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ELBOW中文(简体)翻译:剑桥词典
ELBOW中文(简体)翻译:剑桥词典
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elbow 在英语-中文(简体)词典中的翻译
elbownoun [ C ] uk
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/ˈel.bəʊ/ us
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/ˈel.boʊ/
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B1 the part in the middle of the arm where it bends, or the part of a piece of clothing that covers this area
肘;(衣服的)肘部
Her arm was bandaged from the elbow to the fingers.
她的胳膊从肘部一直到手指全缠上了绷带。
The sleeve of his shirt was torn at the elbow.
他的衬衫的肘部被撕了个口子。
更多范例减少例句I banged my elbow on the shelf.My elbow is still stiff after my fall.
习语
at someone's elbow
give someone the elbow
elbowverb [ T usually + adv/prep ] uk
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/ˈel.bəʊ/ us
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/ˈel.boʊ/
disapproving to push someone rudely with your elbows so that you can move or have more space
用肘推;用肘挤开
He elbowed his way to the front of the crowd.
他挤到了人群的前边。
They elbowed the onlookers aside.
他们把旁观者推到一边。
to hit someone with your elbow, sometimes as a sign to make them notice or remember something
(为让某人注意或提醒某事而)用肘碰
She elbowed me in the ribs before I could say anything.
我还没开口呢,她就用胳膊肘在我肋部碰了一下。
短语动词
elbow someone out
(elbow在剑桥英语-中文(简体)词典的翻译 © Cambridge University Press)
elbow的例句
elbow
There is the same pace of argument, the same stylish footwork, the same skilful use of the elbows.
来自 Cambridge English Corpus
The police did not sit on their elbows then.
来自 Hansard archive
该例句来自Hansard存档。包含以下议会许可信息开放议会许可v3.0
Players can use fists, elbows and knees to disable their opponents.
来自 Wikipedia
该例句来自维基百科,在CC BY-SA许可下可重复使用。
In striving to climb the perilous ascent, they seemed to have got their elbows on the ledge.
来自 Hansard archive
该例句来自Hansard存档。包含以下议会许可信息开放议会许可v3.0
The lesions typically develop on the fingers, hands, knees, and elbows, a result of exposure of the wounds at these sites to the bacteria in water.
来自 Cambridge English Corpus
If a left-handed child is seated on the right of a right-handed child, there are frequent clashes of elbows.
来自 Hansard archive
该例句来自Hansard存档。包含以下议会许可信息开放议会许可v3.0
We do not believe that their elbows should be jogged as they do that work.
来自 Hansard archive
该例句来自Hansard存档。包含以下议会许可信息开放议会许可v3.0
She has the ability to fire freezing blasts from her elbows.
来自 Wikipedia
该例句来自维基百科,在CC BY-SA许可下可重复使用。
示例中的观点不代表剑桥词典编辑、剑桥大学出版社和其许可证颁发者的观点。
B1
elbow的翻译
中文(繁体)
肘, (衣服的)肘部, 用肘推…
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西班牙语
codo, dar un codazo a, abrirse paso a codazos…
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葡萄牙语
cotovelo, dar uma cotovelada em, cotovelo [masculine]…
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ひじ, (人)をひじで押し分ける…
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dirsek, dirsek vurmak, dirsekleyerek yol açmak…
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coude [masculine], coude, jouer des coudes…
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colze, donar un cop de colze a, obrir-se camí a cops de colze…
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elleboog, zich een weg banen…
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கையின் நடுவே உள்ள பகுதி அது விளையக்கூடியது, அல்லது இந்த பகுதியை மறைக்கும் ஆடையின் ஒரு பகுதி…
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कोहनी…
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કોણી…
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albue, skubbe…
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armbåge, armbåga sig fram…
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siku, mengasak-asak…
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der Ellbogen, mit den Ellbogen drängen…
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albue [masculine], albue, bruke albuene…
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کہنی…
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лікоть, штовхати ліктем…
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локоть, толкать локтем, проталкиваться…
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మోచేయి, చేయి మధ్యలో అది వంగి ఉన్న భాగం లేదా ఈ ప్రాంతాన్ని కప్పి ఉంచే వస్త్రం యొక్క భాగం…
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مِرْفَق, كوع, يَدفَع بِالمِرفَق…
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কনুই…
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loket, razit si…
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siku, menyiku…
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ศอก, .ใช้ศอกดัน…
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khuỷu tay, huých khủy tay…
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łokieć, rozpychać, przepychać się (łokciami)…
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팔꿈치, 팔꿈치로 밀치다…
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gomito, dare gomitate, farsi largo a gomitate…
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elbow的发音是什么?
在英语词典中查看 elbow 的释义
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elasticized
Elastoplast
elated
elation
elbow
elbow bump
elbow grease
elbow room
elbow someone out
elbow更多的中文(简体)翻译
全部
elbow bump
elbow room
elbow grease
tennis elbow
elbow someone out
at someone's elbow idiom
give someone the elbow idiom
查看全部意思»
词组动词
elbow someone out
查看全部动词词组意思»
惯用语
at someone's elbow idiom
give someone the elbow idiom
more power to your elbow! idiom
not know your arse from your elbow idiom
查看全部惯用语意思»
“每日一词”
response
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/rɪˈspɒns/
US
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/rɪˈspɑːns/
an answer or reaction
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Forget doing it or forget to do it? Avoiding common mistakes with verb patterns (2)
March 06, 2024
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inverse vaccine
March 11, 2024
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elbow是什么意思_elbow的翻译_音标_读音_用法_例句_爱词霸在线词典
w是什么意思_elbow的翻译_音标_读音_用法_例句_爱词霸在线词典首页翻译背单词写作校对词霸下载用户反馈专栏平台登录elbow是什么意思_elbow用英语怎么说_elbow的翻译_elbow翻译成_elbow的中文意思_elbow怎么读,elbow的读音,elbow的用法,elbow的例句翻译人工翻译试试人工翻译翻译全文简明柯林斯牛津elbowCET4/CET6/考研/GRE/TOEFL/IELTS英 [ˈelbəʊ]美 [ˈelboʊ]释义n.肘(部); 弯处v.用肘推挤; 挤掉大小写变形:Elbow点击 人工翻译,了解更多 人工释义词态变化复数: elbows;第三人称单数: elbows;过去式: elbowed;过去分词: elbowed;现在分词: elbowing;实用场景例句全部肘部弯头扶手弯管用肘推挤用手肘推开She jabbed him with her elbow.她用胳膊肘捅他。牛津词典He's fractured his elbow.他肘部骨折。牛津词典The jacket was worn at the elbows.这件夹克衫的肘部磨破了。牛津词典She elbowed me out of the way to get to the front of the line.她用肘部把我推开朝队伍前面挤。牛津词典He elbowed his way through the crowd.他用手肘从人群中挤了过去。牛津词典Environmental concerns will elbow their way right to the top of the agenda.环境问题将挤到议事日程之首。柯林斯高阶英语词典Non-state firms gradually elbow aside the inefficient state-owned ones...非国有企业逐渐挤掉了效率低下的国有企业。柯林斯高阶英语词典Mr Smith elbowed me in the face...史密斯先生一肘撞在我脸上。柯林斯高阶英语词典He slipped and fell, badly bruising an elbow.他滑倒了,一只胳膊肘严重擦伤。柯林斯高阶英语词典They also claim that the security team elbowed aside a steward...他们还声称保安人员将一位乘务员推搡至一边。柯林斯高阶英语词典Don't hyperextend your elbow.别过分拉伸你的胳膊肘.期刊摘选I've worn through the elbow of this old coat at last.最后我把这件旧外套的肘部磨出了窟窿.《简明英汉词典》Elbow pads and knee pads are essential on a skateboard.滑滑板时带护肘和护膝是必要的.《简明英汉词典》She was cradling a small parcel in the crook of her elbow.她用手臂挎着一个小包裹.《简明英汉词典》The wounded soldier levered himself up on his elbow and shouted for help.那个伤兵用胳膊支起身子,大声呼救.《简明英汉词典》His elbow poked out through his torn shirt sleeve.他的胳膊从衬衫的破袖子中露了出来.《简明英汉词典》The ambulancemen had to elbow their way through the huge crowd standing round the crashed cars.救援人员不得不从围着撞坏的汽车的人群中挤过去.《简明英汉词典》He had a patch on the elbow of his jacket.他的上衣肘部有一块补丁.《简明英汉词典》He jabbed his elbow into my side.他用肘猛戳我的腰部.《现代汉英综合大词典》He raised himself on one elbow and looked at the bedside clock.他用一只胳膊肘撑起来看了看床边的钟.《简明英汉词典》Keep the dictionary at your elbow so you can use it for reference anytime.把这本字典留在你手边,以便随时可以参考.《简明英汉词典》Don't elbow me off the sideway.别把我挤出人行道外.《简明英汉词典》When you bend your elbow, you contract the muscles of the arm.你屈肘时, 手臂的肌肉就会收缩.《简明英汉词典》She jabbed him with her elbow.她用胳膊肘捅他。《牛津高阶英汉双解词典》She poked him in the ribs with her elbow.她用胳膊肘顶他的肋部。《牛津高阶英汉双解词典》When you are sitting, keep your elbow on the arm rest.坐立时,把胳膊肘靠在扶手上。柯林斯例句There was not much elbow room in the cockpit of a Snipe.“沙锥鸟”战斗机的驾驶舱空间不太宽敞。柯林斯例句He lay beside her awkwardly, propped on an elbow.他用一只胳膊肘支着身体,别扭地躺在她旁边。柯林斯例句Surgeons saved a man's arm after it was hacked off at the elbow.一位男子的手臂从肘部被砍下,经外科医生实施手术后得以保住了手臂。柯林斯例句收起实用场景例句英英释义Noun1. hinge joint between the forearm and upper arm and the corresponding joint in the forelimb of a quadruped2. a sharp bend in a road or river3. a length of pipe with a sharp bend in it4. the part of a sleeve that covers the elbow;"his coat had patches over the elbows"5. the joint of a mammal or bird that corresponds to the human elbowVerb1. push one's way with the elbows2. shove one's elbow into another person's ribs收起英英释义词组搭配at one's elbowclose at hand; nearby在手头;在附近elbow-to-elbowvery close together摩肩接踵地,紧挨着give someone the elbow(informal)reject or dismiss someone in a rough, almost contemptuous manner(非正式)对…弃之不顾,抛开,排斥I tried to get her to give him the elbow.我试图让她抛开他。she decided to give tradition the elbow.她决定抛开传统。up to one's elbows in(informal)with one's hands plunged in (something)(非正式)手深陷于某物之中I was up to my elbows in the cheese-potato mixture.我的手深陷在奶酪土豆泥里。at (one's) elbowClose at hand; nearby.在手边;在附近out at the elbowsPoorly dressed.穿得破破烂烂的Lacking money.捉襟见肘:缺少资金的收起词组搭配同义词v.用肘推shovejostlepushshoulderbulldozehustlebumpn.肘rightanglebend行业词典体育网球肘 用肘顶人 用肘挤人 用肘撞人 医学肘:臂的弯曲部 连接臂和前臂的关节,又称cubitus 〔NA〕 肘状物:任何弯曲物 解剖学肘,又称:肘(Cubitus(拉)) 释义词态变化实用场景例句英英释义词组搭配同义词行ELBOW中文(繁體)翻譯:劍橋詞典
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elbow 在英語-中文(繁體)詞典中的翻譯
elbownoun [ C ] uk
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/ˈel.bəʊ/ us
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/ˈel.boʊ/
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B1 the part in the middle of the arm where it bends, or the part of a piece of clothing that covers this area
肘;(衣服的)肘部
Her arm was bandaged from the elbow to the fingers.
她的手臂從肘部一直到手指全部纏上了繃帶。
The sleeve of his shirt was torn at the elbow.
他襯衫的肘部被撕了個洞。
更多範例减少例句I banged my elbow on the shelf.My elbow is still stiff after my fall.
習語
at someone's elbow
give someone the elbow
elbowverb [ T usually + adv/prep ] uk
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/ˈel.bəʊ/ us
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/ˈel.boʊ/
disapproving to push someone rudely with your elbows so that you can move or have more space
用肘推;用肘擠開
He elbowed his way to the front of the crowd.
他擠到了人群的前面。
They elbowed the onlookers aside.
他們把旁觀者推到一邊。
to hit someone with your elbow, sometimes as a sign to make them notice or remember something
(爲讓某人注意或提醒某事而)用肘碰
She elbowed me in the ribs before I could say anything.
我還沒開口呢,她就用肘在我肋部碰了一下。
片語動詞
elbow someone out
(elbow在劍橋英語-中文(繁體)詞典的翻譯 © Cambridge University Press)
elbow的例句
elbow
He was then tied up with a stick through his elbows and under his legs and his hands were handcuffed behind his neck.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
Weidman, however, controlled the top position for the remainder of the round and landed punches and elbows.
來自 Wikipedia
該例句來自維基百科,在CC BY-SA許可下可重複使用。
Whether we like it or not, the world is very much smaller, and we are up against each other's elbows as neighbours and as people.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
We should give greater strength to the elbows of the moderates in the student movements.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
Familial dysbetalipoproteinemia causes larger, tuberous xanthomas; these are red or orange and occur on the elbows and knees.
來自 Wikipedia
該例句來自維基百科,在CC BY-SA許可下可重複使用。
I say more power to their elbows if they will make and can sell more goods —the credits are awaiting use for legitimate borrowers.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
There is the same pace of argument, the same stylish footwork, the same skilful use of the elbows.
來自 Cambridge English Corpus
We do not grudge anyone a full share of the sunshine, but it is due to ourselves to see that we are not elbowed ruthlessly into the shade.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
示例中的觀點不代表劍橋詞典編輯、劍橋大學出版社和其許可證頒發者的觀點。
B1
elbow的翻譯
中文(簡體)
肘, (衣服的)肘部, 用肘推…
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codo, dar un codazo a, abrirse paso a codazos…
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cotovelo, dar uma cotovelada em, cotovelo [masculine]…
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der Ellbogen, mit den Ellbogen drängen…
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albue [masculine], albue, bruke albuene…
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کہنی…
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лікоть, штовхати ліктем…
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локоть, толкать локтем, проталкиваться…
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మోచేయి, చేయి మధ్యలో అది వంగి ఉన్న భాగం లేదా ఈ ప్రాంతాన్ని కప్పి ఉంచే వస్త్రం యొక్క భాగం…
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loket, razit si…
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ศอก, .ใช้ศอกดัน…
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khuỷu tay, huých khủy tay…
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łokieć, rozpychać, przepychać się (łokciami)…
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gomito, dare gomitate, farsi largo a gomitate…
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elbow的發音是什麼?
在英語詞典中查看 elbow 的釋義
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elasticized
Elastoplast
elated
elation
elbow
elbow bump
elbow grease
elbow room
elbow someone out
elbow更多的中文(繁體)翻譯
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elbow bump
elbow room
elbow grease
tennis elbow
elbow someone out
at someone's elbow idiom
give someone the elbow idiom
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片語動詞
elbow someone out
查看全部動詞片語意思»
慣用語
at someone's elbow idiom
give someone the elbow idiom
more power to your elbow! idiom
not know your arse from your elbow idiom
查看全部慣用語意思»
「每日一詞」
response
UK
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/rɪˈspɒns/
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/rɪˈspɑːns/
an answer or reaction
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Forget doing it or forget to do it? Avoiding common mistakes with verb patterns (2)
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Elbow - Wikipedia
Elbow - Wikipedia
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(Top)
1Structure
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1.1Joint
1.1.1Joint capsule
1.1.2Synovial membrane
1.1.3Ligaments
1.2Muscles
1.2.1Flexion
1.2.2Extension
1.3Blood supply
1.4Nerve supply
1.5Development
2Function
Toggle Function subsection
2.1Carrying angle
3Pathology
Toggle Pathology subsection
3.1Tendonitis
3.2Fractures
3.3Dislocation
3.4Infection
3.5Arthritis
3.6Bursitis
3.7Elbow pain
4Clinical significance
Toggle Clinical significance subsection
4.1Tennis elbow
4.2Golfer's elbow
4.3Rheumatoid arthritis
4.4Cubital tunnel syndrome
5Society and culture
6Other primates
7Notes
8References
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Elbow
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From Wikipedia, the free encyclopedia
Joint between the upper and lower parts of the arm
For other uses, see Elbow (disambiguation).
ElbowHuman elbowElbow jointDetailsIdentifiersLatinarticulatio cubitiMeSHD004550TA98A01.1.00.023TA2145FMA24901Anatomical terminology[edit on Wikidata]
The elbow is the region between the upper arm and the forearm that surrounds the elbow joint.[1] The elbow includes prominent landmarks such as the olecranon, the cubital fossa (also called the chelidon, or the elbow pit), and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm;[2] more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body.[3][4]
The term elbow is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used.[1]
The name for the elbow in Latin is cubitus, and so the word cubital is used in some elbow-related terms, as in cubital nodes for example.
Structure[edit]
Joint[edit]
The elbow joint has three different portions surrounded by a common joint capsule. These are joints between the three bones of the elbow, the humerus of the upper arm, and the radius and the ulna of the forearm.
Joint
From
To
Description
Humeroulnar joint
trochlear notch of the ulna
trochlea of humerus
Is a simple hinge-joint, and allows for movements of flexion and extension only.
Humeroradial joint
head of the radius
capitulum of the humerus
Is a ball-and-socket joint.
Proximal radioulnar joint
head of the radius
radial notch of the ulna
In any position of flexion or extension, the radius, carrying the hand with it, can be rotated in it. This movement includes pronation and supination.
When in anatomical position there are four main bony landmarks of the elbow. At the lower part of the humerus are the medial and lateral epicondyles, on the side closest to the body (medial) and on the side away from the body (lateral) surfaces. The third landmark is the olecranon found at the head of the ulna. These lie on a horizontal line called the Hueter line. When the elbow is flexed, they form a triangle called the Hueter triangle, which resembles an equilateral triangle.[5]
Left elbow extended and flexed
At the surface of the humerus where it faces the joint is the trochlea. In most people, the groove running across the trochlea is vertical on the anterior side but it spirals off on the posterior side. This results in the forearm being aligned to the upper arm during flexion, but forming an angle to the upper arm during extension — an angle known as the carrying angle.[6]
The superior radioulnar joint shares the joint capsule with the elbow joint but plays no functional role at the elbow.[7]
Joint capsule[edit]
Capsule of elbow-joint (distended). Anterior and posterior aspects.
The elbow joint and the superior radioulnar joint are enclosed by a single fibrous capsule. The capsule is strengthened by ligaments at the sides but is relatively weak in front and behind.[8]
On the anterior side, the capsule consists mainly of longitudinal fibres. However, some bundles among these fibers run obliquely or transversely, thickening and strengthening the capsule. These bundles are referred to as the capsular ligament. Deep fibres of the brachialis muscle insert anteriorly into the capsule and act to pull it and the underlying membrane during flexion in order to prevent them from being pinched.[8]
On the posterior side, the capsule is thin and mainly composed of transverse fibres. A few of these fibres stretch across the olecranon fossa without attaching to it and form a transverse band with a free upper border. On the ulnar side, the capsule reaches down to the posterior part of the annular ligament. The posterior capsule is attached to the triceps tendon which prevents the capsule from being pinched during extension.[8]
Synovial membrane[edit]
The synovial membrane of the elbow joint is very extensive. On the humerus, it extends up from the articular margins and covers the coronoid and radial fossae anteriorly and the olecranon fossa posteriorly. Distally, it is prolonged down to the neck of the radius and the superior radioulnar joint. It is supported by the quadrate ligament below the annular ligament where it also forms a fold which gives the head of the radius freedom of movement.[8]
Several synovial folds project into the recesses of the joint.[8]
These folds or plicae are remnants of normal embryonic development and can be categorized as either anterior (anterior humeral recess) or posterior (olecranon recess).[9]
A crescent-shaped fold is commonly present between the head of the radius and the capitulum of the humerus.[8]
On the humerus there are extrasynovial fat pads adjacent to the three articular fossae. These pads fill the radial and coronoid fossa anteriorly during extension, and the olecranon fossa posteriorly during flexion. They are displaced when the fossae are occupied by the bony projections of the ulna and radius.[8]
Ligaments[edit]
Left elbow-jointLeft: anterior and ulnar collateral ligamentsRight: posterior and radial collateral ligaments
The elbow, like other joints, has ligaments on either side. These are triangular bands which blend with the joint capsule. They are positioned so that they always lie across the transverse joint axis and are, therefore, always relatively tense and impose strict limitations on abduction, adduction, and axial rotation at the elbow.[8]
The ulnar collateral ligament has its apex on the medial epicondyle. Its anterior band stretches from the anterior side of the medial epicondyle to the medial edge of the coronoid process, while the posterior band stretches from posterior side of the medial epicondyle to the medial side of the olecranon. These two bands are separated by a thinner intermediate part and their distal attachments are united by a transverse band below which the synovial membrane protrudes during joint movements. The anterior band is closely associated with the tendon of the superficial flexor muscles of the forearm, even being the origin of flexor digitorum superficialis. The ulnar nerve crosses the intermediate part as it enters the forearm.[8]
The radial collateral ligament is attached to the lateral epicondyle below the common extensor tendon. Less distinct than the ulnar collateral ligament, this ligament blends with the annular ligament of the radius and its margins are attached near the radial notch of the ulna.[8]
Muscles[edit]
Flexion[edit]
There are three main flexor muscles at the elbow:[10]
Brachialis acts exclusively as an elbow flexor and is one of the few muscles in the human body with a single function. It originates low on the anterior side of the humerus and is inserted into the tuberosity of the ulna.
Brachioradialis acts essentially as an elbow flexor but also supinates during extreme pronation and pronates during extreme supination. It originates at the lateral supracondylar ridge distally on the humerus and is inserted distally on the radius at the styloid process.
Biceps brachii is the main elbow flexor but, as a biarticular muscle, also plays important secondary roles as a stabiliser at the shoulder and as a supinator. It originates on the scapula with two tendons: That of the long head on the supraglenoid tubercle just above the shoulder joint and that of the short head on the coracoid process at the top of the scapula. Its main insertion is at the radial tuberosity on the radius.
Brachialis is the main muscle used when the elbow is flexed slowly. During rapid and forceful flexion all three muscles are brought into action assisted by the superficial forearm flexors originating at the medial side of the elbow.[11]
The efficiency of the flexor muscles increases dramatically as the elbow is brought into midflexion (flexed 90°) — biceps reaches its angle of maximum efficiency at 80–90° and brachialis at 100–110°.[10]
Active flexion is limited to 145° by the contact between the anterior muscles of the upper arm and forearm, more so because they are hardened by contraction during flexion. Passive flexion (forearm is pushed against the upper arm with flexors relaxed) is limited to 160° by the bony projections on the radius and ulna as they reach to shallow depressions on the humerus; i.e. the head of radius being pressed against the radial fossa and the coronoid process being pressed against the coronoid fossa. Passive flexion is further limited by tension in the posterior capsular ligament and in triceps brachii.[12]
A small accessory muscle, so called epitrochleoanconeus muscle, may be found on the medial aspect of the elbow running from the medial epicondyle to the olecranon.[13]
Extension[edit]
Elbow extension is simply bringing the forearm back to anatomical position.[11] This action is performed by triceps brachii with a negligible assistance from anconeus. Triceps originates with two heads posteriorly on the humerus and with its long head on the scapula just below the shoulder joint. It is inserted posteriorly on the olecranon.[10]
Triceps is maximally efficient with the elbow flexed 20–30°. As the angle of flexion increases, the position of the olecranon approaches the main axis of the humerus which decreases muscle efficiency. In full flexion, however, the triceps tendon is "rolled up" on the olecranon as on a pulley which compensates for the loss of efficiency. Because triceps' long head is biarticular (acts on two joints), its efficiency is also dependent on the position of the shoulder.[10]
Extension is limited by the olecranon reaching the olecranon fossa, tension in the anterior ligament, and resistance in flexor muscles. Forced extension results in a rupture in one of the limiting structures: olecranon fracture, torn capsule and ligaments, and, though the muscles are normally left unaffected, a bruised brachial artery.[12]
Blood supply[edit]
The anastomosis and deep veins around the elbow-joint
The arteries supplying the joint are derived from an extensive circulatory anastomosis between the brachial artery and its terminal branches. The superior and inferior ulnar collateral branches of the brachial artery and the radial and middle collateral branches of the profunda brachii artery descend from above to reconnect on the joint capsule, where they also connect with the anterior and posterior ulnar recurrent branches of the ulnar artery; the radial recurrent branch of the radial artery; and the interosseous recurrent branch of the common interosseous artery.[14]
The blood is brought back by vessels from the radial, ulnar, and brachial veins.
There are two sets of lymphatic nodes at the elbow, normally located above the medial epicondyle — the deep and superficial cubital nodes (also called epitrochlear nodes). The lymphatic drainage at the elbow is through the deep nodes at the bifurcation of the brachial artery, the superficial nodes drain the forearm and the ulnar side of the hand. The efferent lymph vessels from the elbow proceed to the lateral group of axillary lymph nodes.[14][15]
Nerve supply[edit]
The elbow is innervated anteriorly by branches from the musculocutaneous, median, and radial nerve, and posteriorly from the ulnar nerve and the branch of the radial nerve to anconeus.[14]
Development[edit]
The elbow undergoes dynamic development of ossification centers through infancy and adolescence, with the order of both the appearance and fusion of the apophyseal growth centers being crucial in assessment of the pediatric elbow on radiograph, in order to distinguish a traumatic fracture or apophyseal separation from normal development. The order of appearance can be understood by the 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 fuse during adolescence, with the internal epicondyle and olecranon fusing last. The ages of fusion are more variable than ossification, but normally occur at 13, 15, 17, 13, 16 and 13 years, respectively.[16] In addition, the presence of a joint effusion can be inferenced by the presence of the fat pad sign, a structure that is normally physiologically present, but pathologic when elevated by fluid, and always pathologic when posterior.[17]
Function[edit]
The function of the elbow joint is to extend and flex the arm.[18] The range of movement in the elbow is from 0 degrees of elbow extension to 150 degrees of elbow flexion.[19] Muscles contributing to function are all flexion (biceps brachii, brachialis, and brachioradialis) and extension muscles (triceps and anconeus).
In humans, the main task of the elbow is to properly place the hand in space by shortening and lengthening the upper limb. While the superior radioulnar joint shares joint capsule with the elbow joint, it plays no functional role at the elbow.[7]
With the elbow extended, the long axis of the humerus and that of the ulna coincide.[20] At the same time, the articular surfaces on both bones are located in front of those axes and deviate from them at an angle of 45°.[21] Additionally, the forearm muscles that originate at the elbow are grouped at the sides of the joint in order not to interfere with its movement. The wide angle of flexion at the elbow made possible by this arrangement — almost 180° — allows the bones to be brought almost in parallel to each other.[7]
Carrying angle[edit]
Normal radiograph; right picture of the straightened arm shows the carrying angle of the elbow
When the arm is extended, with the palm facing forward or up, the bones of the upper arm (humerus) and forearm (radius and ulna) are not perfectly aligned. The deviation from a straight line occurs in the direction of the thumb, and is referred to as the "carrying angle".[22]
The carrying angle permits the arm to be swung without contacting the hips. Women on average have smaller shoulders and wider hips than men, which tends to produce a larger carrying angle (i.e., larger deviation from a straight line than that in men). There is, however, extensive overlap in the carrying angle between individual men and women, and a sex-bias has not been consistently observed in scientific studies.[23]
The angle is greater in the dominant limb than the non-dominant limb of both sexes,[24] suggesting that natural forces acting on the elbow modify the carrying angle. Developmental,[25] aging and possibly racial influences add further to the variability of this parameter.
Pathology[edit]
Left: Lateral X ray of a dislocated right elbowRight: AP X ray of a dislocated right elbow
The types of disease most commonly seen at the elbow are due to injury.
Tendonitis[edit]
Two of the most common injuries at the elbow are overuse injuries: tennis elbow and golfer's elbow.[26] Golfer's elbow involves the tendon of the common flexor origin which originates at the medial epicondyle of the humerus (the "inside" of the elbow).[26] Tennis elbow is the equivalent injury, but at the common extensor origin (the lateral epicondyle of the humerus).[26]
Fractures[edit]
There are three bones at the elbow joint, and any combination of these bones may be involved in a fracture of the elbow. Patients who are able to fully extend their arm at the elbow are unlikely to have a fracture (98% certainty) and an X-ray is not required as long as an olecranon fracture is ruled out.[27] Acute fractures may not be easily visible on X-ray.[28]
Dislocation[edit]
X-ray of ventral dislocation of the radial head. There is calcification of annular ligament, which can be seen as early as 2 weeks after injury.[29]
Elbow dislocations constitute 10% to 25% of all injuries to the elbow. The elbow is one of the most commonly dislocated joints in the body, with an average annual incidence of acute dislocation of 6 per 100,000 persons.[30] Among injuries to the upper extremity, dislocation of the elbow is second only to a dislocated shoulder.
A full dislocation of the elbow will require expert medical attention to re-align, and recovery can take approximately 6 weeks.[citation needed]
Infection[edit]
Infection of the elbow joint (septic arthritis) is uncommon. It may occur spontaneously, but may also occur in relation to surgery or infection elsewhere in the body (for example, endocarditis).[31]
Arthritis[edit]
Elbow arthritis is usually seen in individuals with rheumatoid arthritis or after fractures that involve the joint itself. When the damage to the joint is severe, fascial arthroplasty or elbow joint replacement may be considered.[32]
Bursitis[edit]
Main article: Olecranon bursitis
Olecranon bursitis, tenderness, warmth, swelling, pain in both flexion and extension-in chronic case great flexion-is extremely painful.
Elbow pain[edit]
Main article: elbow pain
Elbow pain occurs when the tenderness of the tissues in the elbow become inflamed. Frequent exercise of the inflamed elbow will assist with healing.
Clinical significance[edit]
Elbow pain can occur for a multitude of reasons, including injury, disease, and other conditions. Common conditions include tennis elbow, golfer's elbow, distal radioulnar joint rheumatoid arthritis, and cubital tunnel syndrome.
Tennis elbow[edit]
Tennis elbow is a very common type of overuse injury. It can occur both from chronic repetitive motions of the hand and forearm, and from trauma to the same areas. These repetitions can injure the tendons that connect the extensor supinator muscles (which rotate and extend 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 upon touch.[33]
A non-invasive treatment for pain management is rest. If achieving rest is an issue, a wrist brace can also be worn. This keeps the wrist in flexion, thereby relieving the extensor muscles and allowing rest. Ice, heat, ultrasound, steroid injections, and compression can also help alleviate pain. After the pain has been reduced, exercise therapy is important to prevent injury in the future. Exercises should be low velocity, and weight should increase progressively.[34] Stretching the flexors and extensors is helpful, as are strengthening exercises. Massage can also be useful, focusing on the extensor trigger points.[35]
Golfer's elbow[edit]
Golfer's elbow is very similar to tennis elbow, but less common. It is caused by overuse and repetitive motions like a golf swing. It can also be caused by trauma. Wrist flexion and pronation (rotating of the forearm) causes irritation to the tendons near the medial epicondyle of the elbow.[36] It can cause pain, stiffness, loss of sensation, and weakness radiating from the inside of the elbow to the fingers.
Rest is the primary intervention for this injury. Ice, pain medication, steroid injections, strengthening exercises, and avoiding any aggravating activities can also help. Surgery is a last resort, and rarely used. Exercises should focus on strengthening and stretching the forearm, and utilizing proper form when performing movements.[37]
Rheumatoid arthritis[edit]
Rheumatoid arthritis is a chronic disease that affects joints. It is very common in the wrist, and is most common at the radioulnar joint. It results in pain, stiffness, and deformities.
There are many different treatments for rheumatoid arthritis, and there is no one consensus for which methods are best. Most common treatments include wrist splints, surgery, physical and occupational therapy, and antirheumatic medication.[38]
Cubital tunnel syndrome[edit]
Cubital tunnel syndrome, more commonly known as ulnar neuropathy, occurs when the ulnar nerve is irritated and becomes inflamed. This can often happen where the ulnar nerve is most superficial, at the elbow. The ulnar nerve passes over the elbow, at the area known as the "funny bone". Irritation can occur due to constant, repeated stress and pressure at this area, or from a trauma. It can also occur due to bone deformities, and oftentimes from sports.[39] Symptoms include tingling, numbness, and weakness, along with pain.
First line pain management techniques include the use of nonsteroidal anti-inflammatory oral medicines. These help to reduce inflammation, pressure, and irritation of the nerve and around the nerve. Other simple fixes include learning more ergonomically friendly habits that can help prevent nerve impingement and irritation in the future. Protective equipment can also be very helpful. Examples of this include a protective elbow pad, and an arm splint. More serious cases often involve surgery, in which the nerve or the surrounding tissue is moved to relieve the pressure. Recovery from surgery can take awhile, but the prognosis is often a good one. Recovery often includes movement restrictions, and range of motion activities, and can last a few months (cubital and radial tunnel syndrome, 2).
Society and culture[edit]
The now obsolete length unit ell relates closely to the elbow. This becomes especially visible when considering the Germanic origins of both words, Elle (ell, defined as the length of a male forearm from elbow to fingertips) and Ellbogen (elbow). It is unknown when or why the second "l" was dropped from English usage of the word.[citation needed] The ell as in the English measure could also be taken to come from the letter L, being bent at right angles, as an elbow.[40] The ell as a measure was taken as six handbreadths; three to the elbow and three from the elbow to the shoulder.[41] Another measure was the cubit (from cubital). This was taken to be the length of a man's arm from the elbow to the end of the middle finger.[42]
Other primates[edit]
Though the elbow is similarly adapted for stability through a wide range of pronation-supination and flexion-extension in all apes, there are some minor difference. In arboreal apes such as orangutans, the large forearm muscles originating on the epicondyles of the humerus generate significant transverse forces on the elbow joint. The structure to resist these forces is a pronounced keel on the trochlear notch on the ulna, which is more flattened in, for example, humans and gorillas. In knuckle-walkers, on the other hand, the elbow has to deal with large vertical loads passing through extended forearms and the joint is therefore more expanded to provide larger articular surfaces perpendicular to those forces.[43]
Derived traits in catarrhini (apes and Old World monkeys), elbows include the loss of the entepicondylar foramen (a hole in the distal humerus), a non-translatory (rotation-only) humeroulnar joint, and a more robust ulna with a shortened trochlear notch.[44]
The proximal radioulnar joint is similarly derived in higher primates in the location and shape of the radial notch on the ulna; the primitive form being represented by New World monkeys, such as the howler monkey, and by fossil catarrhines, such as Aegyptopithecus. In these taxa, the oval head of the radius lies in front of the ulnar shaft 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.[44]
Notes[edit]
^ a b "MeSH Browser". meshb.nlm.nih.gov. Retrieved 8 January 2022.
^ "MeSH Browser". meshb.nlm.nih.gov. Retrieved 8 January 2022.
^ Kapandji 1982, pp. 74–7
^ Palastanga & Soames 2012, p. 138
^ Ross & Lamperti 2006, p. 240
^ Kapandji 1982, p. 84
^ a b c Palastanga & Soames 2012, pp. 127–8
^ a b c d e f g h i j Palastanga & Soames 2012, pp. 131–2
^ Awaya et al. 2001
^ a b c d Kapandji 1982, pp. 88–91
^ a b Palastanga & Soames 2012, p. 136
^ a b Kapandji 1982, p. 86
^ Gervasio, Olga; Zaccone, Claudio (2008). "Surgical Approach to Ulnar Nerve Compression at the Elbow Caused by the Epitrochleoanconeus Muscle and a Prominent Medial Head of the Triceps". Operative Neurosurgery. 62 (suppl_1): 186–193. doi:10.1227/01.neu.0000317392.29551.aa. ISSN 2332-4252. PMID 18424985. S2CID 22925073.
^ a b c Palastanga & Soames 2012, p. 133
^ "Cubital nodes". Inner Body. Retrieved 30 June 2012.
^ Soma, DB (March 2016). "Opening the Black Box: Evaluating the Pediatric Athlete With Elbow Pain". PM&R. 8 (3 Suppl): S101-12. doi:10.1016/j.pmrj.2016.01.002. PMID 26972259. S2CID 30934706.
^ Lee, YJ; Han, D; Koh, YH; Zo, JH; Kim, SH; Kim, DK; Lee, JS; Moon, HJ; Kim, JS; Chun, EJ; Youn, BJ; Lee, CH; Kim, SS (February 2008). "Adult sail sign: radiographic and computed tomographic features". Acta Radiologica. 49 (1): 37–40. doi:10.1080/02841850701675677. PMID 18210313. S2CID 2031763.
^ Dimon, T. (2011). The Body of Motion: its Evolution and Design (pp. 39-42). Berkeley, CA: North Atlantic Books.
^ Thomas, B. P.; Sreekanth, R. (2012). "Distal radioulnar joint injuries". Indian Journal of Orthopaedics. 46 (5): 493–504. doi:10.4103/0019-5413.101031. PMC 3491781. PMID 23162140.
^ Azar, Frederick; Canale, S.; Beaty, James (2016). "12 - Shoulder And Elbow Arthroplasty". Campbell's Operative Orthopaedics E-Book (13 ed.). Elsevier Health Sciences. p. 599. ISBN 978-0-323-39257-0.
^ Soames, Roger (2018). "2 - Upper limb". Anatomy and Human Movement E-Book: Structure and function (7 ed.). Elsevier Health Sciences. p. 102. ISBN 978-0-702-07259-8.
^ Gossage, James; Bultitude, Matthew; Corbett, Steven; Burnand, Katherine; Lahiri, Rajiv (2021). Browse's Introduction to the Symptoms & Signs of Surgical Disease (6 ed.). CRC Press. p. 29. doi:10.1201/9780429447891. ISBN 978-0-429-44789-1.
^ Steel & Tomlinson 1958, pp. 315–7; Van Roy et al. 2005, pp. 1645–56; Zampagni et al. 2008, p. 370
^ Paraskevas et al. 2004, pp. 19–23; Yilmaz et al. 2005, pp. 1360–3
^ Tukenmez et al. 2004, pp. 274–6
^ a b c Walker, Brad (2018). "8 - Sports Injuries of the Elbow". The Anatomy of Sports Injuries (2 ed.). North Atlantic Books. pp. 36–37. ISBN 978-1-623-17283-1.
^ Appelboam et al. 2008
^ O'Dwyer H, O'Sullivan P, Fitzgerald D, Lee MJ, McGrath F, Logan PM (July 2004). "The fat pad sign following elbow trauma in adults: its usefulness and reliability in suspecting occult fracture". Journal of Computer Assisted Tomography. 28 (4): 562–565. doi:10.1097/00004728-200407000-00021. ISSN 0363-8715. PMID 15232392. S2CID 8631113.
^ Earwaker J (1992). "Posttraumatic calcification of the annular ligament of the radius". Skeletal Radiol. 21 (3): 149–54. doi:10.1007/BF00242127. PMID 1604339. S2CID 43615869.
^ Blakeney 2010
^ Rausch V, von Glinski A, Rosteius T, Königshausen M, Schildhauer TA, Seybold D, Gessmann J (18 January 2020). "Secondary purulent infections of the elbow joint: a retrospective, single-center study". BMC Musculoskeletal Disorders. 21 (1): 38. doi:10.1186/s12891-020-3046-6. ISSN 1471-2474. PMC 6969974. PMID 31954400.
^ Matsen 2012
^ Speed, C., Hazleman, B., & Dalton, S. (2006). Fast Facts : Soft Tissue Disorders (2nd Edition). Abingdon, Oxford, GBR: Health Press Limited. Retrieved from http://www.ebrary.com
^ MacAuley, D., & Best, T. (Eds.). (2008). Evidence-Based Sports Medicine. Chichester, GBR: John Wiley & Sons. Retrieved from http://www.ebrary.com
^ Thomson, B. (1 January 2015). (5) Tennis Elbow Treatment By Trigger Point Massage. Retrieved February 17, 2015, from http://www.easyvigour.net.nz/fitness/hOBP5_TriggerPoint_Tennis_Elbow.htm
^ Dhami, S., & Sheikh, A. (2002). At A Glance - Medial Epicondylitis (Golfer's Elbow). Factiva.
^ Golfer's elbow. (9 October 2012). Retrieved March 14, 2015, from http://www.mayoclinic.org/diseases-conditions/golfers-elbow/basics/prevention/con-20027964
^ Lee, Steve K.; Hausman, Michael R. (2005). "Management of the Distal Radioulnar Joint in Rheumatoid Arthritis". Hand Clinics. 21 (4): 577–589. doi:10.1016/j.hcl.2005.08.009. PMID 16274868.
^ Cubital and Radial Tunnel Syndrome: Causes, Symptoms, and Treatment. (29 September 2014). Retrieved February 17, 2015, from http://www.webmd.com/pain-management/cubital-radial-tunnel-syndrome
^ O.D.E>2nd edition 2005
^ O.D.E. 2nd edition 2005,
^ O.D.E. 2nd edition 2005
^ Drapeau 2008, Abstract
^ a b Richmond et al. 1998, Discussion, p. 267
References[edit]
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Blakeney, W G (January 2010). "Elbow Dislocation". Life in the Fast Lane.
Drapeau, MS (July 2008). "Articular morphology of the proximal ulna in extant and fossil hominoids and hominins". Journal of Human Evolution. 55 (1): 86–102. doi:10.1016/j.jhevol.2008.01.005. PMID 18472143.
Kapandji, Ibrahim Adalbert (1982). The Physiology of the Joints: Volume One Upper Limb (5th ed.). New York: Churchill Livingstone.
Matsen, Frederick A. (2012). "Total elbow joint replacement for rheumatoid arthritis: A Patient's Guide" (PDF). UW Medicine.
Palastanga, Nigel; Soames, Roger (2012). Anatomy and Human Movement: Structure and Function (6th ed.). Elsevier. ISBN 9780702040535.
Paraskevas, G; Papadopoulos, A; Papaziogas, B; Spanidou, S; Argiriadou, H; Gigis, J (2004). "Study of the carrying angle of the human elbow joint in full extension: a morphometric analysis". Surgical and Radiologic Anatomy. 26 (1): 19–23. doi:10.1007/s00276-003-0185-z. PMID 14648036. S2CID 24369552.
Richmond, Brian G; Fleagle, John G; Kappelman, John; Swisher, Carl C (1998). "First Hominoid From the Miocene of Ethiopia and the Evolution of the Catarrhine Elbow" (PDF). American Journal of Physical Anthropology. 105 (3): 257–77. doi:10.1002/(SICI)1096-8644(199803)105:3<257::AID-AJPA1>3.0.CO;2-P. PMID 9545073. Archived from the original (PDF) on 2013-05-17.
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Tukenmez, M; Demirel, H; Perçin, S; Tezeren, G (2004). "Measurement of the carrying angle of the elbow in 2,000 children at ages six and fourteen years". Acta Orthopaedica et Traumatologica Turcica. 38 (4): 274–6. PMID 15618770.
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1Structure
Toggle Structure subsection
1.1Joint
1.1.1Joint capsule
1.1.2Synovial membrane
1.1.3Ligaments
1.2Muscles
1.2.1Flexion
1.2.2Extension
1.3Blood supply
1.4Nerve supply
1.5Development
2Function
Toggle Function subsection
2.1Carrying angle
3Pathology
Toggle Pathology subsection
3.1Tendonitis
3.2Fractures
3.3Dislocation
3.4Infection
3.5Arthritis
3.6Bursitis
3.7Elbow pain
4Clinical significance
Toggle Clinical significance subsection
4.1Tennis elbow
4.2Golfer's elbow
4.3Rheumatoid arthritis
4.4Cubital tunnel syndrome
5Society and culture
6Other primates
7Notes
8References
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Elbow
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From Wikipedia, the free encyclopedia
Joint between the upper and lower parts of the arm
For other uses, see Elbow (disambiguation).
ElbowHuman elbowElbow jointDetailsIdentifiersLatinarticulatio cubitiMeSHD004550TA98A01.1.00.023TA2145FMA24901Anatomical terminology[edit on Wikidata]
The elbow is the region between the upper arm and the forearm that surrounds the elbow joint.[1] The elbow includes prominent landmarks such as the olecranon, the cubital fossa (also called the chelidon, or the elbow pit), and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm;[2] more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body.[3][4]
The term elbow is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used.[1]
The name for the elbow in Latin is cubitus, and so the word cubital is used in some elbow-related terms, as in cubital nodes for example.
Structure[edit]
Joint[edit]
The elbow joint has three different portions surrounded by a common joint capsule. These are joints between the three bones of the elbow, the humerus of the upper arm, and the radius and the ulna of the forearm.
Joint
From
To
Description
Humeroulnar joint
trochlear notch of the ulna
trochlea of humerus
Is a simple hinge-joint, and allows for movements of flexion and extension only.
Humeroradial joint
head of the radius
capitulum of the humerus
Is a ball-and-socket joint.
Proximal radioulnar joint
head of the radius
radial notch of the ulna
In any position of flexion or extension, the radius, carrying the hand with it, can be rotated in it. This movement includes pronation and supination.
When in anatomical position there are four main bony landmarks of the elbow. At the lower part of the humerus are the medial and lateral epicondyles, on the side closest to the body (medial) and on the side away from the body (lateral) surfaces. The third landmark is the olecranon found at the head of the ulna. These lie on a horizontal line called the Hueter line. When the elbow is flexed, they form a triangle called the Hueter triangle, which resembles an equilateral triangle.[5]
Left elbow extended and flexed
At the surface of the humerus where it faces the joint is the trochlea. In most people, the groove running across the trochlea is vertical on the anterior side but it spirals off on the posterior side. This results in the forearm being aligned to the upper arm during flexion, but forming an angle to the upper arm during extension — an angle known as the carrying angle.[6]
The superior radioulnar joint shares the joint capsule with the elbow joint but plays no functional role at the elbow.[7]
Joint capsule[edit]
Capsule of elbow-joint (distended). Anterior and posterior aspects.
The elbow joint and the superior radioulnar joint are enclosed by a single fibrous capsule. The capsule is strengthened by ligaments at the sides but is relatively weak in front and behind.[8]
On the anterior side, the capsule consists mainly of longitudinal fibres. However, some bundles among these fibers run obliquely or transversely, thickening and strengthening the capsule. These bundles are referred to as the capsular ligament. Deep fibres of the brachialis muscle insert anteriorly into the capsule and act to pull it and the underlying membrane during flexion in order to prevent them from being pinched.[8]
On the posterior side, the capsule is thin and mainly composed of transverse fibres. A few of these fibres stretch across the olecranon fossa without attaching to it and form a transverse band with a free upper border. On the ulnar side, the capsule reaches down to the posterior part of the annular ligament. The posterior capsule is attached to the triceps tendon which prevents the capsule from being pinched during extension.[8]
Synovial membrane[edit]
The synovial membrane of the elbow joint is very extensive. On the humerus, it extends up from the articular margins and covers the coronoid and radial fossae anteriorly and the olecranon fossa posteriorly. Distally, it is prolonged down to the neck of the radius and the superior radioulnar joint. It is supported by the quadrate ligament below the annular ligament where it also forms a fold which gives the head of the radius freedom of movement.[8]
Several synovial folds project into the recesses of the joint.[8]
These folds or plicae are remnants of normal embryonic development and can be categorized as either anterior (anterior humeral recess) or posterior (olecranon recess).[9]
A crescent-shaped fold is commonly present between the head of the radius and the capitulum of the humerus.[8]
On the humerus there are extrasynovial fat pads adjacent to the three articular fossae. These pads fill the radial and coronoid fossa anteriorly during extension, and the olecranon fossa posteriorly during flexion. They are displaced when the fossae are occupied by the bony projections of the ulna and radius.[8]
Ligaments[edit]
Left elbow-jointLeft: anterior and ulnar collateral ligamentsRight: posterior and radial collateral ligaments
The elbow, like other joints, has ligaments on either side. These are triangular bands which blend with the joint capsule. They are positioned so that they always lie across the transverse joint axis and are, therefore, always relatively tense and impose strict limitations on abduction, adduction, and axial rotation at the elbow.[8]
The ulnar collateral ligament has its apex on the medial epicondyle. Its anterior band stretches from the anterior side of the medial epicondyle to the medial edge of the coronoid process, while the posterior band stretches from posterior side of the medial epicondyle to the medial side of the olecranon. These two bands are separated by a thinner intermediate part and their distal attachments are united by a transverse band below which the synovial membrane protrudes during joint movements. The anterior band is closely associated with the tendon of the superficial flexor muscles of the forearm, even being the origin of flexor digitorum superficialis. The ulnar nerve crosses the intermediate part as it enters the forearm.[8]
The radial collateral ligament is attached to the lateral epicondyle below the common extensor tendon. Less distinct than the ulnar collateral ligament, this ligament blends with the annular ligament of the radius and its margins are attached near the radial notch of the ulna.[8]
Muscles[edit]
Flexion[edit]
There are three main flexor muscles at the elbow:[10]
Brachialis acts exclusively as an elbow flexor and is one of the few muscles in the human body with a single function. It originates low on the anterior side of the humerus and is inserted into the tuberosity of the ulna.
Brachioradialis acts essentially as an elbow flexor but also supinates during extreme pronation and pronates during extreme supination. It originates at the lateral supracondylar ridge distally on the humerus and is inserted distally on the radius at the styloid process.
Biceps brachii is the main elbow flexor but, as a biarticular muscle, also plays important secondary roles as a stabiliser at the shoulder and as a supinator. It originates on the scapula with two tendons: That of the long head on the supraglenoid tubercle just above the shoulder joint and that of the short head on the coracoid process at the top of the scapula. Its main insertion is at the radial tuberosity on the radius.
Brachialis is the main muscle used when the elbow is flexed slowly. During rapid and forceful flexion all three muscles are brought into action assisted by the superficial forearm flexors originating at the medial side of the elbow.[11]
The efficiency of the flexor muscles increases dramatically as the elbow is brought into midflexion (flexed 90°) — biceps reaches its angle of maximum efficiency at 80–90° and brachialis at 100–110°.[10]
Active flexion is limited to 145° by the contact between the anterior muscles of the upper arm and forearm, more so because they are hardened by contraction during flexion. Passive flexion (forearm is pushed against the upper arm with flexors relaxed) is limited to 160° by the bony projections on the radius and ulna as they reach to shallow depressions on the humerus; i.e. the head of radius being pressed against the radial fossa and the coronoid process being pressed against the coronoid fossa. Passive flexion is further limited by tension in the posterior capsular ligament and in triceps brachii.[12]
A small accessory muscle, so called epitrochleoanconeus muscle, may be found on the medial aspect of the elbow running from the medial epicondyle to the olecranon.[13]
Extension[edit]
Elbow extension is simply bringing the forearm back to anatomical position.[11] This action is performed by triceps brachii with a negligible assistance from anconeus. Triceps originates with two heads posteriorly on the humerus and with its long head on the scapula just below the shoulder joint. It is inserted posteriorly on the olecranon.[10]
Triceps is maximally efficient with the elbow flexed 20–30°. As the angle of flexion increases, the position of the olecranon approaches the main axis of the humerus which decreases muscle efficiency. In full flexion, however, the triceps tendon is "rolled up" on the olecranon as on a pulley which compensates for the loss of efficiency. Because triceps' long head is biarticular (acts on two joints), its efficiency is also dependent on the position of the shoulder.[10]
Extension is limited by the olecranon reaching the olecranon fossa, tension in the anterior ligament, and resistance in flexor muscles. Forced extension results in a rupture in one of the limiting structures: olecranon fracture, torn capsule and ligaments, and, though the muscles are normally left unaffected, a bruised brachial artery.[12]
Blood supply[edit]
The anastomosis and deep veins around the elbow-joint
The arteries supplying the joint are derived from an extensive circulatory anastomosis between the brachial artery and its terminal branches. The superior and inferior ulnar collateral branches of the brachial artery and the radial and middle collateral branches of the profunda brachii artery descend from above to reconnect on the joint capsule, where they also connect with the anterior and posterior ulnar recurrent branches of the ulnar artery; the radial recurrent branch of the radial artery; and the interosseous recurrent branch of the common interosseous artery.[14]
The blood is brought back by vessels from the radial, ulnar, and brachial veins.
There are two sets of lymphatic nodes at the elbow, normally located above the medial epicondyle — the deep and superficial cubital nodes (also called epitrochlear nodes). The lymphatic drainage at the elbow is through the deep nodes at the bifurcation of the brachial artery, the superficial nodes drain the forearm and the ulnar side of the hand. The efferent lymph vessels from the elbow proceed to the lateral group of axillary lymph nodes.[14][15]
Nerve supply[edit]
The elbow is innervated anteriorly by branches from the musculocutaneous, median, and radial nerve, and posteriorly from the ulnar nerve and the branch of the radial nerve to anconeus.[14]
Development[edit]
The elbow undergoes dynamic development of ossification centers through infancy and adolescence, with the order of both the appearance and fusion of the apophyseal growth centers being crucial in assessment of the pediatric elbow on radiograph, in order to distinguish a traumatic fracture or apophyseal separation from normal development. The order of appearance can be understood by the 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 fuse during adolescence, with the internal epicondyle and olecranon fusing last. The ages of fusion are more variable than ossification, but normally occur at 13, 15, 17, 13, 16 and 13 years, respectively.[16] In addition, the presence of a joint effusion can be inferenced by the presence of the fat pad sign, a structure that is normally physiologically present, but pathologic when elevated by fluid, and always pathologic when posterior.[17]
Function[edit]
The function of the elbow joint is to extend and flex the arm.[18] The range of movement in the elbow is from 0 degrees of elbow extension to 150 degrees of elbow flexion.[19] Muscles contributing to function are all flexion (biceps brachii, brachialis, and brachioradialis) and extension muscles (triceps and anconeus).
In humans, the main task of the elbow is to properly place the hand in space by shortening and lengthening the upper limb. While the superior radioulnar joint shares joint capsule with the elbow joint, it plays no functional role at the elbow.[7]
With the elbow extended, the long axis of the humerus and that of the ulna coincide.[20] At the same time, the articular surfaces on both bones are located in front of those axes and deviate from them at an angle of 45°.[21] Additionally, the forearm muscles that originate at the elbow are grouped at the sides of the joint in order not to interfere with its movement. The wide angle of flexion at the elbow made possible by this arrangement — almost 180° — allows the bones to be brought almost in parallel to each other.[7]
Carrying angle[edit]
Normal radiograph; right picture of the straightened arm shows the carrying angle of the elbow
When the arm is extended, with the palm facing forward or up, the bones of the upper arm (humerus) and forearm (radius and ulna) are not perfectly aligned. The deviation from a straight line occurs in the direction of the thumb, and is referred to as the "carrying angle".[22]
The carrying angle permits the arm to be swung without contacting the hips. Women on average have smaller shoulders and wider hips than men, which tends to produce a larger carrying angle (i.e., larger deviation from a straight line than that in men). There is, however, extensive overlap in the carrying angle between individual men and women, and a sex-bias has not been consistently observed in scientific studies.[23]
The angle is greater in the dominant limb than the non-dominant limb of both sexes,[24] suggesting that natural forces acting on the elbow modify the carrying angle. Developmental,[25] aging and possibly racial influences add further to the variability of this parameter.
Pathology[edit]
Left: Lateral X ray of a dislocated right elbowRight: AP X ray of a dislocated right elbow
The types of disease most commonly seen at the elbow are due to injury.
Tendonitis[edit]
Two of the most common injuries at the elbow are overuse injuries: tennis elbow and golfer's elbow.[26] Golfer's elbow involves the tendon of the common flexor origin which originates at the medial epicondyle of the humerus (the "inside" of the elbow).[26] Tennis elbow is the equivalent injury, but at the common extensor origin (the lateral epicondyle of the humerus).[26]
Fractures[edit]
There are three bones at the elbow joint, and any combination of these bones may be involved in a fracture of the elbow. Patients who are able to fully extend their arm at the elbow are unlikely to have a fracture (98% certainty) and an X-ray is not required as long as an olecranon fracture is ruled out.[27] Acute fractures may not be easily visible on X-ray.[28]
Dislocation[edit]
X-ray of ventral dislocation of the radial head. There is calcification of annular ligament, which can be seen as early as 2 weeks after injury.[29]
Elbow dislocations constitute 10% to 25% of all injuries to the elbow. The elbow is one of the most commonly dislocated joints in the body, with an average annual incidence of acute dislocation of 6 per 100,000 persons.[30] Among injuries to the upper extremity, dislocation of the elbow is second only to a dislocated shoulder.
A full dislocation of the elbow will require expert medical attention to re-align, and recovery can take approximately 6 weeks.[citation needed]
Infection[edit]
Infection of the elbow joint (septic arthritis) is uncommon. It may occur spontaneously, but may also occur in relation to surgery or infection elsewhere in the body (for example, endocarditis).[31]
Arthritis[edit]
Elbow arthritis is usually seen in individuals with rheumatoid arthritis or after fractures that involve the joint itself. When the damage to the joint is severe, fascial arthroplasty or elbow joint replacement may be considered.[32]
Bursitis[edit]
Main article: Olecranon bursitis
Olecranon bursitis, tenderness, warmth, swelling, pain in both flexion and extension-in chronic case great flexion-is extremely painful.
Elbow pain[edit]
Main article: elbow pain
Elbow pain occurs when the tenderness of the tissues in the elbow become inflamed. Frequent exercise of the inflamed elbow will assist with healing.
Clinical significance[edit]
Elbow pain can occur for a multitude of reasons, including injury, disease, and other conditions. Common conditions include tennis elbow, golfer's elbow, distal radioulnar joint rheumatoid arthritis, and cubital tunnel syndrome.
Tennis elbow[edit]
Tennis elbow is a very common type of overuse injury. It can occur both from chronic repetitive motions of the hand and forearm, and from trauma to the same areas. These repetitions can injure the tendons that connect the extensor supinator muscles (which rotate and extend 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 upon touch.[33]
A non-invasive treatment for pain management is rest. If achieving rest is an issue, a wrist brace can also be worn. This keeps the wrist in flexion, thereby relieving the extensor muscles and allowing rest. Ice, heat, ultrasound, steroid injections, and compression can also help alleviate pain. After the pain has been reduced, exercise therapy is important to prevent injury in the future. Exercises should be low velocity, and weight should increase progressively.[34] Stretching the flexors and extensors is helpful, as are strengthening exercises. Massage can also be useful, focusing on the extensor trigger points.[35]
Golfer's elbow[edit]
Golfer's elbow is very similar to tennis elbow, but less common. It is caused by overuse and repetitive motions like a golf swing. It can also be caused by trauma. Wrist flexion and pronation (rotating of the forearm) causes irritation to the tendons near the medial epicondyle of the elbow.[36] It can cause pain, stiffness, loss of sensation, and weakness radiating from the inside of the elbow to the fingers.
Rest is the primary intervention for this injury. Ice, pain medication, steroid injections, strengthening exercises, and avoiding any aggravating activities can also help. Surgery is a last resort, and rarely used. Exercises should focus on strengthening and stretching the forearm, and utilizing proper form when performing movements.[37]
Rheumatoid arthritis[edit]
Rheumatoid arthritis is a chronic disease that affects joints. It is very common in the wrist, and is most common at the radioulnar joint. It results in pain, stiffness, and deformities.
There are many different treatments for rheumatoid arthritis, and there is no one consensus for which methods are best. Most common treatments include wrist splints, surgery, physical and occupational therapy, and antirheumatic medication.[38]
Cubital tunnel syndrome[edit]
Cubital tunnel syndrome, more commonly known as ulnar neuropathy, occurs when the ulnar nerve is irritated and becomes inflamed. This can often happen where the ulnar nerve is most superficial, at the elbow. The ulnar nerve passes over the elbow, at the area known as the "funny bone". Irritation can occur due to constant, repeated stress and pressure at this area, or from a trauma. It can also occur due to bone deformities, and oftentimes from sports.[39] Symptoms include tingling, numbness, and weakness, along with pain.
First line pain management techniques include the use of nonsteroidal anti-inflammatory oral medicines. These help to reduce inflammation, pressure, and irritation of the nerve and around the nerve. Other simple fixes include learning more ergonomically friendly habits that can help prevent nerve impingement and irritation in the future. Protective equipment can also be very helpful. Examples of this include a protective elbow pad, and an arm splint. More serious cases often involve surgery, in which the nerve or the surrounding tissue is moved to relieve the pressure. Recovery from surgery can take awhile, but the prognosis is often a good one. Recovery often includes movement restrictions, and range of motion activities, and can last a few months (cubital and radial tunnel syndrome, 2).
Society and culture[edit]
The now obsolete length unit ell relates closely to the elbow. This becomes especially visible when considering the Germanic origins of both words, Elle (ell, defined as the length of a male forearm from elbow to fingertips) and Ellbogen (elbow). It is unknown when or why the second "l" was dropped from English usage of the word.[citation needed] The ell as in the English measure could also be taken to come from the letter L, being bent at right angles, as an elbow.[40] The ell as a measure was taken as six handbreadths; three to the elbow and three from the elbow to the shoulder.[41] Another measure was the cubit (from cubital). This was taken to be the length of a man's arm from the elbow to the end of the middle finger.[42]
Other primates[edit]
Though the elbow is similarly adapted for stability through a wide range of pronation-supination and flexion-extension in all apes, there are some minor difference. In arboreal apes such as orangutans, the large forearm muscles originating on the epicondyles of the humerus generate significant transverse forces on the elbow joint. The structure to resist these forces is a pronounced keel on the trochlear notch on the ulna, which is more flattened in, for example, humans and gorillas. In knuckle-walkers, on the other hand, the elbow has to deal with large vertical loads passing through extended forearms and the joint is therefore more expanded to provide larger articular surfaces perpendicular to those forces.[43]
Derived traits in catarrhini (apes and Old World monkeys), elbows include the loss of the entepicondylar foramen (a hole in the distal humerus), a non-translatory (rotation-only) humeroulnar joint, and a more robust ulna with a shortened trochlear notch.[44]
The proximal radioulnar joint is similarly derived in higher primates in the location and shape of the radial notch on the ulna; the primitive form being represented by New World monkeys, such as the howler monkey, and by fossil catarrhines, such as Aegyptopithecus. In these taxa, the oval head of the radius lies in front of the ulnar shaft 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.[44]
Notes[edit]
^ a b "MeSH Browser". meshb.nlm.nih.gov. Retrieved 8 January 2022.
^ "MeSH Browser". meshb.nlm.nih.gov. Retrieved 8 January 2022.
^ Kapandji 1982, pp. 74–7
^ Palastanga & Soames 2012, p. 138
^ Ross & Lamperti 2006, p. 240
^ Kapandji 1982, p. 84
^ a b c Palastanga & Soames 2012, pp. 127–8
^ a b c d e f g h i j Palastanga & Soames 2012, pp. 131–2
^ Awaya et al. 2001
^ a b c d Kapandji 1982, pp. 88–91
^ a b Palastanga & Soames 2012, p. 136
^ a b Kapandji 1982, p. 86
^ Gervasio, Olga; Zaccone, Claudio (2008). "Surgical Approach to Ulnar Nerve Compression at the Elbow Caused by the Epitrochleoanconeus Muscle and a Prominent Medial Head of the Triceps". Operative Neurosurgery. 62 (suppl_1): 186–193. doi:10.1227/01.neu.0000317392.29551.aa. ISSN 2332-4252. PMID 18424985. S2CID 22925073.
^ a b c Palastanga & Soames 2012, p. 133
^ "Cubital nodes". Inner Body. Retrieved 30 June 2012.
^ Soma, DB (March 2016). "Opening the Black Box: Evaluating the Pediatric Athlete With Elbow Pain". PM&R. 8 (3 Suppl): S101-12. doi:10.1016/j.pmrj.2016.01.002. PMID 26972259. S2CID 30934706.
^ Lee, YJ; Han, D; Koh, YH; Zo, JH; Kim, SH; Kim, DK; Lee, JS; Moon, HJ; Kim, JS; Chun, EJ; Youn, BJ; Lee, CH; Kim, SS (February 2008). "Adult sail sign: radiographic and computed tomographic features". Acta Radiologica. 49 (1): 37–40. doi:10.1080/02841850701675677. PMID 18210313. S2CID 2031763.
^ Dimon, T. (2011). The Body of Motion: its Evolution and Design (pp. 39-42). Berkeley, CA: North Atlantic Books.
^ Thomas, B. P.; Sreekanth, R. (2012). "Distal radioulnar joint injuries". Indian Journal of Orthopaedics. 46 (5): 493–504. doi:10.4103/0019-5413.101031. PMC 3491781. PMID 23162140.
^ Azar, Frederick; Canale, S.; Beaty, James (2016). "12 - Shoulder And Elbow Arthroplasty". Campbell's Operative Orthopaedics E-Book (13 ed.). Elsevier Health Sciences. p. 599. ISBN 978-0-323-39257-0.
^ Soames, Roger (2018). "2 - Upper limb". Anatomy and Human Movement E-Book: Structure and function (7 ed.). Elsevier Health Sciences. p. 102. ISBN 978-0-702-07259-8.
^ Gossage, James; Bultitude, Matthew; Corbett, Steven; Burnand, Katherine; Lahiri, Rajiv (2021). Browse's Introduction to the Symptoms & Signs of Surgical Disease (6 ed.). CRC Press. p. 29. doi:10.1201/9780429447891. ISBN 978-0-429-44789-1.
^ Steel & Tomlinson 1958, pp. 315–7; Van Roy et al. 2005, pp. 1645–56; Zampagni et al. 2008, p. 370
^ Paraskevas et al. 2004, pp. 19–23; Yilmaz et al. 2005, pp. 1360–3
^ Tukenmez et al. 2004, pp. 274–6
^ a b c Walker, Brad (2018). "8 - Sports Injuries of the Elbow". The Anatomy of Sports Injuries (2 ed.). North Atlantic Books. pp. 36–37. ISBN 978-1-623-17283-1.
^ Appelboam et al. 2008
^ O'Dwyer H, O'Sullivan P, Fitzgerald D, Lee MJ, McGrath F, Logan PM (July 2004). "The fat pad sign following elbow trauma in adults: its usefulness and reliability in suspecting occult fracture". Journal of Computer Assisted Tomography. 28 (4): 562–565. doi:10.1097/00004728-200407000-00021. ISSN 0363-8715. PMID 15232392. S2CID 8631113.
^ Earwaker J (1992). "Posttraumatic calcification of the annular ligament of the radius". Skeletal Radiol. 21 (3): 149–54. doi:10.1007/BF00242127. PMID 1604339. S2CID 43615869.
^ Blakeney 2010
^ Rausch V, von Glinski A, Rosteius T, Königshausen M, Schildhauer TA, Seybold D, Gessmann J (18 January 2020). "Secondary purulent infections of the elbow joint: a retrospective, single-center study". BMC Musculoskeletal Disorders. 21 (1): 38. doi:10.1186/s12891-020-3046-6. ISSN 1471-2474. PMC 6969974. PMID 31954400.
^ Matsen 2012
^ Speed, C., Hazleman, B., & Dalton, S. (2006). Fast Facts : Soft Tissue Disorders (2nd Edition). Abingdon, Oxford, GBR: Health Press Limited. Retrieved from http://www.ebrary.com
^ MacAuley, D., & Best, T. (Eds.). (2008). Evidence-Based Sports Medicine. Chichester, GBR: John Wiley & Sons. Retrieved from http://www.ebrary.com
^ Thomson, B. (1 January 2015). (5) Tennis Elbow Treatment By Trigger Point Massage. Retrieved February 17, 2015, from http://www.easyvigour.net.nz/fitness/hOBP5_TriggerPoint_Tennis_Elbow.htm
^ Dhami, S., & Sheikh, A. (2002). At A Glance - Medial Epicondylitis (Golfer's Elbow). Factiva.
^ Golfer's elbow. (9 October 2012). Retrieved March 14, 2015, from http://www.mayoclinic.org/diseases-conditions/golfers-elbow/basics/prevention/con-20027964
^ Lee, Steve K.; Hausman, Michael R. (2005). "Management of the Distal Radioulnar Joint in Rheumatoid Arthritis". Hand Clinics. 21 (4): 577–589. doi:10.1016/j.hcl.2005.08.009. PMID 16274868.
^ Cubital and Radial Tunnel Syndrome: Causes, Symptoms, and Treatment. (29 September 2014). Retrieved February 17, 2015, from http://www.webmd.com/pain-management/cubital-radial-tunnel-syndrome
^ O.D.E>2nd edition 2005
^ O.D.E. 2nd edition 2005,
^ O.D.E. 2nd edition 2005
^ Drapeau 2008, Abstract
^ a b Richmond et al. 1998, Discussion, p. 267
References[edit]
Appelboam, A; Reuben, A D; Benger, J R; Beech, F; Dutson, J; Haig, S; Higginson, I; Klein, J A; Le Roux, S; Saranga, S S M; Taylor, R; Vickery, J; Powell, R J; Lloyd, G (2008). "Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children". BMJ. 337: a2428. doi:10.1136/bmj.a2428. PMC 2600962. PMID 19066257.
Awaya, Hitomi; Schweitzer, Mark E.; Feng, Sunah A.; Kamishima, Tamotsu; Marone, Phillip J.; Farooki; Shella; Trudell, Debra J.; Haghighi, Parviz; Resnick, Donald L. (December 2001). "Elbow Synovial Fold Syndrome: MR Imaging Findings". American Journal of Roentgenology. 177 (6): 1377–81. doi:10.2214/ajr.177.6.1771377. PMID 11717088.
Blakeney, W G (January 2010). "Elbow Dislocation". Life in the Fast Lane.
Drapeau, MS (July 2008). "Articular morphology of the proximal ulna in extant and fossil hominoids and hominins". Journal of Human Evolution. 55 (1): 86–102. doi:10.1016/j.jhevol.2008.01.005. PMID 18472143.
Kapandji, Ibrahim Adalbert (1982). The Physiology of the Joints: Volume One Upper Limb (5th ed.). New York: Churchill Livingstone.
Matsen, Frederick A. (2012). "Total elbow joint replacement for rheumatoid arthritis: A Patient's Guide" (PDF). UW Medicine.
Palastanga, Nigel; Soames, Roger (2012). Anatomy and Human Movement: Structure and Function (6th ed.). Elsevier. ISBN 9780702040535.
Paraskevas, G; Papadopoulos, A; Papaziogas, B; Spanidou, S; Argiriadou, H; Gigis, J (2004). "Study of the carrying angle of the human elbow joint in full extension: a morphometric analysis". Surgical and Radiologic Anatomy. 26 (1): 19–23. doi:10.1007/s00276-003-0185-z. PMID 14648036. S2CID 24369552.
Richmond, Brian G; Fleagle, John G; Kappelman, John; Swisher, Carl C (1998). "First Hominoid From the Miocene of Ethiopia and the Evolution of the Catarrhine Elbow" (PDF). American Journal of Physical Anthropology. 105 (3): 257–77. doi:10.1002/(SICI)1096-8644(199803)105:3<257::AID-AJPA1>3.0.CO;2-P. PMID 9545073. Archived from the original (PDF) on 2013-05-17.
Ross, Lawrence M.; Lamperti, Edward D., eds. (2006). Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System. Thieme. p. 240. ISBN 978-3131420817.
Steel, F; Tomlinson, J (1958). "The 'carrying angle' in man". Journal of Anatomy. 92 (2): 315–7. PMC 1249704. PMID 13525245.
Tukenmez, M; Demirel, H; Perçin, S; Tezeren, G (2004). "Measurement of the carrying angle of the elbow in 2,000 children at ages six and fourteen years". Acta Orthopaedica et Traumatologica Turcica. 38 (4): 274–6. PMID 15618770.
Van Roy, P; Baeyens, JP; Fauvart, D; Lanssiers, R; Clarijs, JP (2005). "Arthro-kinematics of the elbow: study of the carrying angle". Ergonomics. 48 (11–14): 1645–56. doi:10.1080/00140130500101361. PMID 16338730. S2CID 13317929.
Yilmaz, E; Karakurt, L; Belhan, O; Bulut, M; Serin, E; Avci, M (2005). "Variation of carrying angle with age, sex, and special reference to side". Orthopedics. 28 (11): 1360–3. doi:10.3928/0147-7447-20051101-16. PMID 16295195.
Zampagni, M; Casino, D; Zaffagnini, S; Visani, AA; Marcacci, M (2008). "Estimating the elbow carrying angle with an electrogoniometer: acquisition of data and reliability of measurements". Orthopedics. 31 (4): 370. doi:10.3928/01477447-20080401-39. PMID 19292279.
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Elbow joint: Pain, joint type, anatomy, and more
Elbow joint: Pain, joint type, anatomy, and more
Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyAsthma & AllergiesAtopic DermatitisBreast CancerCancerCardiovascular HealthCOVID-19DiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisPsoriatic ArthritisSexual HealthUlcerative ColitisWomen's HealthHealth ProductsHealth ProductsNutrition & FitnessVitamins & SupplementsCBDSleepMental HealthAt-Home TestingMen’s HealthWomen’s HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcasts2023 in medicineWhy exercise is key to living a long and healthy lifeWhat do we know about the gut microbiome in IBD?My podcast changed meCan 'biological race' explain disparities in health?Why Parkinson's research is zooming in on the gutToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsFind a DoctorBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsHealth ProductsDiscoverToolsConnectSubscribeWhat to know about the elbow jointMedically reviewed by Megan Soliman, MD — By Zia Sherrell, MPH on July 30, 2021Elbow jointAnatomyElbow painHealthy elbow joint tipsSummaryThe elbow joint connects the upper arm to the lower arm to enable movement. The elbow is complex and consists of bones, ligaments, nerves, and blood vessels.People use the elbow joints extensively in daily life. Repetitively using or overloading the elbow joint can cause injuries and pain. Understanding how to manage elbow health and reduce potential injuries can help people avoid elbow pain.Type of jointThe elbow joint is a synovial hinge joint, similar to the ankle and knee joints. Two or more bones form hinge joints that move along an axis, rather than rotate like the hip joint. The distal humerus and proximal ulna are the primary elbow joint bones.The hinge joint allows the elbow to bend and straighten. It also helps with hand motion by allowing the forearm to rotate.Anatomy of the elbow jointThe elbow joint includes various bones, ligaments, veins, arteries, and nerves.Share on PinterestBones and ligaments of the elbowOsteologyThe elbow has three articulations, or joints:radiohumeral jointulnohumeral jointproximal radioulnar jointStability comes mainly from the bony joints of the ulnar olecranon and the trochlea of the humerus.The olecranon looks like a wrench and has a landmark called the trochlear notch. The trochlea of the humerus fits in the trochlear notch. This is the main point where the elbow pivots while bending and straightening.The trochlear notch wraps about 180 degrees around the humerus, and the tight fit of the two structures enables greater stability.LigamentsAside from the bones, elbow stability comes from the lateral collateral ligament (LCL) and the medial collateral ligament (MCL). These ligaments form the joint capsule.The LCL breaks down into the following ligaments: lateral radial collateral ligamentannular ligamentlateral ulnar collateral ligamentThe annular ligament stabilizes the proximal radioulnar joint. The lateral ulnar collateral ligament ensures that the elbow does not rotate too far towards the back of the body.The MCL breaks down into the following ligaments: posterior oblique ligamentanterior oblique ligamenttransverse ligamentThe anterior oblique ligament keeps the elbow from bending toward the body.Share on PinterestNerves of the elbowNervesThe cubital tunnel is a space in the elbow that houses the ulnar nerve and allows it to pass through the ligaments of the elbow. The nerves that cross the elbow joint mainly go to the forearm and hand structures. The elbow joint is a crossing space for most of the nerves and blood vessels in the upper extremities of the body.Blood supplyThe brachial artery transports blood from the shoulder to the elbow. It splits into two arteries at the elbow, called the radial and ulnar arteries. Both arteries travel across the front of the elbow. Once they reach the forearm, the radial artery travels along the thumbs side of the forearm towards the wrist, and the ulnar artery travels along the pinky finger side of the forearm towards the wrist.Common causes of elbow painThe elbows are complicated joints that people use daily. Overloading or overusing the elbows can lead to injuries and inflammation. That includes:BursitisBursitis is inflammation of the bursa, which is a small fluid-filled sac. Causes of bursitis include: overuseinjuryinfectionother inflammatory processesSymptoms of bursitis include: painswellingrestriction to movementBursitis treatment includes: pain medicinesresticeA doctor may inject a drug into the area surrounding the swollen bursa if another treatment is not helping. If elbow health does not improve after 6 to 12 months, a doctor may suggest surgery to repair damage and relieve pressure.Dislocated elbowA dislocated elbow occurs when the joint surfaces of the elbow separate. Trauma, such as a fall, is often the cause. A dislocation can be complete or partial depending on whether the joint surfaces separate entirely or partially.Complete dislocations are extremely painful. In these cases, the elbow looks deformed or oddly twisted. Partial dislocations may appear normal, but cause pain or some bruising on the inside and outside of the elbow.A doctor must realign the elbow using a reduction maneuver. Individuals with complex cases may need surgery to realign the bones and repair ligaments.Medial epicondylitisMedial epicondylitis, or golfer’s elbow, is a common ailment caused by repetitive bending and force on the elbow joint. People who play sports such as golf and baseball and professionals such as plumbers and construction workers are more likely to experience this injury.Golfer’s elbow symptoms include irritation and pain where the tendon attaches to the bone. Common treatments include non-steroidal anti-inflammatory drugs (NSAIDs), ice, and steroid injections.OsteoarthritisElbow osteoarthritis happens when the cartilage becomes damaged or wears out. While this can result from a previous injury, such as dislocation or fracture, it usually comes from normal cartilage wear from activity and age. Symptoms include pain and a loss of range of motion.Early treatment includes physical therapy, activity moderation, and oral medications to reduce or alleviate pain. Corticosteroids are another treatment option for early-stage osteoarthritis. If these treatments do not control symptoms, surgery may be the next step.Rheumatoid arthritisRheumatoid arthritis (RA) is a chronic inflammatory disease where the immune system attacks the linings of joints and sometimes the internal organs. Symptoms include:joint painswellinginflammationloss of functionTreatment includes medication and self-management strategies. Self-management strategies to reduce pain and disability include having an active lifestyle, maintaining a moderate weight, and avoiding joint injuries.SprainAn elbow sprain involves pulling or tearing ligaments in the elbow joint. Symptoms include: painswellingbruisingrednessdifficulty using the elbowTreatment includes using a sling, cast, or splint to prevent movement, or surgery to repair torn ligaments.Share on PinterestMuscles of the elbowLateral epicondylitisLateral epicondylitis, or tennis elbow, is an inflammation or micro-tearing of the tendons that join the forearm muscle to the outside of the elbow. Symptoms include pain or burning on the outer part of the elbow and weak grip strength.This is often treatable through:restmedicationuse of a bracesteroid injectionsextracorporeal shock wave therapyphysical therapy If these treatments are not successful after 6 to 12 months, surgery may be necessary to remove diseased muscles and reattach healthy muscle to the bone.Keeping the elbow joint healthyThese tips can help keep the elbow joints healthy and reduce the risk of injury:Participate in regular physical activity to ease joint stiffness and strengthen muscles surrounding the joints.Avoid overworking the joints and listen to pain signals.Maintain proper form in sports.Try an anti-inflammatory diet, especially if an individual has arthritis or other inflammatory conditions.SummaryThe elbow is a synovial joint that aids in flexion and extension. It is a crossing point for the nerves and blood vessels of the upper arm and forearm.Many injuries and conditions cause elbow pain. However, exercising, avoiding overuse, maintaining proper form when doing activities, and following an anti-inflammatory diet can help keep the elbow joint healthy. Last medically reviewed on July 30, 2021OsteoarthritisRheumatoid ArthritisBones / OrthopedicsSports Medicine / FitnessHow we reviewed this article:SourcesMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Bursitis. (2021).https://medlineplus.gov/bursitis.htmlCard, R. K., et al. (2020). Anatomy, shoulder and upper limb, elbow joint.https://www.ncbi.nlm.nih.gov/books/NBK532948/Diseases and conditions. (n.d.).https://orthoinfo.aaos.org/en/diseases--conditions/Key public health messages. (2021).https://www.cdc.gov/arthritis/about/key-messages.htmManoj, M., et al. (2020). Bursitis of shoulder region and elbow – Subdeltoid-subacromial and olecranon bursitis ultrasonography and elastography imaging.http://www.journaldmims.com/article.asp?issn=0974-3901;year=2020;volume=15;issue=2;spage=300;epage=302;aulast=ManojRheumatoid arthritis (RA). (2021).https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html#treatmentVessels. (2021).https://www.assh.org/handcare/safety/vesselsWhen elbow pain may mean arthritis. (2021).https://www.arthritis.org/health-wellness/about-arthritis/where-it-hurts/when-elbow-pain-may-mean-arthritisShare this articleMedically reviewed by Megan Soliman, MD — By Zia Sherrell, MPH on July 30, 2021Latest newsHow and why does gut health influence heart health?Swapping meat for mushroom protein may be better for reducing cholesterolAnother 3 common pesticides are now linked to Parkinson's disease riskOzempic may delay kidney disease progression, latest trial results showMediterranean diet and exercise improve gut health, leading to weight lossRelated CoverageWhat to know about elbow pain that occurs when lifting somethingMedically reviewed by Gregory Minnis, DPTElbow pain can occur when lifting an object for several reasons, including tennis elbow and trapped nerves. Learn more about some causes and…READ MOREWhat can cause pain in the left elbow?Medically reviewed by Deborah Weatherspoon, Ph.D., MSNThere are several reasons a person may experience pain in their left elbow. Learn more about the potential causes and treatment options here.READ MOREHow to stop joint pain when it rainsMedically reviewed by Nancy Carteron, M.D., FACRRain and changes in weather can trigger joint pain. It is likely due to changes in barometric pressure, humidity, and temperature, though the exact…READ MOREAbout UsContact UsTerms of UsePrivacy PolicyPrivacy SettingsAdvertising PolicyHealth TopicsHealth HubsMedical AffairsContent IntegrityNewsletters© 2024 Healthline Media UK Ltd, Brighton, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.© 2024 Healthline Media UK Ltd, Brighton, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.AboutCareersAdvertise with usOUR BRANDSHealthlineMedical News TodayGreatistPsych CentralBezzy
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Elbow joint
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AnatomyUpper limbElbow and forearmElbow joint
Elbow joint
Author:
Niamh Gorman, MSc
•
Reviewer:
Francesca Salvador, MSc
Last reviewed: September 11, 2023
Reading time: 14 minutes
Recommended video: Elbow joint
[21:20]
Bones, ligaments and nerve supply of the elbow joint.
Elbow joint
Articulatio cubiti
1/5
Synonyms:
none
The elbow joint is a synovial joint found in the upper limb between the arm and the forearm. It is the point of articulation of three bones: the humerus of the arm and the radius and the ulna of the forearm.
The elbow joint is classified structurally as a synovial joint. It is also classified structurally as a compound joint, as there are two articulations in the joint. Synovial joints, also called diarthroses, are free movable joints. The articular surfaces of the bones at these joints are separated from each other by a layer of hyaline cartilage. Smooth movement at these joints is provided by a highly viscous synovial fluid, which acts as a lubricant.
A fibrous capsule encloses the joint, and is lined internally by a synovial membrane. Synovial joints can be further categorized based on function. The elbow joint is functionally a hinge joint, allowing movement in only one plane (uniaxial).
Key facts about the elbow joint
Type
Hinge joint
Bones
Humerus, radius, ulna
Mnemonics
CRAzy TULips (Capitulum = RAdius, Trochlea = ULna)
Ligaments
Ulnar collateral ligament, radial collateral ligament, annular ligament, quadrate ligament
Blood supply
Proximal to elbow joint - Ulnar collateral artery, radial collateral artery, middle collateral artery
Distal to elbow joint - Radial recurrent artery, ulnar recurret artery
Movements
Flexion -
Biceps brachii, Brachialis, Brachioradialis muscles
Mnemonic: 3 B's bend the elbow
Extension - Triceps brachii muscle
Clinical
Fractures, epicondylitis, arthritis, venipunctures
Contents
Osteology Mnemonic
Ligaments of the elbow joint
Blood supply and innervation
Movements
Flexion
Mnemonic
Extension
Clinical notes
Fractures
Epicondylitis and arthritis
Venipunctures
Sources
+ Show all
Osteology
Humerus
1/4
Synonyms:
none
There are three bones that comprise the elbow joint:
the humerus
the radius
the ulna.
These bones give rise to two joints:
Humeroulnar joint is the joint between the trochlea on the medial aspect of the distal end of the humerus and the trochlear notch on the proximal ulna.
Humeroradial joint is the joint between the capitulum on the lateral aspect of the distal end of the humerus with the head of the radius.
The humeroulnar and the humeroradial joints are the joints that give the elbow its characteristic hinge like properties. The rounded surfaces of the trochlea and capitulum of the humerus rotate against the concave surfaces of the trochlear notch of the ulna and head of the radius.
At the elbow joint, the proximal ends of the radius and ulna articulate with each other at the proximal radioulnar joint.
Elbow joint with ligaments in cadaver
This joint, however, is considered to be a separate articulation than those forming the elbow joint itself. The proximal radioulnar joint is the articulation between the circumferential head of the radius and a fibro-osseous ring formed by the radial groove of the ulna and the annular ligament that hold the head of the radius in this groove. The proximal radioulnar joint is functionally a pivot joint, allowing a rotational movement of the radius on the ulna.
Mnemonic
Here are is a mnemonic that can help you remember the articulations involved in the elbow joint.
CRAzy TULips
Capitulum = RAdius (capitulum of the humerus articulates with the head of radius)
Trochlea = ULnar (the trochlea of the humerus articulates with the trochlear notch of the ulna)
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Ligaments of the elbow joint
There are a collection of ligaments that connect the bones forming the elbow joint to each other, contributing to the stability of the joint. The humeroulnar and the humeroradial joints each have a ligament connecting the two bones involved at the articulation: the ulnar collateral and the radial collateral ligaments.
The ulnar collateral ligament extends from the medial epicondyle of the humerus to the coronoid process of the ulna. It is triangular in shape, and is composed of three parts: an anterior, a posterior and an inferior band.
[Ligaments of the elbow and forearm (overview)]
The radial collateral ligament has a low attachment to the lateral epicondyle of the humerus. The distal fibres blend with the annular ligament that encloses the head of the radius, as well as with the fibres of the supinator and the extensor carpi radialis brevis muscles.
The annular ligament also reinforces the joint by holding the radius and ulna together at their proximal articulation. The quadrate ligament is also present at this joint, and maintains constant tension during pronation and supination movements of the forearm.
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Blood supply and innervation
The blood supply to the elbow joint is derived from a number of periarticular anastamoses that are formed by the collateral and recurrent branches of the brachial, profunda brachii, radial and ulnar arteries. Proximal to the elbow joint, the brachial artery, the largest in the arm, gives off two branches, a superior and inferior ulnar collateral artery. The profunda brachii gives off a radial collateral and a middle collateral artery. These pass towards the joint contributing to the anastomotic loop supplying the joint.
Distal to the elbow joint, the radial artery gives off the radial recurrent artery, and the ulnar artery gives off the anterior and posterior ulnar recurrent arteries. These arteries ascend towards the elbow joint, anastamosing with the branches from the brachial and profunda brachii arteries in the arm.
Superior ulnar collateral artery
Arteria collateralis ulnaris superior
1/5
Synonyms:
Proximal ulnar collateral artery, Arteria collateralis ulnaris proximalis
Movements
As the elbow joint is a hinge joint, movement is in only one plane. The movements at the elbow joint involve movement of the forearm at the elbow joint. Flexion of the forearm at the elbow joint involves decreasing the angle between the forearm and the arm at the elbow joint. Extension involves increasing the angle between the arm and forearm. These movements are performed by two groups of muscles in the arm: the anterior compartment and the posterior compartment of the arm.
Flexion
Most of the muscles producing flexion are found in the anterior compartment of the arm. There are two muscles in this compartment that produce flexion at the elbow joint:
Movements at a hinge jointBiceps Brachii originates as two heads. The tendon of the long head originates from the supraglenoid tubercle of the scapula. It passes through the joint capsule of the shoulder joint and through the bicipital groove on the anterior surface of the humerus. The short head of the biceps brachii muscle originates from the coracoid process of the scapula. These heads join together to form the biceps brachii muscle belly. The muscle inserts via a single tendon onto the radial tuberosity distal to the elbow joint. In the forearm, there is a continuation of this tendon as a flattened connective tissue sheath, the bicipital aponeurosis. This aponeurosis blends with the deep fascia in the anterior forearm.
Brachialis originates from the distal half of the anterior surface of the humerus, as well as from the intermuscular septa on either side of the anterior compartment. It is located deep to the biceps brachii muscle. It forms a singular tendon that inserts onto the tuberosity of the ulna.
Both the biceps brachii and brachialis muscles are innervated by the Musculocutaneous nerve.
While the biceps brachii and the brachialis muscles are the main flexors of the elbow joint, the brachioradialis muscle is also involved in flexion of the forearm at this joint. Brachioradialis originates for the lateral aspect of the distal humerus above the lateral epicondyle. It inserts onto the lateral aspect of the distal radius. Although this muscle is primarily in the forearm, it crosses the elbow joint so therefore it acts on the elbow joint. It is innervated by the radial nerve.
Mnemonic
Learning the muscles that bend the elbow becomes child's play if you anchor them to a mnemonic like the one below.
3 B's bend the elbow
Biceps
Brachialis
Brachioradialis
Extension
Extension of the forearm at the elbow joint is the increase of the angle at the elbow to bring the forearm back to the anatomical position from a flexed position. There is one muscle involved in extension, the triceps brachii muscle. It is the only muscle in the posterior compartment of the arm.
Triceps Brachii originates as three heads. The long head originates from the infraglenoid tubercle of the scapula, the lateral head originates from the lateral aspect of the humerus above the radial groove, and the medial head originates from the medial aspect of the humerus below the level of the radial groove. The three heads converge on a single tendon that inserts onto the olecranon of the ulna. It is supplied by the radial nerve, which passes down through the arm in the radial groove between the lateral and medial heads of the muscle.
While flexion and extension are the only movements that can occur at the elbow joint itself, movement is also afforded at the proximal radioulnar joint, which contributes to the elbow joint. Movements at this joint are called pronation and supination. These are rotational movements that occur when the distal end of the radius moves over the distal end of the ulna by rotating the radius in the pivot joint formed by the circular head of the radius, the radial groove of the ulna and the annular ligament.
Pronation of forearm
Pronatio antebrachii
1/2
Synonyms:
none
Pronation and supination are easily visualised when the elbow is flexed at 90°. Supination is where the palm of the hand is facing upwards; pronation is rotation of the forearm so that the palm is facing downwards. In the anatomical position, the forearm is in the supine position. Pronation in the anatomical position is movement of the forearm so that the palm is facing posteriorly.
Clinical notes
Fractures
Common injuries to the elbow joint include fractures of the bony structures contributing to the joint. Care must be taken when diagnosing a fracture of the elbow joint with respect to the age of the patient. This is because secondary ossification centres in children and adolescents can easily be mistaken for a fracture on a radiograph. Therefore, it is vital that a physician know the age of the child when examining their radiograph. Some of the areas of secondary ossification are as follows:
Capitulum (1 year)
Radial head and medial epicondyle (5 years)
Trochlea (11 years)
Olecranon (12 years)
A supracondylar fracture is a fracture to the humerus above the level of the humeral condyles. This injury most commonly occurs in children. In such injuries, the distal bone fragment can be pulled posteriorly by the triceps muscle. This can cause bowstringing of the brachial arteries by stretching them, which can have adverse effects.
Fracture of the head of the radius is a common fracture of the elbow joint. It is often caused by a fall on an outstretched hand, and can have severe implications including loss of full extension of the forearm at the elbow joint.
Epicondylitis and arthritis
Epicondylitis is inflammation of the soft tissues surrounding the epicondyles of the humerus. It typically occurs due to overuse of the flexor and extensor muscles of the forearm. Pain is localised around the epicondylar region. Tennis players typically get epicondylitis on the lateral epicondyle (common extensor origin), whereas golfers usually have it on the medial epicondyle (common flexor origin).
Arthritis can occur at the elbow joint, and is usually more severe in the dominant limb of the patient.
Venipunctures
Anterior to the elbow joint is a transitional zone between the arm and the forearm called the cubital fossa. Located in the subcutaneous tissue above the cubital fossa is a very superficial vein: the median cubital vein. This is a short vein connecting two longer superficial veins draining the upper limb, the cephalic and basilic veins, together. The medial cubital vein is one of the most common sites for venipuncture, which is collecting blood samples in the upper limb.
Sources
All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.
References:
F. Netter: Atlas of Human Anatomy, 6th Edition, Elsevier Saunders (2014).
J.A. Gosling, P.F. Harris, J.R. Humpherson et al.: Human Anatomy, Colour Atlas and Textbook, 5th Edition, Mosby Elsevier (2008).
R. Drake, A.W. Vogl, A.W.M. Mitchell: Gray’s Anatomy for Students, 3rd Edition, Churchill Livingston Elsevier (2015).
S. Standring: Gray’s Anatomy: The Anatomical Basis of Clinical Practice, 14th Edition, Churchill Livingston Elsevier (2008).
Illustrators:
Ligaments of the elbow and forearm (overview) - Yousun Koh
Movements at a hinge joint - Paul Kim
Pronation of forearm (ventral view) - Paul Kim
Elbow joint (cadaver dissection) - Prof. Carlos Suárez-Quian
Elbow joint: want to learn more about it?
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Elbow - Wikipedia
Elbow - Wikipedia
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(Top)
1Structure
Toggle Structure subsection
1.1Joint
1.1.1Joint capsule
1.1.2Synovial membrane
1.1.3Ligaments
1.2Muscles
1.2.1Flexion
1.2.2Extension
1.3Blood supply
1.4Nerve supply
1.5Development
2Function
Toggle Function subsection
2.1Carrying angle
3Pathology
Toggle Pathology subsection
3.1Tendonitis
3.2Fractures
3.3Dislocation
3.4Infection
3.5Arthritis
3.6Bursitis
3.7Elbow pain
4Clinical significance
Toggle Clinical significance subsection
4.1Tennis elbow
4.2Golfer's elbow
4.3Rheumatoid arthritis
4.4Cubital tunnel syndrome
5Society and culture
6Other primates
7Notes
8References
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Elbow
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From Wikipedia, the free encyclopedia
Joint between the upper and lower parts of the arm
For other uses, see Elbow (disambiguation).
ElbowHuman elbowElbow jointDetailsIdentifiersLatinarticulatio cubitiMeSHD004550TA98A01.1.00.023TA2145FMA24901Anatomical terminology[edit on Wikidata]
The elbow is the region between the upper arm and the forearm that surrounds the elbow joint.[1] The elbow includes prominent landmarks such as the olecranon, the cubital fossa (also called the chelidon, or the elbow pit), and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm;[2] more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body.[3][4]
The term elbow is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used.[1]
The name for the elbow in Latin is cubitus, and so the word cubital is used in some elbow-related terms, as in cubital nodes for example.
Structure[edit]
Joint[edit]
The elbow joint has three different portions surrounded by a common joint capsule. These are joints between the three bones of the elbow, the humerus of the upper arm, and the radius and the ulna of the forearm.
Joint
From
To
Description
Humeroulnar joint
trochlear notch of the ulna
trochlea of humerus
Is a simple hinge-joint, and allows for movements of flexion and extension only.
Humeroradial joint
head of the radius
capitulum of the humerus
Is a ball-and-socket joint.
Proximal radioulnar joint
head of the radius
radial notch of the ulna
In any position of flexion or extension, the radius, carrying the hand with it, can be rotated in it. This movement includes pronation and supination.
When in anatomical position there are four main bony landmarks of the elbow. At the lower part of the humerus are the medial and lateral epicondyles, on the side closest to the body (medial) and on the side away from the body (lateral) surfaces. The third landmark is the olecranon found at the head of the ulna. These lie on a horizontal line called the Hueter line. When the elbow is flexed, they form a triangle called the Hueter triangle, which resembles an equilateral triangle.[5]
Left elbow extended and flexed
At the surface of the humerus where it faces the joint is the trochlea. In most people, the groove running across the trochlea is vertical on the anterior side but it spirals off on the posterior side. This results in the forearm being aligned to the upper arm during flexion, but forming an angle to the upper arm during extension — an angle known as the carrying angle.[6]
The superior radioulnar joint shares the joint capsule with the elbow joint but plays no functional role at the elbow.[7]
Joint capsule[edit]
Capsule of elbow-joint (distended). Anterior and posterior aspects.
The elbow joint and the superior radioulnar joint are enclosed by a single fibrous capsule. The capsule is strengthened by ligaments at the sides but is relatively weak in front and behind.[8]
On the anterior side, the capsule consists mainly of longitudinal fibres. However, some bundles among these fibers run obliquely or transversely, thickening and strengthening the capsule. These bundles are referred to as the capsular ligament. Deep fibres of the brachialis muscle insert anteriorly into the capsule and act to pull it and the underlying membrane during flexion in order to prevent them from being pinched.[8]
On the posterior side, the capsule is thin and mainly composed of transverse fibres. A few of these fibres stretch across the olecranon fossa without attaching to it and form a transverse band with a free upper border. On the ulnar side, the capsule reaches down to the posterior part of the annular ligament. The posterior capsule is attached to the triceps tendon which prevents the capsule from being pinched during extension.[8]
Synovial membrane[edit]
The synovial membrane of the elbow joint is very extensive. On the humerus, it extends up from the articular margins and covers the coronoid and radial fossae anteriorly and the olecranon fossa posteriorly. Distally, it is prolonged down to the neck of the radius and the superior radioulnar joint. It is supported by the quadrate ligament below the annular ligament where it also forms a fold which gives the head of the radius freedom of movement.[8]
Several synovial folds project into the recesses of the joint.[8]
These folds or plicae are remnants of normal embryonic development and can be categorized as either anterior (anterior humeral recess) or posterior (olecranon recess).[9]
A crescent-shaped fold is commonly present between the head of the radius and the capitulum of the humerus.[8]
On the humerus there are extrasynovial fat pads adjacent to the three articular fossae. These pads fill the radial and coronoid fossa anteriorly during extension, and the olecranon fossa posteriorly during flexion. They are displaced when the fossae are occupied by the bony projections of the ulna and radius.[8]
Ligaments[edit]
Left elbow-jointLeft: anterior and ulnar collateral ligamentsRight: posterior and radial collateral ligaments
The elbow, like other joints, has ligaments on either side. These are triangular bands which blend with the joint capsule. They are positioned so that they always lie across the transverse joint axis and are, therefore, always relatively tense and impose strict limitations on abduction, adduction, and axial rotation at the elbow.[8]
The ulnar collateral ligament has its apex on the medial epicondyle. Its anterior band stretches from the anterior side of the medial epicondyle to the medial edge of the coronoid process, while the posterior band stretches from posterior side of the medial epicondyle to the medial side of the olecranon. These two bands are separated by a thinner intermediate part and their distal attachments are united by a transverse band below which the synovial membrane protrudes during joint movements. The anterior band is closely associated with the tendon of the superficial flexor muscles of the forearm, even being the origin of flexor digitorum superficialis. The ulnar nerve crosses the intermediate part as it enters the forearm.[8]
The radial collateral ligament is attached to the lateral epicondyle below the common extensor tendon. Less distinct than the ulnar collateral ligament, this ligament blends with the annular ligament of the radius and its margins are attached near the radial notch of the ulna.[8]
Muscles[edit]
Flexion[edit]
There are three main flexor muscles at the elbow:[10]
Brachialis acts exclusively as an elbow flexor and is one of the few muscles in the human body with a single function. It originates low on the anterior side of the humerus and is inserted into the tuberosity of the ulna.
Brachioradialis acts essentially as an elbow flexor but also supinates during extreme pronation and pronates during extreme supination. It originates at the lateral supracondylar ridge distally on the humerus and is inserted distally on the radius at the styloid process.
Biceps brachii is the main elbow flexor but, as a biarticular muscle, also plays important secondary roles as a stabiliser at the shoulder and as a supinator. It originates on the scapula with two tendons: That of the long head on the supraglenoid tubercle just above the shoulder joint and that of the short head on the coracoid process at the top of the scapula. Its main insertion is at the radial tuberosity on the radius.
Brachialis is the main muscle used when the elbow is flexed slowly. During rapid and forceful flexion all three muscles are brought into action assisted by the superficial forearm flexors originating at the medial side of the elbow.[11]
The efficiency of the flexor muscles increases dramatically as the elbow is brought into midflexion (flexed 90°) — biceps reaches its angle of maximum efficiency at 80–90° and brachialis at 100–110°.[10]
Active flexion is limited to 145° by the contact between the anterior muscles of the upper arm and forearm, more so because they are hardened by contraction during flexion. Passive flexion (forearm is pushed against the upper arm with flexors relaxed) is limited to 160° by the bony projections on the radius and ulna as they reach to shallow depressions on the humerus; i.e. the head of radius being pressed against the radial fossa and the coronoid process being pressed against the coronoid fossa. Passive flexion is further limited by tension in the posterior capsular ligament and in triceps brachii.[12]
A small accessory muscle, so called epitrochleoanconeus muscle, may be found on the medial aspect of the elbow running from the medial epicondyle to the olecranon.[13]
Extension[edit]
Elbow extension is simply bringing the forearm back to anatomical position.[11] This action is performed by triceps brachii with a negligible assistance from anconeus. Triceps originates with two heads posteriorly on the humerus and with its long head on the scapula just below the shoulder joint. It is inserted posteriorly on the olecranon.[10]
Triceps is maximally efficient with the elbow flexed 20–30°. As the angle of flexion increases, the position of the olecranon approaches the main axis of the humerus which decreases muscle efficiency. In full flexion, however, the triceps tendon is "rolled up" on the olecranon as on a pulley which compensates for the loss of efficiency. Because triceps' long head is biarticular (acts on two joints), its efficiency is also dependent on the position of the shoulder.[10]
Extension is limited by the olecranon reaching the olecranon fossa, tension in the anterior ligament, and resistance in flexor muscles. Forced extension results in a rupture in one of the limiting structures: olecranon fracture, torn capsule and ligaments, and, though the muscles are normally left unaffected, a bruised brachial artery.[12]
Blood supply[edit]
The anastomosis and deep veins around the elbow-joint
The arteries supplying the joint are derived from an extensive circulatory anastomosis between the brachial artery and its terminal branches. The superior and inferior ulnar collateral branches of the brachial artery and the radial and middle collateral branches of the profunda brachii artery descend from above to reconnect on the joint capsule, where they also connect with the anterior and posterior ulnar recurrent branches of the ulnar artery; the radial recurrent branch of the radial artery; and the interosseous recurrent branch of the common interosseous artery.[14]
The blood is brought back by vessels from the radial, ulnar, and brachial veins.
There are two sets of lymphatic nodes at the elbow, normally located above the medial epicondyle — the deep and superficial cubital nodes (also called epitrochlear nodes). The lymphatic drainage at the elbow is through the deep nodes at the bifurcation of the brachial artery, the superficial nodes drain the forearm and the ulnar side of the hand. The efferent lymph vessels from the elbow proceed to the lateral group of axillary lymph nodes.[14][15]
Nerve supply[edit]
The elbow is innervated anteriorly by branches from the musculocutaneous, median, and radial nerve, and posteriorly from the ulnar nerve and the branch of the radial nerve to anconeus.[14]
Development[edit]
The elbow undergoes dynamic development of ossification centers through infancy and adolescence, with the order of both the appearance and fusion of the apophyseal growth centers being crucial in assessment of the pediatric elbow on radiograph, in order to distinguish a traumatic fracture or apophyseal separation from normal development. The order of appearance can be understood by the 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 fuse during adolescence, with the internal epicondyle and olecranon fusing last. The ages of fusion are more variable than ossification, but normally occur at 13, 15, 17, 13, 16 and 13 years, respectively.[16] In addition, the presence of a joint effusion can be inferenced by the presence of the fat pad sign, a structure that is normally physiologically present, but pathologic when elevated by fluid, and always pathologic when posterior.[17]
Function[edit]
The function of the elbow joint is to extend and flex the arm.[18] The range of movement in the elbow is from 0 degrees of elbow extension to 150 degrees of elbow flexion.[19] Muscles contributing to function are all flexion (biceps brachii, brachialis, and brachioradialis) and extension muscles (triceps and anconeus).
In humans, the main task of the elbow is to properly place the hand in space by shortening and lengthening the upper limb. While the superior radioulnar joint shares joint capsule with the elbow joint, it plays no functional role at the elbow.[7]
With the elbow extended, the long axis of the humerus and that of the ulna coincide.[20] At the same time, the articular surfaces on both bones are located in front of those axes and deviate from them at an angle of 45°.[21] Additionally, the forearm muscles that originate at the elbow are grouped at the sides of the joint in order not to interfere with its movement. The wide angle of flexion at the elbow made possible by this arrangement — almost 180° — allows the bones to be brought almost in parallel to each other.[7]
Carrying angle[edit]
Normal radiograph; right picture of the straightened arm shows the carrying angle of the elbow
When the arm is extended, with the palm facing forward or up, the bones of the upper arm (humerus) and forearm (radius and ulna) are not perfectly aligned. The deviation from a straight line occurs in the direction of the thumb, and is referred to as the "carrying angle".[22]
The carrying angle permits the arm to be swung without contacting the hips. Women on average have smaller shoulders and wider hips than men, which tends to produce a larger carrying angle (i.e., larger deviation from a straight line than that in men). There is, however, extensive overlap in the carrying angle between individual men and women, and a sex-bias has not been consistently observed in scientific studies.[23]
The angle is greater in the dominant limb than the non-dominant limb of both sexes,[24] suggesting that natural forces acting on the elbow modify the carrying angle. Developmental,[25] aging and possibly racial influences add further to the variability of this parameter.
Pathology[edit]
Left: Lateral X ray of a dislocated right elbowRight: AP X ray of a dislocated right elbow
The types of disease most commonly seen at the elbow are due to injury.
Tendonitis[edit]
Two of the most common injuries at the elbow are overuse injuries: tennis elbow and golfer's elbow.[26] Golfer's elbow involves the tendon of the common flexor origin which originates at the medial epicondyle of the humerus (the "inside" of the elbow).[26] Tennis elbow is the equivalent injury, but at the common extensor origin (the lateral epicondyle of the humerus).[26]
Fractures[edit]
There are three bones at the elbow joint, and any combination of these bones may be involved in a fracture of the elbow. Patients who are able to fully extend their arm at the elbow are unlikely to have a fracture (98% certainty) and an X-ray is not required as long as an olecranon fracture is ruled out.[27] Acute fractures may not be easily visible on X-ray.[28]
Dislocation[edit]
X-ray of ventral dislocation of the radial head. There is calcification of annular ligament, which can be seen as early as 2 weeks after injury.[29]
Elbow dislocations constitute 10% to 25% of all injuries to the elbow. The elbow is one of the most commonly dislocated joints in the body, with an average annual incidence of acute dislocation of 6 per 100,000 persons.[30] Among injuries to the upper extremity, dislocation of the elbow is second only to a dislocated shoulder.
A full dislocation of the elbow will require expert medical attention to re-align, and recovery can take approximately 6 weeks.[citation needed]
Infection[edit]
Infection of the elbow joint (septic arthritis) is uncommon. It may occur spontaneously, but may also occur in relation to surgery or infection elsewhere in the body (for example, endocarditis).[31]
Arthritis[edit]
Elbow arthritis is usually seen in individuals with rheumatoid arthritis or after fractures that involve the joint itself. When the damage to the joint is severe, fascial arthroplasty or elbow joint replacement may be considered.[32]
Bursitis[edit]
Main article: Olecranon bursitis
Olecranon bursitis, tenderness, warmth, swelling, pain in both flexion and extension-in chronic case great flexion-is extremely painful.
Elbow pain[edit]
Main article: elbow pain
Elbow pain occurs when the tenderness of the tissues in the elbow become inflamed. Frequent exercise of the inflamed elbow will assist with healing.
Clinical significance[edit]
Elbow pain can occur for a multitude of reasons, including injury, disease, and other conditions. Common conditions include tennis elbow, golfer's elbow, distal radioulnar joint rheumatoid arthritis, and cubital tunnel syndrome.
Tennis elbow[edit]
Tennis elbow is a very common type of overuse injury. It can occur both from chronic repetitive motions of the hand and forearm, and from trauma to the same areas. These repetitions can injure the tendons that connect the extensor supinator muscles (which rotate and extend 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 upon touch.[33]
A non-invasive treatment for pain management is rest. If achieving rest is an issue, a wrist brace can also be worn. This keeps the wrist in flexion, thereby relieving the extensor muscles and allowing rest. Ice, heat, ultrasound, steroid injections, and compression can also help alleviate pain. After the pain has been reduced, exercise therapy is important to prevent injury in the future. Exercises should be low velocity, and weight should increase progressively.[34] Stretching the flexors and extensors is helpful, as are strengthening exercises. Massage can also be useful, focusing on the extensor trigger points.[35]
Golfer's elbow[edit]
Golfer's elbow is very similar to tennis elbow, but less common. It is caused by overuse and repetitive motions like a golf swing. It can also be caused by trauma. Wrist flexion and pronation (rotating of the forearm) causes irritation to the tendons near the medial epicondyle of the elbow.[36] It can cause pain, stiffness, loss of sensation, and weakness radiating from the inside of the elbow to the fingers.
Rest is the primary intervention for this injury. Ice, pain medication, steroid injections, strengthening exercises, and avoiding any aggravating activities can also help. Surgery is a last resort, and rarely used. Exercises should focus on strengthening and stretching the forearm, and utilizing proper form when performing movements.[37]
Rheumatoid arthritis[edit]
Rheumatoid arthritis is a chronic disease that affects joints. It is very common in the wrist, and is most common at the radioulnar joint. It results in pain, stiffness, and deformities.
There are many different treatments for rheumatoid arthritis, and there is no one consensus for which methods are best. Most common treatments include wrist splints, surgery, physical and occupational therapy, and antirheumatic medication.[38]
Cubital tunnel syndrome[edit]
Cubital tunnel syndrome, more commonly known as ulnar neuropathy, occurs when the ulnar nerve is irritated and becomes inflamed. This can often happen where the ulnar nerve is most superficial, at the elbow. The ulnar nerve passes over the elbow, at the area known as the "funny bone". Irritation can occur due to constant, repeated stress and pressure at this area, or from a trauma. It can also occur due to bone deformities, and oftentimes from sports.[39] Symptoms include tingling, numbness, and weakness, along with pain.
First line pain management techniques include the use of nonsteroidal anti-inflammatory oral medicines. These help to reduce inflammation, pressure, and irritation of the nerve and around the nerve. Other simple fixes include learning more ergonomically friendly habits that can help prevent nerve impingement and irritation in the future. Protective equipment can also be very helpful. Examples of this include a protective elbow pad, and an arm splint. More serious cases often involve surgery, in which the nerve or the surrounding tissue is moved to relieve the pressure. Recovery from surgery can take awhile, but the prognosis is often a good one. Recovery often includes movement restrictions, and range of motion activities, and can last a few months (cubital and radial tunnel syndrome, 2).
Society and culture[edit]
The now obsolete length unit ell relates closely to the elbow. This becomes especially visible when considering the Germanic origins of both words, Elle (ell, defined as the length of a male forearm from elbow to fingertips) and Ellbogen (elbow). It is unknown when or why the second "l" was dropped from English usage of the word.[citation needed] The ell as in the English measure could also be taken to come from the letter L, being bent at right angles, as an elbow.[40] The ell as a measure was taken as six handbreadths; three to the elbow and three from the elbow to the shoulder.[41] Another measure was the cubit (from cubital). This was taken to be the length of a man's arm from the elbow to the end of the middle finger.[42]
Other primates[edit]
Though the elbow is similarly adapted for stability through a wide range of pronation-supination and flexion-extension in all apes, there are some minor difference. In arboreal apes such as orangutans, the large forearm muscles originating on the epicondyles of the humerus generate significant transverse forces on the elbow joint. The structure to resist these forces is a pronounced keel on the trochlear notch on the ulna, which is more flattened in, for example, humans and gorillas. In knuckle-walkers, on the other hand, the elbow has to deal with large vertical loads passing through extended forearms and the joint is therefore more expanded to provide larger articular surfaces perpendicular to those forces.[43]
Derived traits in catarrhini (apes and Old World monkeys), elbows include the loss of the entepicondylar foramen (a hole in the distal humerus), a non-translatory (rotation-only) humeroulnar joint, and a more robust ulna with a shortened trochlear notch.[44]
The proximal radioulnar joint is similarly derived in higher primates in the location and shape of the radial notch on the ulna; the primitive form being represented by New World monkeys, such as the howler monkey, and by fossil catarrhines, such as Aegyptopithecus. In these taxa, the oval head of the radius lies in front of the ulnar shaft 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.[44]
Notes[edit]
^ a b "MeSH Browser". meshb.nlm.nih.gov. Retrieved 8 January 2022.
^ "MeSH Browser". meshb.nlm.nih.gov. Retrieved 8 January 2022.
^ Kapandji 1982, pp. 74–7
^ Palastanga & Soames 2012, p. 138
^ Ross & Lamperti 2006, p. 240
^ Kapandji 1982, p. 84
^ a b c Palastanga & Soames 2012, pp. 127–8
^ a b c d e f g h i j Palastanga & Soames 2012, pp. 131–2
^ Awaya et al. 2001
^ a b c d Kapandji 1982, pp. 88–91
^ a b Palastanga & Soames 2012, p. 136
^ a b Kapandji 1982, p. 86
^ Gervasio, Olga; Zaccone, Claudio (2008). "Surgical Approach to Ulnar Nerve Compression at the Elbow Caused by the Epitrochleoanconeus Muscle and a Prominent Medial Head of the Triceps". Operative Neurosurgery. 62 (suppl_1): 186–193. doi:10.1227/01.neu.0000317392.29551.aa. ISSN 2332-4252. PMID 18424985. S2CID 22925073.
^ a b c Palastanga & Soames 2012, p. 133
^ "Cubital nodes". Inner Body. Retrieved 30 June 2012.
^ Soma, DB (March 2016). "Opening the Black Box: Evaluating the Pediatric Athlete With Elbow Pain". PM&R. 8 (3 Suppl): S101-12. doi:10.1016/j.pmrj.2016.01.002. PMID 26972259. S2CID 30934706.
^ Lee, YJ; Han, D; Koh, YH; Zo, JH; Kim, SH; Kim, DK; Lee, JS; Moon, HJ; Kim, JS; Chun, EJ; Youn, BJ; Lee, CH; Kim, SS (February 2008). "Adult sail sign: radiographic and computed tomographic features". Acta Radiologica. 49 (1): 37–40. doi:10.1080/02841850701675677. PMID 18210313. S2CID 2031763.
^ Dimon, T. (2011). The Body of Motion: its Evolution and Design (pp. 39-42). Berkeley, CA: North Atlantic Books.
^ Thomas, B. P.; Sreekanth, R. (2012). "Distal radioulnar joint injuries". Indian Journal of Orthopaedics. 46 (5): 493–504. doi:10.4103/0019-5413.101031. PMC 3491781. PMID 23162140.
^ Azar, Frederick; Canale, S.; Beaty, James (2016). "12 - Shoulder And Elbow Arthroplasty". Campbell's Operative Orthopaedics E-Book (13 ed.). Elsevier Health Sciences. p. 599. ISBN 978-0-323-39257-0.
^ Soames, Roger (2018). "2 - Upper limb". Anatomy and Human Movement E-Book: Structure and function (7 ed.). Elsevier Health Sciences. p. 102. ISBN 978-0-702-07259-8.
^ Gossage, James; Bultitude, Matthew; Corbett, Steven; Burnand, Katherine; Lahiri, Rajiv (2021). Browse's Introduction to the Symptoms & Signs of Surgical Disease (6 ed.). CRC Press. p. 29. doi:10.1201/9780429447891. ISBN 978-0-429-44789-1.
^ Steel & Tomlinson 1958, pp. 315–7; Van Roy et al. 2005, pp. 1645–56; Zampagni et al. 2008, p. 370
^ Paraskevas et al. 2004, pp. 19–23; Yilmaz et al. 2005, pp. 1360–3
^ Tukenmez et al. 2004, pp. 274–6
^ a b c Walker, Brad (2018). "8 - Sports Injuries of the Elbow". The Anatomy of Sports Injuries (2 ed.). North Atlantic Books. pp. 36–37. ISBN 978-1-623-17283-1.
^ Appelboam et al. 2008
^ O'Dwyer H, O'Sullivan P, Fitzgerald D, Lee MJ, McGrath F, Logan PM (July 2004). "The fat pad sign following elbow trauma in adults: its usefulness and reliability in suspecting occult fracture". Journal of Computer Assisted Tomography. 28 (4): 562–565. doi:10.1097/00004728-200407000-00021. ISSN 0363-8715. PMID 15232392. S2CID 8631113.
^ Earwaker J (1992). "Posttraumatic calcification of the annular ligament of the radius". Skeletal Radiol. 21 (3): 149–54. doi:10.1007/BF00242127. PMID 1604339. S2CID 43615869.
^ Blakeney 2010
^ Rausch V, von Glinski A, Rosteius T, Königshausen M, Schildhauer TA, Seybold D, Gessmann J (18 January 2020). "Secondary purulent infections of the elbow joint: a retrospective, single-center study". BMC Musculoskeletal Disorders. 21 (1): 38. doi:10.1186/s12891-020-3046-6. ISSN 1471-2474. PMC 6969974. PMID 31954400.
^ Matsen 2012
^ Speed, C., Hazleman, B., & Dalton, S. (2006). Fast Facts : Soft Tissue Disorders (2nd Edition). Abingdon, Oxford, GBR: Health Press Limited. Retrieved from http://www.ebrary.com
^ MacAuley, D., & Best, T. (Eds.). (2008). Evidence-Based Sports Medicine. Chichester, GBR: John Wiley & Sons. Retrieved from http://www.ebrary.com
^ Thomson, B. (1 January 2015). (5) Tennis Elbow Treatment By Trigger Point Massage. Retrieved February 17, 2015, from http://www.easyvigour.net.nz/fitness/hOBP5_TriggerPoint_Tennis_Elbow.htm
^ Dhami, S., & Sheikh, A. (2002). At A Glance - Medial Epicondylitis (Golfer's Elbow). Factiva.
^ Golfer's elbow. (9 October 2012). Retrieved March 14, 2015, from http://www.mayoclinic.org/diseases-conditions/golfers-elbow/basics/prevention/con-20027964
^ Lee, Steve K.; Hausman, Michael R. (2005). "Management of the Distal Radioulnar Joint in Rheumatoid Arthritis". Hand Clinics. 21 (4): 577–589. doi:10.1016/j.hcl.2005.08.009. PMID 16274868.
^ Cubital and Radial Tunnel Syndrome: Causes, Symptoms, and Treatment. (29 September 2014). Retrieved February 17, 2015, from http://www.webmd.com/pain-management/cubital-radial-tunnel-syndrome
^ O.D.E>2nd edition 2005
^ O.D.E. 2nd edition 2005,
^ O.D.E. 2nd edition 2005
^ Drapeau 2008, Abstract
^ a b Richmond et al. 1998, Discussion, p. 267
References[edit]
Appelboam, A; Reuben, A D; Benger, J R; Beech, F; Dutson, J; Haig, S; Higginson, I; Klein, J A; Le Roux, S; Saranga, S S M; Taylor, R; Vickery, J; Powell, R J; Lloyd, G (2008). "Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children". BMJ. 337: a2428. doi:10.1136/bmj.a2428. PMC 2600962. PMID 19066257.
Awaya, Hitomi; Schweitzer, Mark E.; Feng, Sunah A.; Kamishima, Tamotsu; Marone, Phillip J.; Farooki; Shella; Trudell, Debra J.; Haghighi, Parviz; Resnick, Donald L. (December 2001). "Elbow Synovial Fold Syndrome: MR Imaging Findings". American Journal of Roentgenology. 177 (6): 1377–81. doi:10.2214/ajr.177.6.1771377. PMID 11717088.
Blakeney, W G (January 2010). "Elbow Dislocation". Life in the Fast Lane.
Drapeau, MS (July 2008). "Articular morphology of the proximal ulna in extant and fossil hominoids and hominins". Journal of Human Evolution. 55 (1): 86–102. doi:10.1016/j.jhevol.2008.01.005. PMID 18472143.
Kapandji, Ibrahim Adalbert (1982). The Physiology of the Joints: Volume One Upper Limb (5th ed.). New York: Churchill Livingstone.
Matsen, Frederick A. (2012). "Total elbow joint replacement for rheumatoid arthritis: A Patient's Guide" (PDF). UW Medicine.
Palastanga, Nigel; Soames, Roger (2012). Anatomy and Human Movement: Structure and Function (6th ed.). Elsevier. ISBN 9780702040535.
Paraskevas, G; Papadopoulos, A; Papaziogas, B; Spanidou, S; Argiriadou, H; Gigis, J (2004). "Study of the carrying angle of the human elbow joint in full extension: a morphometric analysis". Surgical and Radiologic Anatomy. 26 (1): 19–23. doi:10.1007/s00276-003-0185-z. PMID 14648036. S2CID 24369552.
Richmond, Brian G; Fleagle, John G; Kappelman, John; Swisher, Carl C (1998). "First Hominoid From the Miocene of Ethiopia and the Evolution of the Catarrhine Elbow" (PDF). American Journal of Physical Anthropology. 105 (3): 257–77. doi:10.1002/(SICI)1096-8644(199803)105:3<257::AID-AJPA1>3.0.CO;2-P. PMID 9545073. Archived from the original (PDF) on 2013-05-17.
Ross, Lawrence M.; Lamperti, Edward D., eds. (2006). Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System. Thieme. p. 240. ISBN 978-3131420817.
Steel, F; Tomlinson, J (1958). "The 'carrying angle' in man". Journal of Anatomy. 92 (2): 315–7. PMC 1249704. PMID 13525245.
Tukenmez, M; Demirel, H; Perçin, S; Tezeren, G (2004). "Measurement of the carrying angle of the elbow in 2,000 children at ages six and fourteen years". Acta Orthopaedica et Traumatologica Turcica. 38 (4): 274–6. PMID 15618770.
Van Roy, P; Baeyens, JP; Fauvart, D; Lanssiers, R; Clarijs, JP (2005). "Arthro-kinematics of the elbow: study of the carrying angle". Ergonomics. 48 (11–14): 1645–56. doi:10.1080/00140130500101361. PMID 16338730. S2CID 13317929.
Yilmaz, E; Karakurt, L; Belhan, O; Bulut, M; Serin, E; Avci, M (2005). "Variation of carrying angle with age, sex, and special reference to side". Orthopedics. 28 (11): 1360–3. doi:10.3928/0147-7447-20051101-16. PMID 16295195.
Zampagni, M; Casino, D; Zaffagnini, S; Visani, AA; Marcacci, M (2008). "Estimating the elbow carrying angle with an electrogoniometer: acquisition of data and reliability of measurements". Orthopedics. 31 (4): 370. doi:10.3928/01477447-20080401-39. PMID 19292279.
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AnatomyUpper limbElbow and forearmElbow joint
Elbow joint
Author:
Niamh Gorman, MSc
•
Reviewer:
Francesca Salvador, MSc
Last reviewed: September 11, 2023
Reading time: 14 minutes
Recommended video: Elbow joint
[21:20]
Bones, ligaments and nerve supply of the elbow joint.
Elbow joint
Articulatio cubiti
1/5
Synonyms:
none
The elbow joint is a synovial joint found in the upper limb between the arm and the forearm. It is the point of articulation of three bones: the humerus of the arm and the radius and the ulna of the forearm.
The elbow joint is classified structurally as a synovial joint. It is also classified structurally as a compound joint, as there are two articulations in the joint. Synovial joints, also called diarthroses, are free movable joints. The articular surfaces of the bones at these joints are separated from each other by a layer of hyaline cartilage. Smooth movement at these joints is provided by a highly viscous synovial fluid, which acts as a lubricant.
A fibrous capsule encloses the joint, and is lined internally by a synovial membrane. Synovial joints can be further categorized based on function. The elbow joint is functionally a hinge joint, allowing movement in only one plane (uniaxial).
Key facts about the elbow joint
Type
Hinge joint
Bones
Humerus, radius, ulna
Mnemonics
CRAzy TULips (Capitulum = RAdius, Trochlea = ULna)
Ligaments
Ulnar collateral ligament, radial collateral ligament, annular ligament, quadrate ligament
Blood supply
Proximal to elbow joint - Ulnar collateral artery, radial collateral artery, middle collateral artery
Distal to elbow joint - Radial recurrent artery, ulnar recurret artery
Movements
Flexion -
Biceps brachii, Brachialis, Brachioradialis muscles
Mnemonic: 3 B's bend the elbow
Extension - Triceps brachii muscle
Clinical
Fractures, epicondylitis, arthritis, venipunctures
Contents
Osteology Mnemonic
Ligaments of the elbow joint
Blood supply and innervation
Movements
Flexion
Mnemonic
Extension
Clinical notes
Fractures
Epicondylitis and arthritis
Venipunctures
Sources
+ Show all
Osteology
Humerus
1/4
Synonyms:
none
There are three bones that comprise the elbow joint:
the humerus
the radius
the ulna.
These bones give rise to two joints:
Humeroulnar joint is the joint between the trochlea on the medial aspect of the distal end of the humerus and the trochlear notch on the proximal ulna.
Humeroradial joint is the joint between the capitulum on the lateral aspect of the distal end of the humerus with the head of the radius.
The humeroulnar and the humeroradial joints are the joints that give the elbow its characteristic hinge like properties. The rounded surfaces of the trochlea and capitulum of the humerus rotate against the concave surfaces of the trochlear notch of the ulna and head of the radius.
At the elbow joint, the proximal ends of the radius and ulna articulate with each other at the proximal radioulnar joint.
Elbow joint with ligaments in cadaver
This joint, however, is considered to be a separate articulation than those forming the elbow joint itself. The proximal radioulnar joint is the articulation between the circumferential head of the radius and a fibro-osseous ring formed by the radial groove of the ulna and the annular ligament that hold the head of the radius in this groove. The proximal radioulnar joint is functionally a pivot joint, allowing a rotational movement of the radius on the ulna.
Mnemonic
Here are is a mnemonic that can help you remember the articulations involved in the elbow joint.
CRAzy TULips
Capitulum = RAdius (capitulum of the humerus articulates with the head of radius)
Trochlea = ULnar (the trochlea of the humerus articulates with the trochlear notch of the ulna)
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Ligaments of the elbow joint
There are a collection of ligaments that connect the bones forming the elbow joint to each other, contributing to the stability of the joint. The humeroulnar and the humeroradial joints each have a ligament connecting the two bones involved at the articulation: the ulnar collateral and the radial collateral ligaments.
The ulnar collateral ligament extends from the medial epicondyle of the humerus to the coronoid process of the ulna. It is triangular in shape, and is composed of three parts: an anterior, a posterior and an inferior band.
[Ligaments of the elbow and forearm (overview)]
The radial collateral ligament has a low attachment to the lateral epicondyle of the humerus. The distal fibres blend with the annular ligament that encloses the head of the radius, as well as with the fibres of the supinator and the extensor carpi radialis brevis muscles.
The annular ligament also reinforces the joint by holding the radius and ulna together at their proximal articulation. The quadrate ligament is also present at this joint, and maintains constant tension during pronation and supination movements of the forearm.
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Blood supply and innervation
The blood supply to the elbow joint is derived from a number of periarticular anastamoses that are formed by the collateral and recurrent branches of the brachial, profunda brachii, radial and ulnar arteries. Proximal to the elbow joint, the brachial artery, the largest in the arm, gives off two branches, a superior and inferior ulnar collateral artery. The profunda brachii gives off a radial collateral and a middle collateral artery. These pass towards the joint contributing to the anastomotic loop supplying the joint.
Distal to the elbow joint, the radial artery gives off the radial recurrent artery, and the ulnar artery gives off the anterior and posterior ulnar recurrent arteries. These arteries ascend towards the elbow joint, anastamosing with the branches from the brachial and profunda brachii arteries in the arm.
Superior ulnar collateral artery
Arteria collateralis ulnaris superior
1/5
Synonyms:
Proximal ulnar collateral artery, Arteria collateralis ulnaris proximalis
Movements
As the elbow joint is a hinge joint, movement is in only one plane. The movements at the elbow joint involve movement of the forearm at the elbow joint. Flexion of the forearm at the elbow joint involves decreasing the angle between the forearm and the arm at the elbow joint. Extension involves increasing the angle between the arm and forearm. These movements are performed by two groups of muscles in the arm: the anterior compartment and the posterior compartment of the arm.
Flexion
Most of the muscles producing flexion are found in the anterior compartment of the arm. There are two muscles in this compartment that produce flexion at the elbow joint:
Movements at a hinge jointBiceps Brachii originates as two heads. The tendon of the long head originates from the supraglenoid tubercle of the scapula. It passes through the joint capsule of the shoulder joint and through the bicipital groove on the anterior surface of the humerus. The short head of the biceps brachii muscle originates from the coracoid process of the scapula. These heads join together to form the biceps brachii muscle belly. The muscle inserts via a single tendon onto the radial tuberosity distal to the elbow joint. In the forearm, there is a continuation of this tendon as a flattened connective tissue sheath, the bicipital aponeurosis. This aponeurosis blends with the deep fascia in the anterior forearm.
Brachialis originates from the distal half of the anterior surface of the humerus, as well as from the intermuscular septa on either side of the anterior compartment. It is located deep to the biceps brachii muscle. It forms a singular tendon that inserts onto the tuberosity of the ulna.
Both the biceps brachii and brachialis muscles are innervated by the Musculocutaneous nerve.
While the biceps brachii and the brachialis muscles are the main flexors of the elbow joint, the brachioradialis muscle is also involved in flexion of the forearm at this joint. Brachioradialis originates for the lateral aspect of the distal humerus above the lateral epicondyle. It inserts onto the lateral aspect of the distal radius. Although this muscle is primarily in the forearm, it crosses the elbow joint so therefore it acts on the elbow joint. It is innervated by the radial nerve.
Mnemonic
Learning the muscles that bend the elbow becomes child's play if you anchor them to a mnemonic like the one below.
3 B's bend the elbow
Biceps
Brachialis
Brachioradialis
Extension
Extension of the forearm at the elbow joint is the increase of the angle at the elbow to bring the forearm back to the anatomical position from a flexed position. There is one muscle involved in extension, the triceps brachii muscle. It is the only muscle in the posterior compartment of the arm.
Triceps Brachii originates as three heads. The long head originates from the infraglenoid tubercle of the scapula, the lateral head originates from the lateral aspect of the humerus above the radial groove, and the medial head originates from the medial aspect of the humerus below the level of the radial groove. The three heads converge on a single tendon that inserts onto the olecranon of the ulna. It is supplied by the radial nerve, which passes down through the arm in the radial groove between the lateral and medial heads of the muscle.
While flexion and extension are the only movements that can occur at the elbow joint itself, movement is also afforded at the proximal radioulnar joint, which contributes to the elbow joint. Movements at this joint are called pronation and supination. These are rotational movements that occur when the distal end of the radius moves over the distal end of the ulna by rotating the radius in the pivot joint formed by the circular head of the radius, the radial groove of the ulna and the annular ligament.
Pronation of forearm
Pronatio antebrachii
1/2
Synonyms:
none
Pronation and supination are easily visualised when the elbow is flexed at 90°. Supination is where the palm of the hand is facing upwards; pronation is rotation of the forearm so that the palm is facing downwards. In the anatomical position, the forearm is in the supine position. Pronation in the anatomical position is movement of the forearm so that the palm is facing posteriorly.
Clinical notes
Fractures
Common injuries to the elbow joint include fractures of the bony structures contributing to the joint. Care must be taken when diagnosing a fracture of the elbow joint with respect to the age of the patient. This is because secondary ossification centres in children and adolescents can easily be mistaken for a fracture on a radiograph. Therefore, it is vital that a physician know the age of the child when examining their radiograph. Some of the areas of secondary ossification are as follows:
Capitulum (1 year)
Radial head and medial epicondyle (5 years)
Trochlea (11 years)
Olecranon (12 years)
A supracondylar fracture is a fracture to the humerus above the level of the humeral condyles. This injury most commonly occurs in children. In such injuries, the distal bone fragment can be pulled posteriorly by the triceps muscle. This can cause bowstringing of the brachial arteries by stretching them, which can have adverse effects.
Fracture of the head of the radius is a common fracture of the elbow joint. It is often caused by a fall on an outstretched hand, and can have severe implications including loss of full extension of the forearm at the elbow joint.
Epicondylitis and arthritis
Epicondylitis is inflammation of the soft tissues surrounding the epicondyles of the humerus. It typically occurs due to overuse of the flexor and extensor muscles of the forearm. Pain is localised around the epicondylar region. Tennis players typically get epicondylitis on the lateral epicondyle (common extensor origin), whereas golfers usually have it on the medial epicondyle (common flexor origin).
Arthritis can occur at the elbow joint, and is usually more severe in the dominant limb of the patient.
Venipunctures
Anterior to the elbow joint is a transitional zone between the arm and the forearm called the cubital fossa. Located in the subcutaneous tissue above the cubital fossa is a very superficial vein: the median cubital vein. This is a short vein connecting two longer superficial veins draining the upper limb, the cephalic and basilic veins, together. The medial cubital vein is one of the most common sites for venipuncture, which is collecting blood samples in the upper limb.
Sources
All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.
References:
F. Netter: Atlas of Human Anatomy, 6th Edition, Elsevier Saunders (2014).
J.A. Gosling, P.F. Harris, J.R. Humpherson et al.: Human Anatomy, Colour Atlas and Textbook, 5th Edition, Mosby Elsevier (2008).
R. Drake, A.W. Vogl, A.W.M. Mitchell: Gray’s Anatomy for Students, 3rd Edition, Churchill Livingston Elsevier (2015).
S. Standring: Gray’s Anatomy: The Anatomical Basis of Clinical Practice, 14th Edition, Churchill Livingston Elsevier (2008).
Illustrators:
Ligaments of the elbow and forearm (overview) - Yousun Koh
Movements at a hinge joint - Paul Kim
Pronation of forearm (ventral view) - Paul Kim
Elbow joint (cadaver dissection) - Prof. Carlos Suárez-Quian
Elbow joint: want to learn more about it?
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elbow - 搜索 词典
w - 搜索 词典 Rewards网页图片视频学术词典地图更多航班我的必应笔记本elbow美 [ˈelboʊ] 英 [ˈelbəʊ] n.肘;弯头;肘状物;曲折v.用肘推;挤进;跻身进来;讨价还价网络肘部;手肘;弯管复数:elbows 过去分词:elbowed 现在分词:elbowing 搭配同义词adj.+n.left elbowv.bump,dig,jostle,nudge,poke权威英汉双解英汉英英网络释义elbow显示所有例句n.1.肘;肘部the joint between the upper and lower parts of the arm where it bends in the middleShe jabbed him with her elbow.她用胳膊肘捅他。He's fractured his elbow.他肘部骨折。2.(衣服的)肘部the part of a piece of clothing that covers the elbowThe jacket was worn at the elbows.这件夹克衫的肘部磨破了。3.(管子、烟囱等的)弯处,弯头a part of a pipe, chimney , etc. where it bends at a sharp angleIDMget the elbow(informal)被排斥;被甩;被撵走to be told by sb that they no longer want to have a relationship with you; to be told to go awaygive sb the elbow(informal)排斥;甩掉;撵走to tell sb that you no longer want to have a relationship with them; to tell sb to go awayv.1.~ sb/sth (+adv./prep.)用肘推;用肘挤to push sb with your elbow, usually in order to get past themShe elbowed me out of the way to get to the front of the line.她用肘部把我推开朝队伍前面挤。He elbowed his way through the crowd.他用手肘从人群中挤了过去。n.1.肘;肘状物2.(海岸线的)急弯,曲折3.(椅子的)扶手;弯头;【建筑】肘形管,弯管,弯头4.镜腿5.〔技〕肘管,弯管接头,弯头,机械手抓手;急弯6.半圆形线路7.河湾8.螺旋形门1.肘;肘状物2.(海岸线的)急弯,曲折3.(椅子的)扶手;弯头;【建筑】肘形管,弯管,弯头4.镜腿5.〔技〕肘管,弯管接头,弯头,机械手抓手;急弯6.半圆形线路7.河湾8.螺旋形门v.1.用肘推;挤进2.跻身进来3.讨价还价n.1.the joint between the upper and lower parts of the human arm2.the part of a sleeve that covers the elbow3.the joint in an animal's forelimb corresponding to the elbow in a human4.a bend in something such as a river, road, or pipe5.something, especially a piece of pipe, made with a bend in it6.the part in the middle of your arm, where it bends1.the joint between the upper and lower parts of the human arm2.the part of a sleeve that covers the elbow3.the joint in an animal's forelimb corresponding to the elbow in a human4.a bend in something such as a river, road, or pipe5.something, especially a piece of pipe, made with a bend in it6.the part in the middle of your arm, where it bendsv.1.to push or hit somebody or something with an elbow2.to progress through a crowd by pushing with the elbow or elbows3.pllsh with the elbow1.肘英语单词分类:月份、星期…_百度文库 ... hand( 手) elbow( 肘) arm( 臂) ... wenku.baidu.com|基于3818个网页2.弯头PDMS_百度百科 ... PIPE 管子 ELBOW 弯头 VALVE 阀门 ... baike.baidu.com|基于3796个网页3.肘部九年级英语单词表 ... lap 大腿 elbow 肘部 gradually 逐渐地;渐渐地 ... word.langfly.com|基于811个网页4.手肘手字的解释---在线新华字典 ... 手指〖 finger〗 手肘〖 elbow〗 手镯〖 bracelet〗 ... xh.5156edu.com|基于550个网页5.弯管冶金(Metallurgy)专业词汇(D-H) - 不锈钢世界 ... elasticity 弹性 elbow 弯管 electric arc 电弧 ... blog.globalimporter.net|基于460个网页6.肘,肘部大学英语六级词汇表 - 豆丁网 ... elapse v. (光阴)消逝 elbow n. 肘,肘部;弯管 electrician n. 电工,电气技师 ... www.docin.com|基于248个网页7.用肘挤PETS3_资料内容_资料下载_学习资料共享网 ... either (两者之中) 任一 elbow 肘;弯头 v.用肘挤 elder 年龄较大的,年长的 ... www.87994.com|基于191个网页8.肘管石油英语词汇(E1)_专业词汇_专业英语_食品伙伴网 ... elbow union 弯头活接头 elbow 肘管 elbowmeter 弯管流量计 ... www.foodmate.net|基于121个网页更多释义收起释义例句释义:全部全部,肘肘,弯头弯头,肘状物肘状物,曲折曲折,用肘推用肘推,挤进挤进,跻身进来跻身进来,讨价还价讨价还价,肘部肘部,手肘手肘,弯管弯管类别:全部全部,口语口语,书面语书面语,标题标题,技术技术来源:全部全部,字典字典,网络网络难度:全部全部,简单简单,中等中等,难难更多例句筛选收起例句筛选1.After a minute, a paper came out and said that he had tennis elbow . And he should put his elbow in warm water for the next two weeks.过了一分钟,机器中出来一张纸,写着他肘部发炎,应该在以后的两周内把肘部浸泡在温水中。dictsearch.appspot.com2.He had taken up a book from the stall, and there he stood, reading away, as hard as if he were in his elbow-chair, in his own study.他从摊子上取了一本书,站在原地看了起来,就好像是坐在自己书斋的安乐椅里边一般。novel.tingroom.com3.He slept fully dressed with his head on his hand, his elbow sinking deep into the red down-cushions his host had arranged for him.他穿着完全同睡在他头部,另一方面手肘下沉深入红色扎咕主人已经安排他。www.cqwx.net4.Well, well, with the lines in the crook of his elbow the deacon held out his arms to the widow and----.好吧,好吧,在他的胳膊肘执事伸出双臂向寡妇和骗子行----。0769bike.com5.The utility model provides a pair of elbow length gloves suitable for working of a welder, a smith and a smelter.本实用新型提供了一种双管长度手套适合工作的一名焊工,史密斯和冶炼厂。www.132588.com6.As I hesitated on the curb, I felt a hand on my elbow and looked down to see the smile of my small beggar friend looking up at me.当我在街头犹豫的时候,我感到在我胳膊肘处有一只手。我向下看了看,看到那个身材矮小的乞丐朋友微笑地望着我。www.ebigear.com7.Bashed him with my elbow after that until he fell through my arms into a heap at my feet.接着用我的手肘猛击他直到他瘫软在我的脚下。www.bing.com8.Someone is always at my elbow reminding me that I am a descendent of slaves , but it fails to register depression with me.身边总有人在不断使我想到自己是个努力的后代,但这并没有使我沮丧。hi.baidu.com9.But if they want to wear short sleeves, or get a date with a woman, they absolutely have to be smooth and shaven from the elbow down.如果想穿短袖衣服,或是和女人约会,男人就必须刮除前臂的汗毛,保持肌肤的柔软光滑。www.zzlt.cn10.She had set her elbow on her knee and her chin in her hand, and she swung her foot with an air of indifference.她把肘弯支在膝头上,掌心托着下巴颏,摇晃着一只脚,神气满不在乎。www.ebigear.com12345© 2024 Microsoft隐私声明和 Cookie法律声明广告帮Elbow joint: Pain, joint type, anatomy, and more
Elbow joint: Pain, joint type, anatomy, and more
Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyAsthma & AllergiesAtopic DermatitisBreast CancerCancerCardiovascular HealthCOVID-19DiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisPsoriatic ArthritisSexual HealthUlcerative ColitisWomen's HealthHealth ProductsHealth ProductsNutrition & FitnessVitamins & SupplementsCBDSleepMental HealthAt-Home TestingMen’s HealthWomen’s HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcasts2023 in medicineWhy exercise is key to living a long and healthy lifeWhat do we know about the gut microbiome in IBD?My podcast changed meCan 'biological race' explain disparities in health?Why Parkinson's research is zooming in on the gutToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsFind a DoctorBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsHealth ProductsDiscoverToolsConnectSubscribeWhat to know about the elbow jointMedically reviewed by Megan Soliman, MD — By Zia Sherrell, MPH on July 30, 2021Elbow jointAnatomyElbow painHealthy elbow joint tipsSummaryThe elbow joint connects the upper arm to the lower arm to enable movement. The elbow is complex and consists of bones, ligaments, nerves, and blood vessels.People use the elbow joints extensively in daily life. Repetitively using or overloading the elbow joint can cause injuries and pain. Understanding how to manage elbow health and reduce potential injuries can help people avoid elbow pain.Type of jointThe elbow joint is a synovial hinge joint, similar to the ankle and knee joints. Two or more bones form hinge joints that move along an axis, rather than rotate like the hip joint. The distal humerus and proximal ulna are the primary elbow joint bones.The hinge joint allows the elbow to bend and straighten. It also helps with hand motion by allowing the forearm to rotate.Anatomy of the elbow jointThe elbow joint includes various bones, ligaments, veins, arteries, and nerves.Share on PinterestBones and ligaments of the elbowOsteologyThe elbow has three articulations, or joints:radiohumeral jointulnohumeral jointproximal radioulnar jointStability comes mainly from the bony joints of the ulnar olecranon and the trochlea of the humerus.The olecranon looks like a wrench and has a landmark called the trochlear notch. The trochlea of the humerus fits in the trochlear notch. This is the main point where the elbow pivots while bending and straightening.The trochlear notch wraps about 180 degrees around the humerus, and the tight fit of the two structures enables greater stability.LigamentsAside from the bones, elbow stability comes from the lateral collateral ligament (LCL) and the medial collateral ligament (MCL). These ligaments form the joint capsule.The LCL breaks down into the following ligaments: lateral radial collateral ligamentannular ligamentlateral ulnar collateral ligamentThe annular ligament stabilizes the proximal radioulnar joint. The lateral ulnar collateral ligament ensures that the elbow does not rotate too far towards the back of the body.The MCL breaks down into the following ligaments: posterior oblique ligamentanterior oblique ligamenttransverse ligamentThe anterior oblique ligament keeps the elbow from bending toward the body.Share on PinterestNerves of the elbowNervesThe cubital tunnel is a space in the elbow that houses the ulnar nerve and allows it to pass through the ligaments of the elbow. The nerves that cross the elbow joint mainly go to the forearm and hand structures. The elbow joint is a crossing space for most of the nerves and blood vessels in the upper extremities of the body.Blood supplyThe brachial artery transports blood from the shoulder to the elbow. It splits into two arteries at the elbow, called the radial and ulnar arteries. Both arteries travel across the front of the elbow. Once they reach the forearm, the radial artery travels along the thumbs side of the forearm towards the wrist, and the ulnar artery travels along the pinky finger side of the forearm towards the wrist.Common causes of elbow painThe elbows are complicated joints that people use daily. Overloading or overusing the elbows can lead to injuries and inflammation. That includes:BursitisBursitis is inflammation of the bursa, which is a small fluid-filled sac. Causes of bursitis include: overuseinjuryinfectionother inflammatory processesSymptoms of bursitis include: painswellingrestriction to movementBursitis treatment includes: pain medicinesresticeA doctor may inject a drug into the area surrounding the swollen bursa if another treatment is not helping. If elbow health does not improve after 6 to 12 months, a doctor may suggest surgery to repair damage and relieve pressure.Dislocated elbowA dislocated elbow occurs when the joint surfaces of the elbow separate. Trauma, such as a fall, is often the cause. A dislocation can be complete or partial depending on whether the joint surfaces separate entirely or partially.Complete dislocations are extremely painful. In these cases, the elbow looks deformed or oddly twisted. Partial dislocations may appear normal, but cause pain or some bruising on the inside and outside of the elbow.A doctor must realign the elbow using a reduction maneuver. Individuals with complex cases may need surgery to realign the bones and repair ligaments.Medial epicondylitisMedial epicondylitis, or golfer’s elbow, is a common ailment caused by repetitive bending and force on the elbow joint. People who play sports such as golf and baseball and professionals such as plumbers and construction workers are more likely to experience this injury.Golfer’s elbow symptoms include irritation and pain where the tendon attaches to the bone. Common treatments include non-steroidal anti-inflammatory drugs (NSAIDs), ice, and steroid injections.OsteoarthritisElbow osteoarthritis happens when the cartilage becomes damaged or wears out. While this can result from a previous injury, such as dislocation or fracture, it usually comes from normal cartilage wear from activity and age. Symptoms include pain and a loss of range of motion.Early treatment includes physical therapy, activity moderation, and oral medications to reduce or alleviate pain. Corticosteroids are another treatment option for early-stage osteoarthritis. If these treatments do not control symptoms, surgery may be the next step.Rheumatoid arthritisRheumatoid arthritis (RA) is a chronic inflammatory disease where the immune system attacks the linings of joints and sometimes the internal organs. Symptoms include:joint painswellinginflammationloss of functionTreatment includes medication and self-management strategies. Self-management strategies to reduce pain and disability include having an active lifestyle, maintaining a moderate weight, and avoiding joint injuries.SprainAn elbow sprain involves pulling or tearing ligaments in the elbow joint. Symptoms include: painswellingbruisingrednessdifficulty using the elbowTreatment includes using a sling, cast, or splint to prevent movement, or surgery to repair torn ligaments.Share on PinterestMuscles of the elbowLateral epicondylitisLateral epicondylitis, or tennis elbow, is an inflammation or micro-tearing of the tendons that join the forearm muscle to the outside of the elbow. Symptoms include pain or burning on the outer part of the elbow and weak grip strength.This is often treatable through:restmedicationuse of a bracesteroid injectionsextracorporeal shock wave therapyphysical therapy If these treatments are not successful after 6 to 12 months, surgery may be necessary to remove diseased muscles and reattach healthy muscle to the bone.Keeping the elbow joint healthyThese tips can help keep the elbow joints healthy and reduce the risk of injury:Participate in regular physical activity to ease joint stiffness and strengthen muscles surrounding the joints.Avoid overworking the joints and listen to pain signals.Maintain proper form in sports.Try an anti-inflammatory diet, especially if an individual has arthritis or other inflammatory conditions.SummaryThe elbow is a synovial joint that aids in flexion and extension. It is a crossing point for the nerves and blood vessels of the upper arm and forearm.Many injuries and conditions cause elbow pain. However, exercising, avoiding overuse, maintaining proper form when doing activities, and following an anti-inflammatory diet can help keep the elbow joint healthy. Last medically reviewed on July 30, 2021OsteoarthritisRheumatoid ArthritisBones / OrthopedicsSports Medicine / FitnessHow we reviewed this article:SourcesMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Bursitis. (2021).https://medlineplus.gov/bursitis.htmlCard, R. K., et al. (2020). Anatomy, shoulder and upper limb, elbow joint.https://www.ncbi.nlm.nih.gov/books/NBK532948/Diseases and conditions. (n.d.).https://orthoinfo.aaos.org/en/diseases--conditions/Key public health messages. (2021).https://www.cdc.gov/arthritis/about/key-messages.htmManoj, M., et al. (2020). Bursitis of shoulder region and elbow – Subdeltoid-subacromial and olecranon bursitis ultrasonography and elastography imaging.http://www.journaldmims.com/article.asp?issn=0974-3901;year=2020;volume=15;issue=2;spage=300;epage=302;aulast=ManojRheumatoid arthritis (RA). (2021).https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html#treatmentVessels. (2021).https://www.assh.org/handcare/safety/vesselsWhen elbow pain may mean arthritis. (2021).https://www.arthritis.org/health-wellness/about-arthritis/where-it-hurts/when-elbow-pain-may-mean-arthritisShare this articleMedically reviewed by Megan Soliman, MD — By Zia Sherrell, MPH on July 30, 2021Latest newsHow and why does gut health influence heart health?Swapping meat for mushroom protein may be better for reducing cholesterolAnother 3 common pesticides are now linked to Parkinson's disease riskOzempic may delay kidney disease progression, latest trial results showMediterranean diet and exercise improve gut health, leading to weight lossRelated CoverageWhat to know about elbow pain that occurs when lifting somethingMedically reviewed by Gregory Minnis, DPTElbow pain can occur when lifting an object for several reasons, including tennis elbow and trapped nerves. Learn more about some causes and…READ MOREWhat can cause pain in the left elbow?Medically reviewed by Deborah Weatherspoon, Ph.D., MSNThere are several reasons a person may experience pain in their left elbow. Learn more about the potential causes and treatment options here.READ MOREHow to stop joint pain when it rainsMedically reviewed by Nancy Carteron, M.D., FACRRain and changes in weather can trigger joint pain. It is likely due to changes in barometric pressure, humidity, and temperature, though the exact…READ MOREAbout UsContact UsTerms of UsePrivacy PolicyPrivacy SettingsAdvertising PolicyHealth TopicsHealth HubsMedical AffairsContent IntegrityNewsletters© 2024 Healthline Media UK Ltd, Brighton, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.© 2024 Healthline Media UK Ltd, Brighton, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.AboutCareersAdvertise with usOUR BRANDSHealthlineMedical News TodayGreatistPsych CentralBezzy
Elbow | Joints, Muscles, Movements | Britannica
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elbow
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skeleton
tennis elbow
arm
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elbow, in human anatomy, hinge joint formed by the meeting of the humerus (bone of the upper arm) and the radius and ulna (bones of the forearm). The elbow allows the bending and extension of the forearm, and it also allows the rotational movements of the radius and ulna that enable the palm of the hand to be turned upward or downward.The elbow forms from the expansion of the lower end of the humerus into two thick knobs, or condyles: the humerus’ dome-shaped lateral condyle articulates with a shallow depression on the end of the radius, and the humerus’ spool-shaped trochlea fits into a notch in the ulna. In addition, the edge of the radius’ head fits into a shallow groove on the side of the ulna. The bending and extension of the elbow joint are achieved, respectively, by contractions of the biceps and triceps muscles. These movements chiefly involve only the humerus and ulna; rotation of the forearm involves the smaller radius bone as well.
Britannica Quiz
Characteristics of the Human Body
The elbow is especially susceptible to stress injuries, although its surrounding capsule contains cushioning synovial membranes and is reinforced by ligaments. Thick lateral ligaments support the hinge action of the humerus–ulna junction, and a strong annular ligament around the upper part of the radius helps to hold that bone in place. These ligaments prevent the forward displacement of the forearm bones, but acute stresses can produce rearward dislocations of them. Attempts to force elbow movement past full extension of the arm (180 degrees) tear the joint’s protective capsule, producing elbow sprains, while chronic and repeated stressful motions, such as the rotation of the forearm in some sports, can cause pain from overuse of the joint (tennis elbow).
This article was most recently revised and updated by Amy Tikkanen.
elbow - WordReference.com 英汉词典
elbow - WordReference.com 英汉词典
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UK:*UK and possibly other pronunciationsUK and possibly other pronunciations/ˈɛlbəʊ/US:USA pronunciation: IPA and respellingUSA pronunciation: IPA/ˈɛlboʊ/ ,USA pronunciation: respelling(el′bō)
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WordReference English-Chinese Dictionary © 2024:主要翻译英语中文
elbow n (arm joint)SCSimplified Chinese 手肘 shǒu zhǒu
SCSimplified Chinese 肘关节 shǒu zhǒu,zhǒu guān jié
Brian bent his elbow.
布莱恩弯了弯手肘。
elbow n (right-angled pipe) (管子的)SCSimplified Chinese 弯曲处 wān qū chù TCTraditional Chinese 彎曲處
The plumber used an elbow to run the pipe around the corner.
水管工用直角管让水管绕过拐角处。
elbow [sb]⇒ vtr (deliberate: jab with elbow)SCSimplified Chinese 肘击
SCSimplified Chinese 用肘部推
Karen noticed Jon was falling asleep in the lecture, so she elbowed him.
卡伦发现乔恩在课上睡着了,所以她用手肘撞了撞他。
elbow [sb] vtr (accidental: hit with elbow) (非故意)SCSimplified Chinese 用手肘撞到,用肘推搡
People in the crowd were elbowing Edward in their desperation to get away from the monster.
人群用手肘推开爱德华,绝望地想逃离怪物。
有所遗漏?报告错误或提出改进建议
其他翻译英语中文
elbow n (part of sleeve)SCSimplified Chinese 肘部
Fred was knitting a jumper, but he found the elbows difficult.
有所遗漏?报告错误或提出改进建议
WordReference English-Chinese Dictionary © 2024:复合形式:英语中文
elbow bump n (greeting: tapping elbows)SCSimplified Chinese 撞肘问候
elbow grease n figurative (physical effort) (口语)SCSimplified Chinese 苦活,重活儿,苦工 kǔ huó,zhòng huó er ,kǔ gōng
It takes a considerable amount of elbow grease to clean the oven.
elbow in, elbow your way in vi + adv figurative, informal (force way in) (比喻用手肘推开人群)SCSimplified Chinese 挤过 jǐ guò
A man in the crowd shouted at me for elbowing in.
有个男的对我挤进人群非常不满,朝我大喊大叫。
elbow macaroni n uncountable (bendy tubes of pasta)SCSimplified Chinese 弯管通心粉
elbow [sb] out of the way v expr (push [sb] aside)SCSimplified Chinese 用肘将某人挤开
An old lady elbowed Dan out of the way as he was trying to get on the bus.
elbow pad n often pl (protective coverings for elbows)SCSimplified Chinese 护肘 hù zhǒu
It's a good idea to wear elbow pads when you're learning to rollerskate.
elbow room n figurative, informal (space to move)SCSimplified Chinese 活动空间 huó dòng kōng jiān
With the lift almost full there wasn't much elbow room.
elbow your way through v expr (push through a crowd, etc.)SCSimplified Chinese 挤出去 jǐ chū qù TCTraditional Chinese 擠出去
elbow-bump⇒ vi (tap elbows in greeting)SCSimplified Chinese 撞肘问候
SCSimplified Chinese 撞肘致意
elbow-bump [sb]⇒ vtr (tap [sb]'s elbow in greeting)SCSimplified Chinese 撞肘问候
give [sb/sth] the elbow v expr informal, figurative (break with, reject)SCSimplified Chinese 与...分手 TCTraditional Chinese 與…分手
SCSimplified Chinese 与...决裂
SCSimplified Chinese 放弃 fàng qì TCTraditional Chinese 放棄
My sister has finally given her no-good boyfriend the elbow. Isn't it about time we gave these old-fashioned customs the elbow?
more power to [sb], more power to [sb]'s elbow expr (expression of encouragement)SCSimplified Chinese 加油 jiā yóu TCTraditional Chinese 加油
SCSimplified Chinese 再加把劲
Well, it sounds like Adam's thought it through carefully, so if it's really what he wants to do, more power to his elbow.
tennis elbow n informal, figurative (inflammation of the elbow joint) (非正式用语,比喻)SCSimplified Chinese 打网球引起的肘部发炎 dǎ wǎng qiú yǐn qǐ de zhǒu bù fā yán
I never knew you could get tennis elbow even if you don't play tennis.
有所遗漏?报告错误或提出改进建议
Collins Chinese Dictionary Plus (3rd edition), 2011:
elbow [ˈɛlbəu]
I n
[c]
1 (Anat) 肘 zhǒu [个 gè]
2
[of sleeve] 肘部 zhǒubù
II vt
[+ person] 用肘打 yòng zhǒu dǎ to elbow one's way through the crowd 挤(擠)过(過)人群 jǐguò rénqún to elbow sb aside 把某人挤(擠)到一旁 bǎ mǒurén jǐdào yīpáng
在这些条目还发现'elbow':
在英文解释里:
brace
- crook
- dig
- ditch
- elbow-bump
- poking
- scrape
- short-sleeved
- tennis elbow
- upper arm
中文:
手肘
- 肘
在单词列表中: Top 2000 English words, Parts of the upper body, PET Vocabulary List - E, 更多……同义词: bend, turn, crook, curve, angle, 更多……习惯性搭配: need to [use, put in] more elbow grease, [it] just needs a little elbow grease, requires a lot of elbow grease, 更多……
标题中含有单词 'elbow' 的论坛讨论:未在Chinese论坛中找到有关“elbow”的讨论...to elbow his way upward in the world. - English Only forum
an elbow in the ribs - English Only forum
an idiom: live elbow to elbow - English Only forum
and thus wear out his elbow, - English Only forum
at elbow or at the elbow - English Only forum
at his left elbow - English Only forum
Christ was just at their elbow - English Only forum
crook of the arm/elbow, leg/knee - English Only forum
crook the elbow - English Only forum
doesn't know his ass from his elbow - English Only forum
drive his elbow - English Only forum
elbow creek - English Only forum
elbow deep - English Only forum
elbow deep in blood - English Only forum
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Elbow in - English Only forum
Elbow licker - English Only forum
elbow throwing - English Only forum
Elbow withdrawn? / at the back? - English Only forum
elbow/knee gear - English Only forum
elbows in arms or elbow in arms? - English Only forum
feel scandal at one's elbow - English Only forum
hand between a wrist and an elbow. - English Only forum
Harry’s turn for an elbow - English Only forum
He < got on one elbow. > - English Only forum
he poked one overcoated elbow through the glass - English Only forum
If one sees a step or an elbow - English Only forum
keep your quarters in your elbow - English Only forum
kill it below the elbow - English Only forum
lean one's elbow on/against the bar - English Only forum
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elbow 在英語-中文(簡體)詞典中的翻譯
elbownoun [ C ] uk
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/ˈel.bəʊ/ us
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/ˈel.boʊ/
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B1 the part in the middle of the arm where it bends, or the part of a piece of clothing that covers this area
肘;(衣服的)肘部
Her arm was bandaged from the elbow to the fingers.
她的胳膊从肘部一直到手指全缠上了绷带。
The sleeve of his shirt was torn at the elbow.
他的衬衫的肘部被撕了个口子。
更多範例减少例句I banged my elbow on the shelf.My elbow is still stiff after my fall.
習語
at someone's elbow
give someone the elbow
elbowverb [ T usually + adv/prep ] uk
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/ˈel.bəʊ/ us
Your browser doesn't support HTML5 audio
/ˈel.boʊ/
disapproving to push someone rudely with your elbows so that you can move or have more space
用肘推;用肘挤开
He elbowed his way to the front of the crowd.
他挤到了人群的前边。
They elbowed the onlookers aside.
他们把旁观者推到一边。
to hit someone with your elbow, sometimes as a sign to make them notice or remember something
(为让某人注意或提醒某事而)用肘碰
She elbowed me in the ribs before I could say anything.
我还没开口呢,她就用胳膊肘在我肋部碰了一下。
片語動詞
elbow someone out
(elbow在劍橋英語-中文(簡體)詞典的翻譯 © Cambridge University Press)
elbow的例句
elbow
They might easily be elbowed out—that has actually happened—to make room for some friend, connection or relative of one of those in a high position.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
The police did not sit on their elbows then.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
The patients were assessed at the shoulders, elbows, wrists, hips and knees and a global score was obtained by addition.
來自 Cambridge English Corpus
Another one28 uses a locomotion of the earthworm type and is formed by rubber elbows.
來自 Cambridge English Corpus
We do not grudge anyone a full share of the sunshine, but it is due to ourselves to see that we are not elbowed ruthlessly into the shade.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
Two of the children had been kneecapped, one in both knees, with similar treatment to elbows and ankles.
來自 Hansard archive
該例句來自Hansard存檔。包含以下議會許可信息開放議會許可v3.0
There are sectors of industry which have lobbied powerfully against non-remunerated blood donation and, as usual, patients have been elbowed out of the way in the process.
來自 Europarl Parallel Corpus - English
The safest thing to do is to touch elbows.
來自 Wikipedia
該例句來自維基百科,在CC BY-SA許可下可重複使用。
示例中的觀點不代表劍橋詞典編輯、劍橋大學出版社和其許可證頒發者的觀點。
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elbow的翻譯
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肘, (衣服的)肘部, 用肘推…
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codo, dar un codazo a, abrirse paso a codazos…
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cotovelo, dar uma cotovelada em, cotovelo [masculine]…
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локоть, толкать локтем, проталкиваться…
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elbow的發音是什麼?
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elasticized
Elastoplast
elated
elation
elbow
elbow bump
elbow grease
elbow room
elbow someone out
elbow更多的中文(簡體)翻譯
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elbow bump
elbow room
elbow grease
tennis elbow
elbow someone out
at someone's elbow idiom
give someone the elbow idiom
查看全部意思»
片語動詞
elbow someone out
查看全部動詞片語意思»
慣用語
at someone's elbow idiom
give someone the elbow idiom
more power to your elbow! idiom
not know your arse from your elbow idiom
查看全部慣用語意思»
「每日一詞」
response
UK
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/rɪˈspɒns/
US
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/rɪˈspɑːns/
an answer or reaction
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Forget doing it or forget to do it? Avoiding common mistakes with verb patterns (2)
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