyle of humerus

Palmar fascia

Assistive in wrist flexion

Median nerve

Ulnar artery

Our Elbow Our Elbow and Hand and Hand

Allow Complex Allow Complex MovementMovementSuch as…Such as…

AND…AND…

The Ligaments, Bursae, Cartilage, andThe Ligaments, Bursae, Cartilage, andArticular Capsule of the Elbow Joint and HandArticular Capsule of the Elbow Joint and Hand

Ligaments Of the ElbowLigaments Of the ElbowArticular CapsuleArticular Capsule

Radial AnnularRadial AnnularLigamentLigament

Ulnar Collateral Ulnar Collateral LigamentLigament

Radial CollateralRadial CollateralLigamentLigament

Ligaments of the HandLigaments of the Hand

PalmarPalmarAponeurosisAponeurosis

Flexor RetinaculumFlexor RetinaculumCommonCommon

Flexor SheathFlexor Sheath

BursaeBursae

SubcutaneousSubcutaneousOlecranon BursaOlecranon Bursa

SubtendinousSubtendinousOlecranon BursaOlecranon Bursa

CartilageCartilage

Articular Cartilage…Articular Cartilage…

Interosseous Interosseous MembraneMembrane

Articular CapsuleArticular CapsuleSynovial MembraneSynovial Membrane Fibrous LayerFibrous Layer

Surface AnatomySurface Anatomy

Lateral EpicondyleLateral Epicondyle

Medial EpicondyleMedial Epicondyle

Radial StyloidRadial Styloid ProcessProcess

Ulnar StyloidUlnar StyloidProcessProcess

Olecranon ProcessOlecranon Process

Site of the Median NerveSite of the Median Nerve Tendon of Palmaris LongusTendon of Palmaris Longus

Tendon of FlexorTendon of FlexorCarpi RadialisCarpi Radialis

Anatomical Snuff BoxAnatomical Snuff Box

HypothenarHypothenarEminenceEminence

Thenar EvidenceThenar Evidence

Cubital FossaCubital Fossa

Distal Wrist Distal Wrist CreaseCrease

Clinical Concerns:

• Carpal Tunnel Syndrome:• Compression of the median nerve.

– mixed nerve that provides sensation to thumb, index, middle and middle –finger side of the ring fingers.

– Causes pain, tingling and numbness

Cause:Swelling or thickening of lining of the tendons in

your carpal tunnel.Repetitive use or injury-keyboarding, use of

powertools, pinching, gripping etc.Fluid retention due to pregnancy

Other Risk Factors: Sex, Heredity, health conditions (ie: diabetes, obesity, arthritis)

Treatment:Wrist splinting, Nonsteroidal anti-inflammatory

drugs, corticosteroids, physical therapySurgery

Prevention: Reduce force and relax grip, frequent breaks, improve posture, watch form, keep your hands warm.

Clinical Concerns cont’:

• Tennis Elbow (lateral epicondylitis)• Overuse injury caused by repeated contraction of the

forearm muscles.

Causes:– Stress to tissue results in inflammation or tiny tears

of the tendons that attach the forearm muscles to the bone outside your elbow.

– Repeated use of backhand stroke with poor technique- common motions: hammering, painting, raking, weaving……..playing tennis.

Signs and Symptoms:– Pain that radiates from the outside of elbow to

forearm and wrist. – Pain when you touch or bump the outside of elbow– Pain when you extend your wrist– A weak grip, painful grip when during certain

activities like shaking hands or turning a doorknob

Treatment: anti-inflammatory drugs, ice, rest, PRICE, exercises, corticosteroids, braces.

Surgery: (1 in 10)- trimming inflammed tendon or re-attachment.