Kinesiology of Elbow & Forearm Flashcards
(78 cards)
What is the normal carrying angle of the elbow?
13°
What might be the functional significance of normal cubitus valgus?
Keeping carried objects away from the side of the thigh during walking
What could be the effect of excessive cubitus valgus?
Structures under stretch (e.g. ulnar nerve)
- Structures crossing the cubital fossa on the medial side
What does the articular capsule enclose?
(elbow)
- Humero-ulnar joint
- Humeroradial joint
- Proximal radio-ulna joint
What ligaments is the articular capsule (elbow) strengthened by?
- Medial collateral ligament (anterior fibers)
- Medial collateral ligament (posterior fibers)
- Radial collateral ligaments
- Lateral (ulnar) collateral ligaments
- Annular ligament
What kind of stability does the medial collateral ligament (anterior fibers) provide?
Provides:
- Articular stability throughout sagittal plane movement
- Significant resistance against a valgus (abduction) produced force to elbow
- Strongest & stiffest ligament of elbow
What kind of stability does the medial collateral ligament (posterior fibers) provide?
Resists valgus-produced force & becomes taut in extreme elbow flexion
- Less defined compared to anterior fibres
What increases tension of radial collateral ligaments?
Varus force on elbow
What increases tension of lateral (ulnar) collateral ligaments?
- Varus force
- External rotation
- Flexion
What increases the tension of the annular ligament?
- Distraction of radius
How does the annular ligament provide stability to the elbow joint?
The fovea of the radius is shallow while the capitulum is large
Annular ligament reinforces/protects the “connection” between the fovea & capitulum (keeps both in place)
What is the medial collateral ligament susceptible to?
Injury
- When extended elbow is violently forced into excessive valgus (e.g. fall onto outstretched & supinated arm)
- Non-weight bearing valgus producing –> repetitive strain (e.g. overhead activities like baseball/pitchers)
What are the ligaments in the lateral collateral ligament complex?
Radial collateral ligament
Lateral (ulnar) collateral ligament
What are the fibres of the medial collateral ligament?
- Anterior fibers (Strongest & stiffest)
- Posterior fibres
- Transverse fibers (Poorly developed)
What does the fibro-osseous ring consist of?
Annular ligament
Radial notch of ulna
(The head of radius articulates with proximal ulnar by fibro-osseous ring)
What is the articular disc at the distal radio-ulnar joint known as?
Triangular fibrocartilage
How does the lateral ulnar collateral ligament provide stability?
Distal attachment to ulna = forms a sling that supports radial head = prevents excessive ext. rotation
Taut at full flexion
What does the triangular fibrocartilage complex (TFCC) consist of?
(7)
- Articular disc (triangular fibrocartilage)
- Distal radio-ulnar joint capsular ligament
- Palmar ulnocarpal ligament
- Ulnotriquetral ligament
- Ulnolunate ligament
- Ulnar collateral ligament
- Fascia sheath of extensor carpi ulnaris tendon
What is the terrible triad injury of the elbow?
- Elbow joint dislocation (with ligamentous injury)
- Fracture of radial head
- Fracture of coronoid process
E.g. falling onto outstretched & supinated arm = injury to MCL + above 3 components
What structures stabilize the humero-ulnar joint?
- Well-fitting joint surfaces
- Joint capsule
- Medial collateral ligament
- Biceps brachii
- Brachialis
- Triceps brachii
- Anconeus
What structures stabilize the humeroradial joint?
- Joint capsule
- Lateral collateral ligament complex
- Biceps brachii
- Brachialis
- Triceps brachii
- Anconeus
What structures stabilise the proximal radio-ulnar joint?
- Joint capsule
- Annular ligament
- Quadrate ligament
- Interosseous membrane
- Biceps brachii
- Brachialis
- Triceps brachii
What structures stabilise the distal radio-ulnar joint?
- Triangular fibrocartilage complex (TFCC)
- Volar & dorsal radioulnar ligaments
- Extensor carpi ulnaris tendon sheath - Pronator quadratus
- Interosseous mbn
What is the role of the interosseous mbn?
- Most fibres of the interosseous mbn referred to as central band –> binds radius firmly to ulna (distal oblique fibres are small & poorly developed)
- Serves as attachment site for extrinsic muscles of hand
- Provides a mechanism of transmitting force proximally thru upper limb