• Brachioradialis (lateral)
• Pronator Teres (medial)
• Imaginary line joining lateral and medial epicondyles of humerus

• median nerve C5-T1
• radial nerve C5-T1
• biceps brachii tendinous insertion
• terminal branching of brachial artery into radial and ulnar artery
• subcutaneous median cubital vessel connects basilic and cephalic vein

1. biceps tendon in middle of fossa
2. brachial artery medial to the tendon
3. median nerve medial to the artery

Coracoid Process: attachment for coracobrachialis & biceps short head

Supraglenoid tubercle: attachment for biceps brachii (long heads)

Infrglenoid tubercle: attachment for triceps brachii (long heads)

spiral (radial) groove: passage for radial nerve & profunda brachii

lateral & medial epicondyles: attachment for mm. of forearm

• medial: common flexor tendon
• lateral: common extensor tendon

lateral & medial supracondylar ridges: anchorage for septa

capitulum: articulates with head of radius

trochlea: articulates with olecranon of ulna

olecranon fossa: receives olecranon of ulna when forearm extends

head: articulates with capitulum of humerus & radial notch of ulna

radial tuberosity: biceps brachii attaches

styloid process: attachment for radial collateral ligament of wrist

The styloid process is longer than that of ulna, so that the distal end of the radius is commonly fractured: Colles fracture

olecranon: prominence of elbow, attachment for triceps brachii

semilunar (trochlear) notch: articulates with trochlea of humerus

coranoid process: anterior lip of above notch, brachialis m. attaches

radial notch: receives head of radius

head: rounded distal end articulates with wrist: articular disc permitting greater ulnar than radial deviation

styloid process: attachment for ulnar collateral ligament of wrist

• brachial artery
• Deep brachial artery (Profunda Brachii)
• radial artery

1. continuation of axillary artery at inferior border of teres major
2. follows medial surface of arm to cubital fossa
3. ends in radial and ulnar artery

Other branches include:

• deep brachial (profunda brachii)
• superior and inferior ulnar collateral aa.
• muscular branches to anterior arm

• branch of brachial artery follows radial nerve in spiral groove on posterior humerus
• continues as radial collateral artery to join lateral anastomosis at elbow
• supplies triceps

terminal branch of brachial

lateral artery of forearm

is superficial by the styloid process

passes posteriorly into the snuffbox

ends in arterial arches of hand

radial recurrent, a branch, joins anastomosis at elbow

terminal branch of brachial

medial artery of forearm

ends in arterial arches of hand

Branches include:

• common interosseous artery: gives off anterior and posterior interosseous branches (supply deep structures of anterior and posterior forearm, adjacent to interosseous membrane)

• anterior & posterior ulnar recurrent aa. & recurrent interosseous artery (all join anastomosis at elbow)

cephalic vein

basilic vein

veins of cubital fossa

• Ascends lateral aspect of upper limb from dorsal venous arch of hand
• traverses deltopectoral triangle into axillary vein

ascends medial

passes deeply to become axillary vein

standard arrangement: median cubital vein ascends obliquely across cubital fossa to basilic vein

Common variation: Y-shaped union of median cephalic, median basilic and median antebrachial vein

attachements: coracoid process of scapula to medial border of mid-humerus

actions: flexion & adduction of humerus at shoulder

attachments:

coracoid process of scapula (short head) and supraglenoid tubercle of scapula (long head) to radial tuberosity and bicipital aponeurosis that protects the median nerve and brachial artery

actions:

• flexion at elbow
• supination against load
• some flexion at shoulder

attachments: front of humerus to ulnar tuberosity & coranoid process of ulna

actions: flexion of forearm at elbow

innervation: radial nerve C5-C7

• pronator teres
• flexor carpi radialis
• palmaris longus
• flexor carpi ulnaris ***
• flexor digitorum superficialis
• flexor digitorum profundus ***
• flexor pollicis longus
• pronator quadratus

All are innervated by median nerve C7-T1 except flexor carpi ulnarus and flexor digitorum profundus

attaches at midportion of lateral border of radius

actions: pronation

attachment at base of second metacarpal of hand

actions:

• flexion of hand at wrist
• ABduction of hand (radial deviation)

attachment at palmar aponeurosis

actions: flexion of hand at wrist

attachment at pisiform

hook of hamate& base of fifth metacarpal

actions:

• flexion of hand at wrist
• ADDuction of hand (ulnar deviation)

innervation: ulnar nerve C8-T1

humeral head attachment at medial epicondyle, ulnar collateral ligament & coranoid process

radial head to superior anterior border of radius; distal attachment to middle of phalanx of digits 2 through 5

actions: flexion of hand & digits 2-5 at MCP and PIP joints

• Flexor Digitorum Profundus
• Flexor Pollicis Longus
• Pronator Quadratus

attachments: ulna & interosseous membrane to distal phalanx of digits 2-5

innervations:

• median nerve (C5-T1: lateral part)
• ulnar nerve( C8-T1: medial part)

actions: flexion of hand at wrist and of digits at MCP and all IP

attachments: from radius & interosseous membrane to distal phalanx of thumb

actions: flexion of phalanges of thumb

attachments: from distal ulna to distal radius

actions: pronation

consists of 3 joints surrounded by a capsular ligament

1. hinge joint: between trochlea of humerus with semilunar (trochlear) notch of ulna; uniaxial limitation resides with humeroulnar half
2. ball&socket joint: between capitulum of humerus & head of radius
3. pivot joint: between head of radius & radial notch of ulna

 Posterior dislocations are most common, follow a fall on an outstretched arm

radial head glides against radial notch of ulna in pivoting type joint

distal end of radius has ulnar notch which glides over head of ulna in pronation/supination

radius & ulna secured to each other along most of their lengths by the interosseous membrane

considered with both anterior and posterior compartments

attachments: lateral supracondylar ridge of humerus to styloid process of radius

actions: flexion of forearm at elbow

innervation: radial nerve C5-C7