elbow is the visible connection between the top and bottom of the arm. These include famous landmarks such as olecranon, elbow hole, epicondilateral lateral and medial, and elbow joint . The elbow joint is a synovial hinge joint between the humerus in the upper arm and the fingers and ulna in the forearm that allows the forearm and hand to move in the direction and away from the body.
This elbow is specific to humans and other primates.
The name for the elbow in Latin is cubitus , so the word cubital is used in terms of elbow-related terms, as in cubital nodes for examples.
Video Elbow
Struktur
Bersama
The elbow joint has three distinct sections surrounded by a common joint capsule. It is a connection between three elbow bones, the upper arm's humerus, and the radius and the forearm ulna.
When in anatomical position there are four main elbow bone markers. At the bottom of the humerus are the medial and lateral epicondyle, on the side closest to the body (medial) and on the far side of the body surface (lateral). The third marker is the olecranon found in the ulna's head. It lies on a horizontal line called the Hueter line . When the elbows are folded, they form an equilateral triangle called Hueter Triangle .
On the surface of the humerus where it faces the joint is the trochlea. The path that runs across the troklea is, in most people, vertical on the anterior side but spirals out on the posterior side. This causes the forearm to be aligned with the upper arm during flexion, but forms an angle to the upper arm during extension - an angle known as the carrier angle.
The radioulnar superior joint shares the joint capsule with the elbow joint but does not play a functional role on the elbow.
Joints capsule
The elbow joint and radioulnar superior joint are covered by a single fibrous capsule. Capsules are reinforced by ligaments on the sides but relatively weak in front and back.
On the anterior side of the capsule consists mainly of longitudinal fibers. However, some of the bundles between the fibers are tilted, thickening and strengthening the capsule, and are referred to as the capsular ligament. The inner fiber of the brachial muscle inserts anteriorly into the capsule and acts to pull it and the underlying membrane during flexion to prevent them from being squeezed.
On the posterior side the capsule is thin and mainly consists of transverse fibers. Some of these fibers extend in the olecranon fossa without being attached to it and form a transverse band with a free upper limit. On the ulnar side, the capsule reaches into the posterior portion of the annular ligament. The posterior capsule attaches to the triceps tendon which prevents the capsule from being squashed during the extension.
synovial membrane
The synovial membrane of the elbow joint is very wide. In the humerus, it extends from articular margins and covers the coronoid and anterior radial fossa and posterior olecranon fossa. Separately, it is extended to the neck radius and radioulnar superior joints. This is supported by the squared ligament under the annular ligament where it also forms a fold that gives the head the freedom of the motion of the fingers.
Some synovial folds into the joint niches. These folds or plicae are the rest of normal embryonic development and can be categorized as anterior (anterior humeral recess) or posterior (olecranon recess). A crescent-shaped fold is usually between the head of the fingers and the humeral capitula.
In the humerus there are extracinoviral fat pads adjacent to three articular fossa. This bearing fills the radial fossa and anterior coronoid during elongation, and the posterior olecranon fossa during flexion. They evacuate when the fossa is occupied by the projection of the ulna bone and the fingers.
Ligaments
Elbows, like other joints, have ligaments on either side. This is a triangular band that integrates with a joint capsule. They are positioned so that they are always on the axis of the transverse joint and therefore, always relatively tense and impose strict restrictions on abduction, adduction, and axial rotation at the elbow.
The ulnar collateral ligament has its peak in the medial epicondyle. The anterior band extends from the anterior side of the medial epicondyle to the medial edge of the coronoid process, while the posterior band extends from the posterior side of the medial epicondyle to the medial side of olecranon. The two bands are separated by a thinner transition section and the distal portion is united by the transverse bands below which the synovial membrane protrudes during joint movement. The anterior band is closely related to the tendons of the flexor superficial muscles of the forearm, even the origin of the superficial flexor digitorum. The ulnar nerve crosses the transition when entering the forearm.
Lateral radial bonds are attached to the lateral epicondyle below the general extensor tendon. Less different from the ulnar collateral ligament, this ligament merges with the annular ligaments of the fingers and the margins are attached near the radial notch of the ulna.
Muscle
Extensions
Elbow extension only brings the forearm back to the anatomical position. This action is done by triceps brachii with the help of the neglected of the anconeus. Triceps originate with two posterior heads on the humerus and with long heads on the shoulder blades just below the shoulder joint. It is posteriorly inserted on the olecranon.
Triceps are maximally efficient with 20-30 Â ° flexed elbows. As the angle of flexion increases, the olecranon position approaches the major axis of the humerus which decreases muscle efficiency. In full flexion, however, the triceps tendon is "coiled" on the olecranon as in a pulley that compensates for loss of efficiency. Because the long head of the triceps is biarticular (acting on two joints), its efficiency also depends on the shoulder position.
Extensions are limited by the olecranon reaching the olecranon fossa, the tension in the anterior ligament, and the resistance to the flexor muscle. The resulting extension is imposed in a rupture in one of the limiting structures: olecranon fracture, torn capsule and ligaments, and, although the muscles are usually unaffected, bruised arteries are bruised.
Blood supply
The artery supplying the joints originates from a wide circulation anastomosis between the brachial artery and its terminal branch. The superior and inferior ulnar collateral branches of the brachial artery and the radial and central collateral branches of the deep brachial artery descend from above to reconnect to the joint capsule, where they are also connected to the ulnar border of the anterior and posterior ulnar arteries; radial branch of the radial artery; and the interosseous recurrent branch of the common interosseous artery.
The blood is brought back by blood vessels from the radial, ulnar, and brachial veins. There are two sets of lymph nodes at the elbow, usually located above the medial epicondyle - deep and superficial cubic glands (also called epitrochlear nodes). Lymphatic drainage of the elbow is through the deep nodes in the brachial artery bifurcation, superficial nodes depleting the forearm and the ulnar hand side. The efferent lymph vessels from the elbow continue into the lateral group of axillary lymph nodes.
Supply of nerves
The elbows are inserted anteriorly by the branches of the musculocutaneous, median, and radial, and posterior nerves of the ulnar nerve and the radial nerve branches to the anconeus.
Development
Elbows have a dynamic development of hardening centers through infancy and adolescence, in the order of both appearance and fusion of apophyseal growth centers that are important in the assessment of pediatric elbow on radiography, to distinguish traumatic fractures or apophyseal separation from normal. development. The order of appearance can be understood by mnemonic CRITOE, referring to the capitellum, radial head, internal epicondyle, trochlea, olecranon, and external epicondyle at ages 1, 3, 5, 7, 9 and 11 years. These apophyseal centers then converge during adolescence, with internal epicondyle and olecranon converging last. Fusion age is more varied than ossification, but usually occurs at 13, 15, 17, 13, 16 and 13 years, respectively. In addition, the presence of joint effusion may be inferred by the presence of a fat pad sign, a structure usually present physiologically, but pathologically when elevated by fluid, and always pathologically when posterior.
Maps Elbow
Function
The function of the elbow joint is to extend and flex the arm grip and grab the objects. The range of motion at the elbow is from 0 degrees elbow extension to 150 from elbow flexion. The muscles that contribute to the function are all flexed (biceps brachii, brachialis, and brachioradialis) and extension muscles (triceps and anconeus).
In humans, the main task of the elbow is to place the hands in space by shortening and lengthening the upper limb. While the superior radioulnar joint shares the joint capsule with the elbow joint, it does not play a functional role on the elbow.
With the elbow extended, the long axis of the humerus and the ulna coincide. At the same time, the articular surface of both bones is located in front of the axis and deviates from them at an angle of 45 °. In addition, the forearm muscles derived from the elbows are grouped on the sides of the joint so as not to interfere with movement. The wide angle of flexion on the elbow is made possible by this arrangement - almost 180 ° - allowing bones to be carried almost in parallel with each other.
Carrying angle
When the arm is extended, with the palms facing forward or upward, the upper arm bone (humerus) and the forearm (radius and ulna) are not perfectly aligned. The deviation from a straight line occurs toward the thumb, and is referred to as "carrying angle" (shown on the right side of the image, right).
The carrying angle allows the arm to be swung without contacting the hip. The average woman has smaller shoulders and hips that are wider than men, which tend to produce larger carrier angles (ie, deviations larger than straight lines than in men). There is, however, a wide overlap in the carrier angle between individual men and women, and sex bias has not been consistently observed in scientific studies. This however can be attributed to a very small sample size in the previously cited study. A more recent study based on a sample size of 333 people of both sexes concluded that bringing angles was a suitable secondary sexual characteristic.
The angle is greater in the dominant extremity than the non-dominant limb of both sexes, indicating that the natural forces acting on the elbows modify the carrier angle. The development, aging and possible racial influences add to the variability of these parameters.
Pathology
The type of disease most commonly seen on the elbow is due to injury.
Tendonitis
The two most common injuries to the elbow are excessive injury: tennis elbow and golfer's elbow. The golfer's elbow involves a common flexor tendon originating from the medullary epicondyle of the humerus (the "inner" part of the elbow). Tennis elbow is an equivalent injury, but at the origin of general extensor (lateral epicondyle of the humerus).
Fracture
There are three bones in the elbow joint, and any combination of these bones may be involved in an elbow fracture. Patients who are able to fully extend their arms at the elbow may not have fractures (98% certainty) and X-rays are not required as long as olecranon fractures are ruled out. Acute fractures may not be readily apparent on X-rays.
Dislocation
Elbow dislocations represent 10% to 25% of all elbow injuries. Elbow is one of the most common dislocation joints in the body, with an average annual incidence of acute dislocation 6 per 100,000 people. Among injuries to the upper limb, the elbow dislocation is the second after the dislocated shoulder. A full dislocation of the elbow will require expert medical attention to align again, and recovery may take about 8-14 weeks. A small number of people (10% or less) report near full recovery and minimal permanent restrictions, but a 5-15% permanent restriction of movement is common.
Infection
Elbow joint infections (septic arthritis) are rare. This may occur spontaneously, but may also occur in relation to surgery or infection elsewhere in the body (eg, endocarditis).
Arthritis
Arthritis of the elbow is usually seen in individuals with rheumatoid arthritis or after a fracture involving the joint itself. When severe joint damage, arthroplasty fascia or elbow joint replacement may be considered.
Bursitis
Olecranon bursitis, pain in the posterior part of the elbow, tenderness, warmth, swelling, pain in both flexion and extension, in extreme cases extreme painful flexion
Pain management for common problems in radioulnar and elbow joints
Elbow pain can occur for many reasons, including injury, illness, and other conditions. Common conditions include tennis elbow, golfer's elbow, distal joint rheumatoid arthritis, and cubital tunnel syndrome.
Tennis elbow
Tennis elbow is a very common type of superficial injury. This can happen both from chronic repeated movements of the hands and forearms, and from trauma to the same area. This repetition can injure the tendon that connects the supinator extensor muscle (which rotates and extends the forearm) to the olecranon process (also known as the "elbow"). Pain occurs, often radiating from the lateral forearm. Weakness, numbness, and stiffness are also very common, along with tenderness to the touch. Non-invasive treatment for pain management is rest. If reaching rest is a problem, a wrist clip can also be worn. This keeps the wrist bent, thereby reducing the extensor muscles and allowing rest. Ice, heat, ultrasound, steroid injections, and compression can also help relieve pain. Once the pain has been reduced, exercise therapy is important to prevent future injuries. Exercise should be low speed, and weight should increase progressively. Stretching flexors and extensors is helpful, as are strengthening exercises. Massage can also be useful, focusing on extensor trigger points.
Golfer's elbow
Elbow Golfer is very similar to tennis elbow, but less common. This is due to excessive and repetitive movements such as a golf swing. It can also be caused by trauma. Flexible wrists and pronation (twisting the forearm) cause irritation of the tendon near the medial epicondyle of the elbow. May cause pain, stiffness, loss of sensation, and weakness radiating from the inside of the elbow to the fingers. Rest is the main intervention for this injury. Ice, painkillers, steroid injections, strengthening exercises, and avoiding aggravating activities can also help. Surgery is the last option, and rarely used. Exercises should focus on strengthening and stretching the forearm, and utilizing the right shape while performing the movement.
Rheumatoid joint joint joints distal (DRUJ)
Rheumatoid arthritis is a chronic disease that attacks the joints. This is very common in the wrist, and most commonly occurs in radioulnar joints. It produces pain, stiffness, and disability. There are many different treatments for rheumatoid arthritis, and there is no consensus on which method is best. The most common treatments include wrist splints, surgery, physical and occupational therapy, and antirheumatic drugs.
cubital tunnel syndrome
Cubital tunnel syndrome, better known as ulnar neuropathy, occurs when the ulnar nerve is irritated and becomes inflamed. This can often happen where the ulnar nerve is most shallow, at the elbow. The ulnar nerve passes through the elbow, in an area known as "funny bone". Irritation can occur due to constant repeated pressure and pressure in this area, or from trauma. It can also occur due to bone deformities, and often from sports. Symptoms include tingling, numbness, and weakness, along with pain. First-line pain management techniques include the use of nonsteroidal anti-inflammatory oral medications. It helps reduce inflammation, pressure, and irritation of the nerves and around the nerves. Other simple improvements include learning more ergonomically-friendly habits that can help prevent future neurological and irritant wounds. Protective equipment can also be very helpful. Examples include elbow brace pads, and splint arms. More serious cases often involve surgery, where the nerves or surrounding tissues are removed to reduce the pressure. Recovery from surgery can be time consuming, but the prognosis is often good. Recovery often includes movement restrictions, and various motion activities, and may last several months (cubital and radial tunnel syndrome, 2).
Society and culture
Now a long obsolete unit is closely related to the elbow. This becomes especially noticeable when considering the German origins of both words, Elle (ell, defined as the length of the male arm from the elbow to the fingertips) and Elbbogen (elbow). It is not known when or why the second "l" is removed from English usage of the word. The ell as in English size can also be taken from the letter L, which is bent at the right angle, as the elbow. Elas as a measure taken as six handbreadths; three to elbows and three from elbow to shoulder. The other size is pinch (from
Other primates
Although the elbows are equally adapted for stability through various supine-supination and extension-flexion in all apes, there are some minor differences. In arboreal apes such as orangutans, large forearm muscles derived from the humeral epicles of the humerus produce significant transverse forces in the elbow joint. The structure to withstand this force is the keel that is pronounced on the trochlear notch in the ulna, which is flatter, for example, humans and gorillas. In the knuckle-walker, on the other hand, the elbow has to deal with a large vertical load that passes through the long arm and therefore the joint is further extended to give the larger articular surface perpendicular to those forces.
The traits derived on the catarrhini elbows (ape and Old World monkeys) include loss of the entepicondylar foramen (hole in the distal humerus), the non-translatory humeroulnar joint (rotation-only), and the stronger ulna with a shorter trochlear indentation..
The proximal radioulnar joint is also lowered to the higher primates at the site and the radial notch shape on the ulna; primitive shapes represented by New World monkeys, such as howler monkeys, and by fossil catarrhines, such as Aegyptopithecus . In this taxa, the oval head of the radius is located in front of the ulnar axis so that the former overlaps the latter by half its width. With this forearm configuration, the ulna supports the radius and maximum stability is achieved when the forearm is fully pronated.
Note
References
Source of the article : Wikipedia
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