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Anatomy

Upper Limb

Question 191 of 239

A 65 year old man presents to the ED complaining of right elbow pain. He describes a 3 day history of increasing swelling and pain at the right elbow. On examination you note he is febrile and the elbow is hot and erythematous, you suspect a septic arthritis. Which of the following synovial joint types best describes the elbow joint:

Answer:

The elbow is a synovial hinge joint.

Elbow Joint

Anatomy / Upper Limb / Posterior Arm

Last Updated: 18th October 2019

Table: Anatomical Overview of the Elbow Joint

Joint Elbow
Type Synovial hinge joint
Articulations Trochlea of humerus with trochlear notch of ulna and capitulum of humerus with head of radius
Stabilising factors Joint capsule, radial and ulnar collateral ligaments
Movements Flexion and Extension

Joint Articulations

The elbow is a synovial hinge joint. It is formed by the articulations between the trochlea of the humerus and the trochlear notch of the ulnar and between the capitulum of the humerus and the head of the radius.

Joint Movements

The movements of the elbow joint are extension and flexion.

Table: Movements of the Elbow Joint

Movement Main Muscles Involved Main Nerves Involved
Flexion Biceps brachii, brachialis, brachioradialis Musculocutaneous nerve, radial nerve
Extension Triceps brachii, anconeus Radial nerve

Joint Ligaments

The collateral ligaments of the elbow are medial and lateral thickenings of the joint capsule.

The radial collateral ligament arises from the lateral epicondyle of the humerus and blends distally with the annular ligament of the radius.

The ulnar collateral ligament arises from the medial epicondyle and distally attaches to the olecranon and coronoid process of the ulna.

The annular ligament is a strong band of fibres that encircles the head of the radius, and retains it in contact with the radial notch of the ulna. The annular ligament is attached by both its ends to the anterior and posterior margins of the radial notch of the ulna.

Elbow Joint. (Image by OpenStax College, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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