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Radiological aspects of arm, forearm and elbow joint
- 2. Arm and ForearmArm and Forearm with Elbow Jointwith Elbow Joint Dr. Zobayer Mahmud Khan Resident, Phase- B
- 3. Objectives
- 4. • Mention the compartments of the arm and forearm • Define fascial compartment • Describe the lateral and medial intermuscular septum • Explain the development of limbs • Identify the gross structures of Humerus, radius, ulna and elbow joint • Name the muscles of the arm, forearm Objectives
- 5. • Identify the cross and longitudinal sections through the arm, forearm • Know the anterior humeral line and radiocapitellar line and their importance • Enumerate the ossification centres of humerus, around elbow joint • Explain the importance of knowing ossification centres • Participate in a mock test Objectives
- 6. The arm Anterior compartment (Flexor compartment) Posterior compartment (Extensor compartment) The forearm Anterior compartment (Flexor compartment) Posterior compartment (Extensor compartment)
- 7. Compartment A fascial compartment is a section within the body that contains muscles and nerves, vessels and is separated from other by intermuscular septum.
- 9. • Lateral intermuscular septum • Medial intermuscular septum
- 10. Extends from the lower part of the crest of the greater tubercle of the humerus, along the lateral supracondylar ridge, to the lateral epicondyle. Blended with the tendon of the deltoid muscle, gives attachment to the triceps brachii behind, and to the brachialis, brachioradialis, and extensor carpi radialis longus muscles in front. Perforated by the radial nerve and profunda branch of the brachial artery. Lateral Intermuscular septum
- 11. • Extends from the lower part of the crest of the lesser tubercle of the humerus below the teres major, and passes along the medial supracondylar ridge to the medial epicondyle; it is blended with the tendon of the coracobrachialis, and gives attachment to the triceps brachii behind and the brachialis in front. • It is perforated by the ulnar nerve, the superior ulnar collateral artery, and the posterior branch of the inferior ulnar collateral artery. Medial Intermuscular septum
- 12. Limb Development
- 13. At the end of the fourth week Limb buds Specific Spinal Segment (upper limb, C5-T2: lower limb, L2-S2) Apical Ectodermal Ridge (APR) Progressive region Zone of polarizing activity Rotation Limb Development
- 14. Bones form by endochondral Ossification. Muscle cell migrate from somites in a segmental fashion and segregate into dorsal and ventral muscle group. Later Fusion and splitting of these groups into different muscles distorts the original segmental pattern. Limb Development
- 15. Digits form when apoptosis occurs in the AER to separate this structure into five separate ridges. Final separation of the digits is achieved by additional apoptosis in the interdigital spaces. Limb Development
- 16. Bone and X-ray
- 21. Muscles
- 22. ?Biceps brachii
- 23. ?Brachialis
- 25. ?Triceps brachii
- 26. Coracobrachialis
- 30. Ossified from eight centers, One primary and seven secondary centres. Number Site Time of appearance Time of Fusion One Body Eighth week of fetal life twentieth year One Head First year Six year One Greater Tubercle Second year Six year One Lesser Tubercle Fifth year Six year one for the capitulum, the trochlea, and one for each epicondyle.
- 31. ForearmForearm
- 32. Bone and X-ray
- 35. Muscles
- 37. ?Pronator teres
- 41. ?Palmaris longus
- 42. Opposite view ?Extensor carpi radialis longus
- 44. ?Extensor carpi radialis longus
- 45. ?Extensor carpi radialis brevis
- 52. Elbow Joint
- 53. Bone and X-ray
- 57. A line drawn down the neck of the radius should intersect the capitullum. A line drawn down the anterior surface of the humerus should intersect the middle third of the capitullum.
- 58. Importance
- 59. • If the radiocapitellar line does not intersect the capitellum, there is radial head dislocation. • If the anterior humeral line does not intersect the capitellum, there is subtle supracondylar fracture..
- 61. C R I T O E
- 62. Elbow ossification centres Age at appearance (years) Age at closure (years) Capitulum 1-2 14 Radius 3 16 Internal (medial) Epicondyle 5 15 Trochlea 7 14 Olecrenon 9 14 External (lateral) Epicondyle 11 16
- 68. Importance
- 69. • If you can see a trochlea but no internal epicondyle, then you need to look very hard for the avulsed ossification center. • If the trochlear center is present, but there is no medial epicondyle then you are most likely looking at a medial epicondylar fracture where the ossification center has been avulsed and displaced.
- 70. Mock test
- 80. Fat Pad
- 81. Mass of closely packed fat cells surrounded by fibrous tissue septa. They are extensively supplied with capillaries and nerve endings.
- 82. Fat Pad Sign
- 83. Sail sign
- 84. https://radiopaedia.org/ Video tutorials of Dr. Akram Jaffar Video tutorials of Visible human project Video tutorials of Anatomy Zone