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Elbow - Coggle Diagram
Elbow
Muscular Actions
elbow flexors (7)
biceps brachii
proximal attachment
long head
Supraglenoid fossa of scapula
short head
coracoid process of scapula
distal attachment
Radial tuberosity of the radius
when is it most active
(between 30° to 120° of flexion and position of
forearm in pronation & supination
most effective flexor in what position
supination
what happens during pronation
Attachment twisted under radius
its only active when
against resistance
brachialis
brachioradialis
when is it most efficient
with rapid elbow flexion and
against resistance
Does it increase its activity when the arm is semipronated or pronated
no
pronator teres
ECRL
ECRB
flexor carpi ulnaris
which is the strongest flexor
brachialis
is output influenced by pronation or supination
no
when is it active
at all positions, speeds, with or
without resistance
Flexion force production (includes 3 positions)
Semi-pronated > Supinated > Pronated
why is this significant
Semi-pronated most common in ADL
Elbow extensors
Triceps
has how many heads
4
what is the 4th head of the triceps called
Anconeus
what is it known as
strongest arm muscle
Is Output affected by position of forearm supination/pronation
no
3 portions
long head
lateral head
medial head
which is the least active
long head (why)
bc only one that also crosses shoulder joint
which is the most active
medial head
when is it active
in all positions at all speeds against min or max resistance
which is the most strongest
lateral head
when is it active
against resistance
when is extension force production the greatest
Greatest at 90° of flexion
why is this sigificant
Common position for ADL
Pronators (2)
Pronator quadratus
Pronator teres
when does contribution increase (2 ways)
with rapid pronation or
against high load
when is it most active
at 60° of forearm flexion
which is most active and produces the most force
pronator quadratus
when is it active
in any position, fast or slow, with or w/o resistance
Supinators (2)
supinator
only m. contributing to what
slow unresisted supination in all elbow position
biceps brachii
when is it active for supination
Active when elbow is flexed at 90 degrees
when does it increase its effectiveness
with rapid or resisted supination
are flexors or extensors stronger
Flexors nearly 2X stronger than extensors
in all positions
what does this allow
Makes us more effective at pulling than
with pushing
when is pronation/supination force production the greatest
Greatest at mid-range for both
Exercises
what types of exercises are commonly used
Stretching exercise, manual resistance, isotonic
resistance
eccentric exercises are very important for conditions such as
lateral epicondylitis
Ligaments (5)
Collateral Ligaments (2)
Medial (ulnar) collateral ligament
what does it do
Connects the ulna to the humerus on the inside of the elbow
what does it resist
valgus stress upon the elbow
why is this important
bc Most forces directly medially in elbow
• Lateral (radial) collateral ligament
what does it do
Connects the radius to the humerus on the outside of the elbow
provides support against what
rarer varus forces
Annular Ligament
what does it do (2)
Wraps around the head of the radius and attaches to the ulna
Holds radius in elbow but allows
rotation
Quadrate Ligament
what does it do
Connects the radius to the ulna
Oblique or Weitbrecht Ligament
Joints
Humeroulnar joint (HU)
what is the joint composed of (2)
Trochlea of humerus
what is the trochlea covered by
articular cartilage
symmetrical or assymetrical
asymmetrical ( what does this create)
1 more item...
covers what surfaces on the trochlear notch (3)
anterior,
inferior, and posterior surfaces
Trochlea of ulna
what connects the ulna to the radius
Medial (ulnar) collateral ligament
flexion is limited by what 5 things
coronoid fossa on anterior humerus, coronoid process in front of ulna, soft tissue, posterior capsule,
extensor mm
Ext is limited by what 4 things
Olecranon fossa on humerus
• Olecranon process on ulna, joint capsule and flexor mm
what type of joint
hinge joint
Arthrokinematics
Loose-pack position (2 things)
70° flexion,
10° supination
Close pack position (2 things)
Full extension and supination
• Humeroradial joint (HR)
what is the distal articulation on the humerus
Capitulum
what is covering the anterior and inferior surfaces
articular cartilage
what type of joint is it
pivot joint
the movement is between what 2 area
capitulum
radial head
Arthrokinematics
Loose-pack position (2 things)
Full extension and supination
Close pack position (2 things)
90° Flexion, 5°
supination
• Proximal Radioulnar joint (PRU)
Articulation exists between (2 things)
Radial head
•
rotates within what 2 things
within fibrous osseous ring and annular ligament
if the annular ligament slipped over the radial head, what would occur
nurse maids elbow
Radial fossa on side of ulna
does what 2 motions
pronation and supination
what is pronation limited by (3)
ligaments, joint capsule, and soft
tissue compression as radius and ulna cross
what is supination limited by (3)
ligaments, capsule, and pronator
mm
what occurs in full pronation (2)
Radius crosses ulna diagonally
• Ulna moves laterally slightly
what membrane is in between the ulna/radius
interosseous membrane
what does it do
transmit force
Arthrokinematics
what is the concave surface
ulna
Loose pack position (2 things)
35° Flexion,
70° supination
Close pack position (2 ways)
Full supination
or pronation
how does it move
it spins
what 2 things give additional support to radioulanr joint
Quadrate ligament and interosseous
membrane
• Distal Radioulnar joint (DRU
ulna separated from carpals by what
fibrocartilage disc
what does this allow
ulna to pronate/supinate
without influencing carpal movements
which bone does more gripping function
ulna
which bone has more fine motor function
radius
Arthrokinematics
what is the concave surface
radius
during pronation, what direction is the roll and glide
anterior roll, anterior glide
Loose pack position
10° supination
Close pack position (2 ways)
Full supination
or pronation
Select Injuries
• Lateral epicondylalgia
aka
tennis elbow
causes irritation of which mm. (5)
ECRB,ECRL, ECU, Extensor digitorum, supinator
what does it usually involve
inflammation of
tendinous attachment into periosteum
palpation of what is typically painful
lateral humeral condyle
• Medial epicondylalgia
commonly happens during what
any repetitive gripping activity
causes irritation of which mm. (2)
Pronator teres
• Flexor carpi radialis (FCR)
• Olecranon Bursitis
most common symptom
edema
Interventions (3)
Anti-inflammatories
• Remove/change irritating stimulus
• Strengthen/stretch muscles in area
• Ulnar Nerve Irritation
often develops from what
entrapment at cubital tunnel
what is it often irritated by (4)
OA, spurs, fxs, soft tissue lesions
what symptoms usually arise (2)
Numbness/tingling 4th and 5th fingers, elbow/forearm pain
PT often focuses on what 3 things
n Δ biomechanics, Δ motor programs, neural glides
which nn. are often also injured