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Elbow

life science Maturity 9-11 Next article →

The elbow is the complex region located between the upper arm and the forearm. It surrounds the elbow joint, which allows the forearm and hand to move toward or away from the body. While the term "elbow" is specifically used for humans and other primates, other vertebrates possess a similar structure called a forelimb joint. The anatomy of this area is vital for many daily movements. It includes several prominent landmarks like the olecranon and the cubital fossa, which is the elbow pit.

Coude fp
Coude fp

The elbow joint functions through the interaction of three distinct bones. The humerus is the bone of the upper arm. The radius and the ulna are the two bones of the forearm. These bones meet at three different points to create a complex system of movement. First, the humeroulnar joint connects the trochlea of the humerus to the trochlear notch of the ulna. This is a simple hinge joint that allows for flexion and extension. Second, the humeroradial joint connects the capitulum of the humerus to the head of the radius. This acts as a ball-and-socket joint. Third, the proximal radioulnar joint connects the head of the radius to the radial notch of the ulna. This allows the radius to rotate, enabling movements known as pronation and supination.

Several bony landmarks define the elbow's shape. At the bottom of the humerus are the medial and lateral epicondyles. The medial epicondyle is on the side closest to the body, while the lateral epicondyle is on the side away from it. The olecranon is found at the head of the ulna. When the elbow is flexed, these three points form a shape called the Hueter triangle. In most people, the humerus has a groove on the trochlea that spirals on the posterior side. This creates a carrying angle, where the forearm forms an angle to the upper arm during extension.

To keep the joint stable, a fibrous joint capsule encloses the entire area. This capsule is strengthened by ligaments on the sides. The ulnar collateral ligament is located on the medial side. It has an anterior band, a posterior band, and a thinner intermediate part. The ulnar nerve actually crosses this intermediate part. On the other side, the radial collateral ligament attaches to the lateral epicondyle. Inside the capsule, a synovial membrane provides lubrication. This membrane is very extensive and covers many parts of the bones. It even includes folds called plicae, which are remnants of embryonic development.

X-ray of ventral dislocation of the radial head with calcification of annular ligament
X-ray of ventral dislocation of the radial head with calcification of annular ligament

Muscles act as the engines for elbow movement. To perform flexion, or bending the arm, three main muscles work together. The brachialis acts exclusively as an elbow flexor. The brachioradialis helps with flexion and also aids in rotation. The biceps brachii is a major flexor that also helps stabilize the shoulder. For extension, or straightening the arm, the triceps brachii is the primary muscle. The triceps originates on the humerus and the scapula and inserts onto the olecranon. These muscles have different levels of efficiency depending on the angle of the joint. For example, the biceps is most efficient when the elbow is at 80 to 90 degrees.

Blood and nerves are essential for the elbow's health. The joint receives blood from an extensive circulatory anastomosis. This is a network where different arteries, like the brachial and ulnar arteries, connect to one another. Lymphatic drainage occurs through two sets of nodes located above the medial epicondyle. These are the deep and superficial cubital nodes. The nerves that provide sensation and movement control include the musculocutaneous, median, radial, and ulnar nerves. This complex network ensures the muscles and tissues receive necessary nutrients and signals.

The elbow undergoes a specific developmental process during childhood. Small centers of bone, called apophyseal growth centers, appear in a predictable order. Doctors use the mnemonic CRITOE to remember this sequence: capitellum, radial head, internal epicondyle, trochlea, olecranon, and external epicondyle. These centers appear at ages 1, 3, 5, 7, 9, and 11. Later, during adolescence, these centers fuse together into solid bone. Understanding this timeline is crucial for doctors. It helps them distinguish between normal growth and a traumatic fracture in pediatric patients.

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File:Coude fp.PNG
Coude fp.PNG
File:X-ray of ventral dislocation of the radial head with calcification of annular ligament.jpg
X-ray of ventral dislocation of the...
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