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Anatomy slides

Elbow and Wrist
POK 1 “Guidance for Routine
          Handling “

• These anatomy slides should help you focus
  your attention;
• ? Think what structures are you targeting and
  locating & why
• ? What are the bony landmarks
• ? What will you applicators be
• ? Where are your contact points
• ? What structures might you stabilize/move
Elbow joint
Elbow joint movement
Elbow joint
Annular ligament
Myology (Muscles)
• Muscles of the upper arm
• Anterior
  – Biceps brachii
  – Brachialis
• Posterior
  – Aconeus
  – Triceps Brachii
• Lateral
  – Brachioradialis
Biceps brachii & Brachialis
Triceps brachii & Anconeus
Biceps brachii & Brachialis
Elbow flexion / Extension
•   Flexion;          • Extension;
•   Brachialis        • Triceps Brachii
•   Biceps Brachii    • Anconeus
•   Brachioradialis
Forearm Pronation / Supination
• Pronation;           • Supination;
• Pronator Quadratus   • Supinator
• Pronator teres       • Biceps Brachii (with
                         elbow flexed)
Biceps brachii
• Origin
  – Long head - supraglenoid tubercle
  – Short head - coracoid process
• Insertion
  – Radial tuberosity & bicipital aponeurosis
• Action
  – Shoulder & elbow flexion, supination
• Innervation
  – Musculocutaneus nerve (C5-C6)
The Wrist and Hand
• Keep thinking about;
• The relationship of all the bones of the
  upper Limb
• What are the anatomical links?
• What muscles have an effect over more
  than 1 joint ?
• What are the main nerves that supply the
  Upper limb and hand?
Fibrous joints (Syndesmosis)
Types of Synovial Joints
Carpal bones
• 8 carpal bones - form the carpus
  – Scaphoid     = boat shaped
  – Lunate       = moon/crescent shaped
  – Triquetral   = three cornered
  – Pisiform     = pea shaped
  – Hamate       = hook shaped
  – Capitate     = head
  – Trapezoid    = no parallel sides
  – Trapezium    = parallel sides
Supination & Pronation
Movements of the radiocarpal and
      midcarpal joints
Carpal tunnel
Deep flexors



         FDP
 FPL

         PQ
Superficial flexors


     PT

              FDS

    FCR
              FCU
     PL
Deep extensors

         Supinator




         APL




              EPB

              EPL

         EI
Superficial extensors




     ECU
              EDM
              ED
Thenar
muscles
Thenar & Hypothenar muscles




                          Adductor pollicis



Opponens digiti minimi            Flexor Pollicis Brevis
   Flexor digiti minimi           Opponens pollicis
 Abductor digiti minimi

                          Abductor pollicis brevis
Radial nerve
• Major nerve of the
  Posterior cord
• C5,C6,C7,C8,T1
• Supplies
   –   Triceps
   –   Anconeus
   –   Brachialis (lat)
   –   Brachioradialis
   –   Ex Carpi Rad Long
• At the LHE bifurcates
   – Deep interosseous
   – Superficial Rad nerve
Ulna nerve
• Terminal Branch of
  the medial cord
• C7,C8,T1
• Supplies
  – Some wrist flexors
  – Flex Digit Prof
  – Flex Carpi Ulnaris
Median nerve
• Arises from
  – Lateral Cord C5,C6,C7
  – Medial Cord      C8,
    T1
• Supplies
  – Wrist Flexors
  – Thenar muscles
Carpal tunnel

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Slides6

  • 2. POK 1 “Guidance for Routine Handling “ • These anatomy slides should help you focus your attention; • ? Think what structures are you targeting and locating & why • ? What are the bony landmarks • ? What will you applicators be • ? Where are your contact points • ? What structures might you stabilize/move
  • 6.
  • 7.
  • 9. Myology (Muscles) • Muscles of the upper arm • Anterior – Biceps brachii – Brachialis • Posterior – Aconeus – Triceps Brachii • Lateral – Brachioradialis
  • 10. Biceps brachii & Brachialis
  • 11. Triceps brachii & Anconeus
  • 12. Biceps brachii & Brachialis
  • 13. Elbow flexion / Extension • Flexion; • Extension; • Brachialis • Triceps Brachii • Biceps Brachii • Anconeus • Brachioradialis
  • 14. Forearm Pronation / Supination • Pronation; • Supination; • Pronator Quadratus • Supinator • Pronator teres • Biceps Brachii (with elbow flexed)
  • 15. Biceps brachii • Origin – Long head - supraglenoid tubercle – Short head - coracoid process • Insertion – Radial tuberosity & bicipital aponeurosis • Action – Shoulder & elbow flexion, supination • Innervation – Musculocutaneus nerve (C5-C6)
  • 16. The Wrist and Hand • Keep thinking about; • The relationship of all the bones of the upper Limb • What are the anatomical links? • What muscles have an effect over more than 1 joint ? • What are the main nerves that supply the Upper limb and hand?
  • 19.
  • 20.
  • 21. Carpal bones • 8 carpal bones - form the carpus – Scaphoid = boat shaped – Lunate = moon/crescent shaped – Triquetral = three cornered – Pisiform = pea shaped – Hamate = hook shaped – Capitate = head – Trapezoid = no parallel sides – Trapezium = parallel sides
  • 23. Movements of the radiocarpal and midcarpal joints
  • 25. Deep flexors FDP FPL PQ
  • 26. Superficial flexors PT FDS FCR FCU PL
  • 27. Deep extensors Supinator APL EPB EPL EI
  • 28. Superficial extensors ECU EDM ED
  • 29.
  • 30.
  • 32. Thenar & Hypothenar muscles Adductor pollicis Opponens digiti minimi Flexor Pollicis Brevis Flexor digiti minimi Opponens pollicis Abductor digiti minimi Abductor pollicis brevis
  • 33. Radial nerve • Major nerve of the Posterior cord • C5,C6,C7,C8,T1 • Supplies – Triceps – Anconeus – Brachialis (lat) – Brachioradialis – Ex Carpi Rad Long • At the LHE bifurcates – Deep interosseous – Superficial Rad nerve
  • 34. Ulna nerve • Terminal Branch of the medial cord • C7,C8,T1 • Supplies – Some wrist flexors – Flex Digit Prof – Flex Carpi Ulnaris
  • 35. Median nerve • Arises from – Lateral Cord C5,C6,C7 – Medial Cord C8, T1 • Supplies – Wrist Flexors – Thenar muscles Carpal tunnel