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Lecture 4 - Elbow Slides

The document discusses the anatomy of the elbow and upper extremity. It identifies and describes key bony structures of the distal humerus, proximal radius, and proximal ulna. These include the trochlea, capitulum, epicondyles, supracondylar ridges, radial head, neck and tuberosity, olecranon, coronoid process, and trochlear and radial notches. Radiographic views and 3D reconstructions are used to illustrate the relationships between these structures. Clinical correlations regarding common injuries and conditions are also discussed.

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134 views

Lecture 4 - Elbow Slides

The document discusses the anatomy of the elbow and upper extremity. It identifies and describes key bony structures of the distal humerus, proximal radius, and proximal ulna. These include the trochlea, capitulum, epicondyles, supracondylar ridges, radial head, neck and tuberosity, olecranon, coronoid process, and trochlear and radial notches. Radiographic views and 3D reconstructions are used to illustrate the relationships between these structures. Clinical correlations regarding common injuries and conditions are also discussed.

Uploaded by

ubcradadmin
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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The Elbow And Compartments Of p The Upper Extremity

Department of Radiology, Vancouver General Hospital

Dr. Lawrence Josey Magnetic Resonance Imaging Fellow

Objectives
Be able to identify the following structures on a p y g plain radiograph: g p Distal end of the humerus Lateral epicondyle Medial epicondyle Lateral supracondylar ridge Medial supracondylar ridge Capitulum Trochlea Proximal end of Radius Head of Radius Neck of Radius Radial Tuberosity Proximal end of Ulna Olecranon Coronoid process Tuberosity of ulna Trochlear notch Radial notch

Anatomy Review Anatom Re ie

Anatomy Review: Basic Terms


Anatomical position: 1. 2. 3. 3 4. Standing Feet together Arms to the side A t th id Head and palms facing forwards

Frequently Used T F tl U d Terms: Apply Anatomical Position Superior / Inferior p Higher in position / Lower in position Lateral / Medial Away from midline / Closer to midline Anterior / Posterior Front / Back Proximal / Distal Closer to origin / Away from the origin

Anatomical Review: Basic Terms


Additional anatomic terminology may be used in the hand : Radial / Ulnar

Ulnar Radial

Ulnar Radial

Anatomical position not necessary

Anatomical Review: Basic Terms


Additional anatomic terminology may be used in the hand : Volar or Palmar / Dorsal

Volar / Palmar Volar /Palmar Dorsal Dorsal

Anatomical position not necessary

Radiograph Views of the Elbow


AP View Lateral View

Distal Humerus Anatomy Review

There are two articulating surfaces or condyles of the humerus: y

Trochlea: Articulates with the ulna o Spindle-shaped, concave articular surface

Capitulum: Articulates with the radius o Convex Articular Surface

Anatomy Review

1 4

2 5 3 1

4
1. 2. 3. 4. 5. Trochlea Capitulum Olecranon (behind trochlea) ( ) Ulna Radius

Distal Humerus Anatomy Review


Epicondyles - Bony protuberances above (epi) the condyles Medial Epicondyle

Medial i M di l epicondyle d l 1. Palpable landmark on medial side of elbow 2. Attachment of forearm muscles of the anterior compartments (wrist ( flexors)

Lateral epicondyle 1. Attachment of muscles of the posterior compartments (wrist extensors)

Lateral Epicondyle

Distal Humerus Anatomy Review

Supracondylar ridges (or epicondylar, supraepicondylar ridge) Formed as the shape of humerus becomes flattened distally Medial Supracondylar Ridge

Lateral supracondylar ridge Ridge located superior to lateral epicondyle Lateral Supracondylar Ridge

Medial supracondylar ridge Ridge located superior to medial epicondyle

Proximal Radius Anatomy Review


Head Thick disc-shaped structure Articulates with the capitulum and ulna

Neck Cylindrical shape between the head and radial diaphysis

Radial tuberosity Large blunt projection on anteromedial surface of radius The surface is roughened for the attachment of biceps brachii tendon

Proximal Radius Anatomy Review

Radial Head

Radial Neck

Radial R di l Tuberosity

Proximal Ulna Anatomy Review


Olecranon Large projection of bone Attachment for triceps brachii

Coronoid process Projects anteriorly from proximal end of ulna Superior surface articulates with trochlea

Tuberosity of ulna Triangular shaped area of roughening Attachment for brachialis muscle

Coronoid Process

Olecranon

Tuberosity of Ulna

Proximal Ulna Anatomy Review

Trochlear notch Large depression formed by olecranon and coronoid process Articulates with trochlea of humerus

Radial notch Depression on lateral side of ulna for articulation with radial head This articulation is involved in with pronation and supination of the arm

Trochlear Notch

Radial Notch

AP Radiograph vs. 3D Reconstruction of Elbow


Medial Supracondylar p y Ridge

Medial Supracondylar Ridge

Lateral Supracondylar Ridge g

Medial Epicondyle

3 1

Lateral Epicondyle

2 6
1. 2. 3. 4. 5. 6. 7. Radial Neck Trochlea Capitulum Olecranon (behind trochlea) Ulna Radius Radial Head Radial Tuberosity

2 6 4 5

4 7
Coronoid Process of Ulna

Coronoid Process of Ulna

AP View of Elbow
Medial Supracondylar Ridge Lateral Supracondylar Ridge Medial Epicondyle E i d l

3 1

2 6

Lateral Epicondyle Radial Neck 1. 2. 2 3. 4. 5. 6. 7. Trochlea Capitulum C i l Olecranon (behind trochlea) Ulna Radius Radial Head Radial Tuberosity

Coronoid Process of Ulna

4 7 5

3D Reconstruction of Right Elbow: Posterior View

1 3 4 6 5 7 2
1. 1 2. 3. 4. 5. 6. 7. 8. 9. Medial Epicondyle Lateral Epicondyle Olecranon Trochlear Notch Ulna Radial Head Radius Medial Supracondylar Ridge Lateral Supracondylar Ridge

Lateral View of Elbow

1. 2. 3. 3 4. 5. 6. 7.

Shaft of Humerus Trochlea Olecranon Ol Coronoid Process Head of Radius Radial Tuberosity y Tuberosity of Ulna

4 2
Trochlear Notch

5 7

CT of Elbow (Right)- Axial

CT of Elbow (Right)- Axial


1. Olecranon 1 Ol 2. Ulnar Nerve 3. Ulna Anterior A t i Anterior

Capitulum

3
Trochlea

1 1 2
Posterior

2
Posterior

CT of Elbow- Coronal vs. 3D Reconstruction


1. 2. 3. 4. Medial Epicondyle Lateral Epicondyle p y Trochlea Capitulum Olecranon Fossa 5. Ulna: Radial Notch 6. Ulna 7. Radial Head

1 2 3 4 7 6 5 2 4 7 5 3

Clinical Correlations
Head of Radius Fracture Common injury associated with fall on outstretched hand (FOOSH) Force is transmitted to radial head fracture Normal Displaced Radial Head Fracture

Clinical Correlations
Epicondylitis Overuse of the flexor and extensor muscles of forearm may in inflammation and pain at the origins of those muscles Golfers elbow (wrist flexors) medial epicondylitis Tennis elbow (wrist extensors) lateral epicondylitis Lateral Epicondylitis MRI T1 Weighted Lateral Epicondylitis MRI T2 Weighted

Bright signal due to high water content suggests inflammation

Clinical Correlations
The Funny Bone When you hit your inner elbow on a hard surface, you feel a tingling sensation Hitting the ulnar nerve! Ulnar nerve passes around the p posterior surface of medial epicondyle The ulnar nerve is the largest unprotected nerve in the body so p y injury is common Y can palpate it b t it will f l f You l t it, but ill feel funny! !

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