Human Anatomy Vol 1

DlSSECTION
Remove all the muscles covering the adjacent sides of
radius, ulna and the intervening interosseous membrane.
This will expose the superior and inferior radioulnar joints
including the interosseous membrane.
Cut through the annular ligament to see the superior
radioulnar joint.
Clean and define the interosseous membrane. Lastly
cutthrough the capsule of inferior radioulnar jointto locate
the intra-articular fibrocartilaginous disc of the joint.
Learn the movements of supination and pronation
on dry bones and on yourself.

JOINTS OF UPPER LIMB

Lateral epicondyle

Common extensor origin

Fig. 10.15: Tennis elbow

Fig. 10.14: Aspiration of elbow joint

Fig. 10.16: Student's elbow

Subluxation of the head of the radius (pulled elbow)

occurs in children when the forearm is suddenly

pulled in pronation. The head of the radius slips

out from the annular ligament (see Fig.2.29).

Tennis elbow: Occurs in tennis players. Abrupt

pronation with fully extended elbow may lead to

pain and tenderness over the lateral epicondyle

which gives attachment to common extensor

origin (Fig. 10.15). This is possibly due to:

a. Sprain of radial collateral ligament.

b. Tearing of fibres of the extensor carpi radialis

brevis.

c. Recent reseatches have pointed out that it is

more of a degenerative condition rather than

inflammatory condition.

Student's (Miner's) elbow is characterisedby effusion

into the bursa over the subcutaneous posterior

surface of the olecranon process. Students during

lectures support their head (for sleeping) with their

hands with flexed elbows. The bursa on the

olecranon process gets inllamed (Fig. 10.16).

Golfer's elbow is the microtrauma of medial

epicondyle of humerus, occurs commonly in golf

players, The common flexor origin undergoes

repetitive strain and results in a painful condition

on the medial side of the elbow (Fig. 10,17).

If carrying angle (normal is 13') is more, the

condition is cubitus valgus, ulnar nerve may get

stretched leading to weakness of intrinsic muscles

of hand. If the angle is less itis called cubitus varus

(Fig. 10.18).

Under optimal position of the elbow: Generally

elbow flexion between 30 and 40 degrees is

sufficient to perform common activities of daily

living such as eating, combing, dressing, etc.

Because of this reason even people who have lost

terminal flexion or extension after a hactrte /

trauma are able to accomplish these personal tasks

without much problems.

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