The elbow joint consists of 3. Elbow joint

Radial artery, a. radialis, in direction is a continuation of the brachial artery. It goes medially from m. brachioradialis, first covered by it, and then in the sulcus radialis; in the lower third of the forearm, where the muscles turn into tendons, the radial artery is covered on the surface only by fascia and skin, which is why it is easily accessible for studying the pulse. Having reached the apex of the styloid process of the radius, a. radialis goes to the back, going around the lateral edge of the wrist and lying in the so-called snuffbox, from where it comes out onto the palm in the first interosseous space between the bases of the I and II metacarpal bones. In the palm of the hand is the radial artery along with the deep branch a. ulnaris forms arcus palmaris profundus - a deep palmar arch.

Branches radial artery:

1. A. recurrens radialis, recurrent radial artery, begins in the ulnar fossa, goes proximally to the anterior surface of the lateral epicondyle, where it anastomoses with the above a. collateralis radialis from a. produnda brachii.

2. Rami musculares - to the surrounding muscles.

3. Ramus carpeus palmaris, palmar carpal branch, begins in the lower part of the forearm and goes to the ulnar side towards a similar branch from a. ulnaris. From anastomosis with ramus carpeus palmaris a. ulnaris on the palmar surface of the wrist is formed by rete carpi palmare.

4. Ramus palmaris superficialis, the superficial palmar branch, passes over the thenar or pierces its superficial layers and, connecting with the end of the ulnar artery, enters the arcus palmaris superficialis.

5. Ramus carpeus dorsalis, the dorsal carpal branch, departs in the area of ​​the “snuffbox” and with the branch of the same name a. ulnaris forms a network on the back of the wrist, rete carpi dorsale, which also receives branches from the interosseous arteries (aa. interosseae anterior et posterior).

6. A. metacarpea dorsalis prima, the first dorsal metacarpal artery, goes on the back of the hand to the radial side of the index finger and to both sides of the thumb.

7. A. princeps pollicis, the first artery of the thumb, departs from the radius as soon as the latter penetrates through the first interosseous space into the palm, runs along the palmar surface of the first metacarpal bone and divides into branches, aa. digitalis palmares, to both sides of the thumb and to the radial side of the index finger. Ulnar artery

Ulnar artery, a. ulnaris, represents one of the two terminal branches (the larger one) of the brachial artery. From its origin in the ulnar fossa (opposite the neck of the radius), it fits under m. pronator teres, goes obliquely to the middle third of the forearm, deviating to the ulnar side. In the lower two-thirds it runs parallel to the ulna, first in the space between m. flexor digitorum superficialis and m. flexor carpi ulnaris, in the lower third, due to the transition of muscles into tendons, its position becomes more superficial (sulcus ulnaris). At the radial side of the pisiform bone, the ulnar artery passes into the canalis carpi ulnaris (spatium interaponeuroticum) and, passing to the palm, is part of the arcus palmaris superficialis.

Branches of the ulnar artery:

1. A. recurrens ulnaris, the recurrent ulnar artery, gives off two branches - rami anterior et posterior, which pass in front and behind the medial epicondyle, anastomosing with aa. collaterales ulnares superior et inferior. Thanks to these anastomoses, as well as the above-mentioned anastomoses between the branches of a. profunda brachii and a. radialis in the circumference of the elbow joint, an arterial network is obtained - rete articulare cubiti.

2. A. interossea communis, the common interosseous artery, goes to the interosseous membrane, at the proximal edge of which it divides into two branches:

a) a. interossea anterior along the anterior surface of the interosseous membrane reaches m. pronator quadratus, pierces the membrane and goes to the rear, where it ends in the rete carpi dorsale. At the beginning of his journey a. interossea anterior gives a. mediana (directed to the palm together with n. medianus), aa. diaphysis radii et ulnae - to the bones of the forearm and rami musculares - to the surrounding muscles;

b) a. interossea posterior passes through the upper opening of the interosseous membrane to the back side, giving off a. interossea recurrens, lies between the superficial and deep layers of the extensors and in the wrist area anastomoses with a. interossea anterior.

3. Ramus carpeus palmaris, the palmar carpal branch, goes towards the branch of the same name of the radial artery, with which it anastomoses.

4. Ramus carpeus dorsalis, dorsal carpal branch, departs near the pisiform bone, goes under m. flexor carpi ulnaris on the back side towards the branch of the same name a. radialis.

5. Ramus palmaris profundus, the deep palmar branch, penetrates under the tendons and nerves of the palm and together with a. radialis is involved in the formation of the deep palmar arch.

The elbow joint receives arterial blood from the rete articulare formed by aa. collateralis ulnares superior et inferior, (from A. brachialis), a. collateralis media and collateralis radialis (a. profunda brachii), a. recurrens radialis (from A. radialis), a. reccurens interossea (from A. interossea posterior), a. recurrens ulnaris anterior et posterior (from A. ulnaris).

Venous outflow through the veins of the same name occurs into the deep veins of the upper limb - vv. radiales, ulnares, brachiales. The outflow of lymph occurs through deep lymphatic vessels in the nodi lymphatici cubitales. Innervation of the joint capsule is provided by n. medianus, n.radialis, n. ulnaris.

The elbow joint is a rather interesting joint in the human body, which connects the shoulder and forearm to each other. Three bones are involved in its formation: the humerus, the ulna and the radius.

Considering the structural features of the elbow joint, it is classified as a complex and combined joint. Such features allow you to perform 4 types of movements: flexion and extension, pronation and supination.

A complex joint is an articulation of bones in which more than 2 articular surfaces take part.

Combined joint- This is an articulation that consists of several separate joints united by one articular capsule. The elbow joint includes 3 separate ones:

• humeroulnar,
• brachioradialis,
• proximal radioulnar.

You should know that each of these joints has a different structure: the humeroulnar joint is trochlear, the brachioradial joint is spherical, the proximal radioulnar joint is cylindrical.

Let us consider in detail the structure of the elbow joint.

Anatomy of the elbow joint

As already mentioned, the elbow joint consists of three separate joints, which are enclosed in one capsule. All articular surfaces are covered with cartilage.

Bones that take part in the formation of the elbow joint

Shoulder-ulnar joint

Consists of the trochlear bone of the humerus and the trochlear notch of the ulna. It is block-shaped in shape, which ensures movement along one axis in the range of 140º.

Humeral joint

Consists of the articular surfaces of the head of the condyle of the humerus and the articular fossa of the head of the radius. Its shape is spherical, but movements in it are carried out not along three, but only two axes - vertical and frontal.

Proximal radioulnar joint

Connects the radial notch of the ulna and the circumference of the radial head. It is cylindrical in shape, which ensures movement around a vertical axis.

The complex structure of the elbow provides it with such types of movements as flexion and extension, supination and pronation of the forearm.

Elbow ligaments

Joint capsule

The joint capsule securely surrounds all three joints. It is attached around the humerus. It descends onto the forearm and is securely fixed around the ulna and radius bones. In the anterior and posterior parts, the capsule is thin and poorly stretched, making the joint vulnerable to damage. On the sides it is well strengthened by elbow ligaments.

The synovial membrane forms several folds and separate pockets (bursae). They take part in movements, make them smoother, and provide protection to joint structures. But, unfortunately, these bursae can become damaged and inflamed, which is accompanied by the development of elbow bursitis.

Ligamentous apparatus

The joint is strengthened by the following ligaments:

• Ulnar collateral. It extends from the internal epicondyle of the humerus, descends and attaches to the trochlear notch of the elbow.
• Radial collateral. It originates from the lateral epicondyle of the shoulder, descends, bends around the head of the radius in two bundles and attaches to the radial notch of the ulna.
• Annular radius. It is attached to the anterior and posterior parts of the radial notch of the ulna, and its fibers surround the circumference of the radius. In this way, the latter is held in place near the ulna.
• Square. Connects the radial notch of the elbow and the neck of the radius.
• Interosseous membrane of the forearm although it does not belong to the ligaments of the elbow joint, it takes part in the process of fixing the bones of the forearm. It consists of very strong connective tissue fibers and is stretched between the inner edges of the radius and ulna along their entire length.

Muscular frame

The elbow joint is protected by a good muscular frame, which consists of a large number of flexor and extensor muscles. It is their coordinated work that allows you to perform subtle and precise movements in the elbow.

Methods for assessing the condition of the elbow joint

Several diagnostic methods will help assess the condition of the elbow joint.

Inspection and palpation

The skin over the joint is normally smooth and elastic. In the position of an extended elbow, it easily folds and pulls back a little. If you have certain diseases, you can see a change in the color of the skin (blueness, redness), the skin may become hot to the touch, stretched and shiny. You can also notice swelling, nodules, and deformation.

Palpation is carried out when the arm is bent at the shoulder joint and the muscles are completely relaxed. During palpation, you need to evaluate the condition of the skin, the presence of swelling, the integrity of the bone elements, their shape, pain and range of motion, and the presence of crunching in the joint.

The elbow joint is superficial and easily accessible for examination.

Radiography

X-rays of the elbow joint are the main method for diagnosing its diseases. As a rule, photographs are taken in two projections. This makes it possible to see almost everything pathological changes bones that form the joint. It is important to remember that pathologies of the soft tissue components of the elbow (ligaments, cartilage, bursa, muscles, capsule) cannot be detected on an x-ray.

Tomography

Computed tomography or magnetic resonance imaging allows you to more accurately study the structure of the joint and its individual components and identify even the most minimal pathological changes. And what’s also important is that tomography allows you to perfectly visualize not only bone structures, but also everything soft fabrics.

MRI allows not only to make the correct diagnosis (arthrosis in this image), but also to make a 3D reconstruction of the joint

Ultrasound

The elbow joint is located superficially, so it is perfectly accessible for ultrasound examination. The ease of performing ultrasound, its safety, the lack of special preparation for the examination and high information content make this method indispensable in the diagnosis of most elbow pathologies.

Arthroscopy

This is a modern, highly informative, but invasive method for studying the condition of the elbow joint. The essence of the method is as follows. Under local anesthesia, a surgeon or orthopedic traumatologist makes a small incision in the projection of the elbow, through which a special conductive mini-camera is inserted into its cavity. The image is transmitted to a large medical monitor and magnified several times. Thus, the doctor can see with his own eyes how the joint is structured from the inside and whether there is any damage to its individual structures.

If necessary, the arthroscopy procedure can immediately turn from diagnostic to therapeutic. If a specialist identifies a pathology, then additional surgical instruments are introduced into the joint cavity, with the help of which the doctor quickly eliminates the problem.

Elbow puncture

A puncture (puncture) of the elbow joint is carried out to determine the nature of the reasons for the accumulation of exudate in its cavity (pus, blood, serous fluid, fibrinous discharge) with subsequent identification of the causative agent of inflammation, as well as this procedure, in addition to diagnostic, has a therapeutic effect. With its help, excess fluid is evacuated from the joint, which has a positive effect on the course of the disease and the patient’s well-being. Also, various medications are administered into the joint cavity in this way, for example, antibacterial drugs.

Puncture of the elbow joint is not only a diagnostic method, but also a therapeutic one.

Possible diseases

Many people experience pain in the elbow joint from time to time, but for some it is chronic and severe, accompanied by other symptoms. pathological signs and dysfunction of the joint. In such cases, you need to think about one of the possible elbow ailments. Let's look at the most common diseases.

Arthrosis

Osteoarthritis of the elbow affects the joint relatively rarely when compared with the amount of pathology localized in the knee and hip joints. At risk are people whose work involves increased load on the joint, those who have suffered injury or surgery on the elbow, patients with primary endocrine and metabolic disorders, and a history of arthritis.

Among the main symptoms of the pathology are:

• aching pain medium intensity, which appears after overload of the joint, at the end of the working day and goes away after rest;
• the appearance of clicks or crunches when moving the elbow;
• gradual limitation of range of motion, which in severe cases can reach the level of ankylosis and is accompanied by loss of arm function.

Diagnostics includes laboratory research techniques to exclude inflammatory etiology present symptoms, X-ray examination, in some cases they resort to MRI or arthroscopy.

The treatment is long-term and complex using medications(anti-inflammatory, painkillers, chondroprotectors) and non-drug methods (physiotherapy, physical therapy). In severe cases, they resort to reconstructive surgery or even endoprosthetics of the elbow joint.

Chronic elbow pain is the main symptom of arthrosis

Arthritis

Arthritis is an inflammatory lesion of a joint. It is important to note that there are several causes of arthritis. These include infections (bacterial, viral, fungal), and allergic reactions in the body, and autoimmune processes (rheumatoid arthritis). Arthritis can be acute or chronic.

Despite the different etiologies, the symptoms of arthritis are quite similar:

• intense constant pain;
• skin hyperemia;
• edema;
• limited mobility due to pain and swelling.

The elbow joint is most often affected by rheumatoid arthritis. You should think about the disease in the following cases:

• presence of stiffness in the joint in the morning;
• symmetric arthritis, that is, both elbow joints become inflamed at the same time;
• the disease has a chronic undulating course with periods of exacerbations and remissions;
• V pathological process Other joints are often involved (small joints of the hands, ankles, wrists, knees).

If pain in the elbow is accompanied by stiffness in the joint, then rheumatoid arthritis should be suspected.

The most common cause of pain in the elbow joint is epicondylitis. At risk are people who carry heavy loads on duty, often perform rotational movements with their arms, and athletes (especially tennis, golf, arm wrestling).

There are two types of epicondylitis:

1. Lateral is an inflammation of the area of ​​bone tissue where the tendons of the muscle fibers of the forearm are attached to the lateral epicondyle of the shoulder.
2. Medial – develops in case of inflammation of the medial epicondyle of the humerus in the elbow area.

With medial and lateral epicondylitis, pain spreads to certain muscle groups

The main symptom of epicondylitis is pain that occurs in the area of ​​the damaged epicondyle and spreads to the anterior or posterior group of muscles of the forearm. First, pain occurs after physical overload, for example, after training in athletes, and then pain develops even as a result of minimal movements, for example, lifting a cup of tea.

Bursitis

This is an inflammation of the joint capsule, which is located on the back of the elbow. Most often, this disease develops in people with chronic trauma to the posterior surface of the elbow joint.

Symptoms of bursitis:

• throbbing or twitching pain in the elbow area;
• redness and swelling development;
• the formation of a tumor along the posterior surface of the joint, which can reach the size of a chicken egg;
• limited range of motion in the elbow due to pain and swelling;
• appear frequently general symptoms– fever, general weakness, malaise, headache etc.

Elbow bursitis requires urgent treatment, since if the pus is not evacuated from the bursa in time, it can spread to adjacent tissues with the development of an abscess or phlegmon.

This is what elbow bursitis looks like

Injuries

Traumatic injuries to the elbow joint occur quite often in both adults and children. When a joint is injured, the following pathological conditions or a combination thereof may be observed:

• dislocation of forearm bones;
• intra-articular fractures of the humerus, ulna or radius;
• sprain, partial or complete rupture of ligaments;
• hemorrhage into the joint (hemarthrosis);
• damage to the muscles that attach to the elbow;
• rupture of the joint capsule.

Only a specialist can make a correct diagnosis after examination and additional examination methods described above.

With an elbow injury, the ulnar nerve can easily be damaged; this complication is especially common when falling on the back surface of the joint.

More rare diseases

There are more rare diseases elbow joint. These include:

• chondrocalcinosis;
• hygroma, or synovial cyst;
• damage to nerve fibers in the elbow area;
• specific infections (tuberculosis, syphilitic, brucellosis arthritis);
• diffuse fasciitis;
• osteochondritis dissecans.

Thus, the elbow joint is a complex joint of bones, which is particularly strong, but due to some anatomical and functional features, this joint is subject to overload and, as a result, a large number of diseases. Therefore, if you experience frequent pain in the elbow area, you must seek specialized medical help.

The most complete answers to questions on the topic: “innervation of the elbow joint.”

The human body is a coherent system. Thanks to the correct arrangement of its parts, all functions necessary for life are carried out. The main support of the body is the skeleton. The next most important components are joints and ligaments. Thanks to these formations, people are able to make any movements.

The joints of the upper limbs are numerous. Most of them are observed in the area of ​​the hands and fingers. However, in order to move the entire upper limb, the work of three main joints is required: the shoulder, elbow and wrist. The anatomy of these formations is complex because they contain many parts (bones, ligaments, muscles, nerves and blood vessels).

What is the elbow joint?

The anatomy of the elbow joint, shoulder joint, as well as the wrist joint, is a well-coordinated mechanism that has several components. Each of these formations is important. Only thanks to the correct structure of the entire joint can it perform its functions. Anomalies or diseases of bone tissue or ligaments lead to disturbances in the movements of the upper limb. The same applies to pathologies of blood vessels and nerves.

The anatomy of the elbow joint includes 3 bones, several ligaments, a capsule and muscles. For the functioning of each of these formations, blood supply and innervation are necessary. Like any part of the body, it has blood vessels and nerves and the elbow joint.

Its anatomy is created so that all components jointly perform a single function - limb movement. In general, the concept of “elbow” includes not only the joint, but also the forearm. Thanks to the coordinated work of these entities, it can perform the following functions:

1. Flexion of the upper limb.
2. Pronation and supination.
3. Arm extension.
4. From- and adduction of the forearm.

Bones and joints of the elbow

The anatomy of the elbow joint is difficult, as it is a complex joint. This is primarily due to the fact that it consists of 3 bones. In addition, each of them is connected using small joints. All of them are located under a special capsule - a bag.

You can clearly examine this formation in a special atlas. There you can see all the joints that make up the elbow joint. The anatomy (photos in the atlas help to better understand it) of this formation is presented there from various angles and sections so that its entire structure is clear.

The bone included in the described joint and located on top (proximally) is called the humerus. It starts from the scapular cavity and ends at the level of the elbow. Refers to the tubular bones of the skeleton. If you look at it in cross section, you can see that the lower part has the shape of a triangle. In this zone there is an articular surface. Its middle part is connected to the ulna and forms a small joint. It is called the humeroulnar joint.

On the side (laterally) there is a connection with the radius. There, too, there is a joint called the brachioradial joint. The two bones that make up the elbow joint on the distal side are also connected to each other. They form the third joint - the proximal radioulnar. And all of the listed formations together are covered with a bag.

elbow joint, articulatio cubiti, formed by the articulation of three bones: humerus, ulna and radius, between which three joints are formed, enclosed in a common articular capsule: humeroulnar, humeroradial and proximal radioulnar. Thus, in terms of its structure, the elbow joint is a complex joint.

shoulder joint, articulatio humeroulnaris. The joint is formed by the articulation of the trochlea of ​​the humerus and the trochlear notch of the ulna. In terms of the shape of the articular surfaces, it is a trochlear joint.

humeral joint, articulatio humeroradialis. It is the articulation of the head of the humerus and the articular fossa of the head of the radius. The joint is spherical.

Proximal radioulnar joint, articulatio radioulnaris proximdlis. This is a cylindrical joint. Formed by the articulation of the articular circumference of the radius and the radial notch of the ulna.

Joint capsule The elbow joint is strengthened by ligaments: ulnar collateral, radial collateral, annular ligament of the radius and quadrate ligament.

In the elbow joint, movements are possible around the frontal axis and around the longitudinal axis running along the axis of the radius.

On the radiograph of the elbow joint in a direct projection, the articular surface of the humerus has the appearance of a curved line corresponding to the outlines of the head of the condyle and trochlea. The general x-ray joint space of the humeroulnar and humeroradial joints is zigzag-shaped, the thickness of the “clearance” strip is 2-3 mm. The shadow of the olecranon process of the bone of the same name is superimposed on it and the joint space of the proximal radioulnar joint is visible.

brachialis muscle, m. brachialis. Function: flexes the forearm at the elbow joint. Innervation: n. musculocutaneus. Blood supply:aa. collaterale ulnares superior et inferior, a. brachialis, a. reccurens radialis.

Triceps brachii muscle, m.triceps brachii. Function: extends the forearm at the elbow joint. Innervation: n. radialis. Blood supply: a. Circumflexa posterior humeri, a. profunda brachii, aa. сollateralis, a. reccurens radialis.

Brachioradialis muscle, m. brachioradialis. Function: flexes the forearm at the elbow joint, rotates the radius. Innervation: n radialis. Blood supply: a. Radialis, a. collateralis radialis, a. recurrent radialis

2.Penis, penis, consists from spongy cavernous tissue located in the form of cavernous bodies:

Paired cavernous body of the penis, corpus cavernosum penis;

Unpaired spongy body of the penis, corpus spongiosum penis.

The back of the penis has a fixed part covered with the skin of the scrotum, attached to the front surface of the pubic bones - the root of the penis, radix penis.

There is a distinction between the body of the penis, corpus penis, and the head of the penis, glans penis.

At the top of the head, the external opening of the urethra, ostium urethrae extemum, opens.

On the lower surface, the skin of the head, the foreskin, forms a longitudinal fold - the frenulum of the foreskin, frenulum preputii.

The corpus cavernosum is surrounded by a dense connective tissue tunica albuginea of ​​the corpus cavernosum, tunica albuguinea corporis cavernosi.

Male urethra, urethra masculina,divided into three parts:

Prostate, pars prostatica;

Membranous, pars membranacea;

Spongy, pars spongiosa.

It starts from the bladder with the internal opening of the urethra and extends to the external opening of the urethra, located at the top of the glans penis. The part of the urethra from the internal opening to the seminal colliculus is called the posterior urethra, the distal part is called the anterior urethra.

The prostatic part penetrates the prostate gland from above, from behind downwards and forward. It has a length of 3-4 cm and begins with a narrow part from the internal opening of the urethra (the first bottleneck of the canal). In the middle of its length, an expansion of the urethra is formed (the first expansion).

On the posterior wall of the mucous membrane there is a median fold - the ridge of the urethra. In the middle of its length, the ridge passes into a longitudinally located seminiferous mound; distally, this fold reaches the membranous part.

The membranous part is the shortest part of the urethra, has a length of 1.5-2 cm. It is tightly fixed in the urogenital diaphragm, through which it passes. The proximal part of this part of the canal is the narrowest along the entire canal (second bottleneck). The membranous part of the canal and the distal part of the prostate are covered by striated muscle fibers of the sphincter of the urethra, m. sphincter urethrae.

Penis:

Afferent (sensory) innervation - n. dorsalis penis (from n. pudendus);

Sympathetic innervation - nn. cavernosi penis (from pi. hypogastrieus inferior);

Penis- n. lymphatici inguinales superficiales, iliaci interni.

Prostate gland, prostata,- an unpaired organ made of glandular and smooth muscle tissue, located in the lower part of the pelvic cavity. The gland covers the initial part of the urethra, its prostatic part, pars prostatica, as well as the ejaculatory ducts, ductus ejaculatorii.

It distinguishes:

The apex of the prostate gland, apex prostalae, directed downwards towards the urogenital diaphragm,

The base of the prostate gland directed towards the bladder, basis prostatae.

The prostate gland consists of the right and left lobes, lobus dexter et lobus sinister. The lobes are separated along the posterior surface of the gland by a vaguely pronounced groove and isthmus of the prostate gland, isthmus prostatae.

The prostate gland consists of glandular substance, substantia glandularis, and muscular substance, substantia muscularis. It is surrounded by a capsule, from which connective tissue elastic fibers and smooth muscles that make up the stroma of the gland flow into it. The stroma is located between the ducts, dividing the glandular substance into lobules. Muscle fibers pass into the gland from the wall of the bladder adjacent to its base.

Innervation: plexus hypogastricus. Blood supply, ah. rectalis media, vesicalis inferior.

Bulbourethral gland, glandula bulbourethralis, steam room, located behind the membranous part of the urethra. The individual lobules of the gland are connected to each other by dense connective tissue. The individual passages of each lobule, connecting, form the common excretory duct of the bulbo-urethral gland, ductus glandulae bullwurethras. Innervation: plexus hypogastricus. Blood supply, ah. buibi penis (a. pudenda interaa).

Prostate gland:

Sympathetic innervation - PL. Prostaticus (prostatic plexus) from pl. hypogastricus inferior;

Parasympathetic innervation - nn. splanchnici pelvini.

Prostate gland- p. lymphatici iliaci interni.

3.The inferior vena cava, sources of its formation and topography. Tributaries of the inferior vena cava and their anastomoses.

inferior vena cava, v. cdva inferior, has no valves, is located retroperitoneally. Starts at level intervertebral disc between the IV and V lumbar vertebrae from the confluence of the left and right common iliac veins on the right. There are parietal and visceral tributaries of the inferior vena cava.

Parietal tributaries:

1. Lumbar veins, vv. lumbales; their course and the areas from which they collect blood correspond to the branches of the lumbar arteries. Often the first and second lumbar veins drain into the azygos vein rather than into the inferior vena cava. The lumbar veins of each side anastomose with each other using the right and left ascending lumbar veins. Blood flows from the vertebral venous plexuses into the lumbar veins through the spinal veins.

2. Inferior phrenic veins, vv. phrenicae inferiores, right and left, are adjacent in two to the artery of the same name, flow into the inferior vena cava after its exit from the hepatic groove of the same name.

Visceral tributaries:

1. Testicular (ovarian) vein, v. testicularis (ovarica), steam room, starts from the posterior edge of the testicle (from the hilum of the ovary) with numerous veins that entwine the artery of the same name, forming a pampiniform plexus, plexus pampiniformis. In men, the pampiniform plexus is part of the spermatic cord. Merging with each other, small veins form one venous trunk on each side. The right testicular (ovarian) vein drains into the inferior vena cava, and the left testicular (ovarian) vein drains at a right angle into the left renal vein.

2. renal vein, v. rendlis, steam room, goes from the gate of the kidney in a horizontal direction (in front of the renal artery) and at the level of the intervertebral disc between the I and II lumbar vertebrae flows into the inferior vena cava. The left renal vein is longer than the right and passes in front of the aorta. Both veins anastomose with the lumbar veins, as well as with the right and left ascending lumbar veins.

3. adrenal vein, v. suprarendlis, emerges from the adrenal hilum. This is a short, valveless vessel. The left adrenal vein drains into the left renal vein, and the right into the inferior vena cava. Part of the superficial adrenal veins flows into the tributaries of the inferior vena cava (into the lower diaphragmatic, lumbar, renal veins), and the other part into the tributaries portal vein(in pancreatic, splenic, gastric veins).

4. Hepatic veins, vv. hepdticae (3-4), are located in the liver parenchyma (the valves in them are not always expressed). The hepatic veins flow into the inferior vena cava at the place where it lies in the groove of the liver. One of the hepatic veins (usually the right one), before flowing into the inferior vena cava, is connected to the venous ligament of the liver (lig. venosum) - an overgrown venous duct that functions in the fetus.

Superficial and deep veins lower limb, their anatomy, topography, anastomoses.

Superficial veins of the lower limb. Dorsal digital veins, vv. digitdles dorsales pedis, emerge from the venous plexuses of the fingers and flow into dorsal venous arch of the foot, arcus venosus dorsalis pedis. From this arch originate the medial and lateral marginal veins, vv. marginales medi-alis et tateralis. The continuation of the first is the great saphenous vein of the leg, and the second is the small saphenous vein of the leg.

The plantar digital veins, vv., begin on the sole of the foot. digitdles plantares. Connecting with each other, they form the plantar metatarsal veins, vv. metatarsales plantares, which flow into plantar venous arch, arcus venosus plantaris. From the arch along the medial and lateral plantar veins, blood flows into the posterior tibial veins.

Great saphenous vein of the leg, v. saphena magna, begins in front of the medial malleolus and receives veins from the sole of the foot and flows into the femoral vein. The great saphenous vein of the leg receives numerous saphenous veins of the anteromedial surface of the leg and thigh and has many valves. Before it flows into the femoral vein, the following veins flow into it: external genital veins, vv. pudendae externae; superficial vein surrounding the ilium, v. circumflexa iliaca superficialis, superficial epigastric vein, v. epigastrica superficialis; dorsal superficial veins of the penis (clitoris), vv. dorsales superficidles penis (clitoridis); anterior scrotal (labial) veins, vv. scrotales (labiates) anteriores.

Small saphenous vein of the leg, v. saphena parva, is a continuation of the lateral marginal vein of the foot and has many valves. Collects blood from the dorsal venous arch and saphenous veins of the sole, lateral part of the foot and heel area. The small saphenous vein drains into the popliteal vein. Numerous superficial veins of the posterolateral surface of the leg flow into the small saphenous vein of the leg. Its tributaries have numerous anastomoses with the deep veins and with the great saphenous vein of the leg.

Deep veins of the lower limb. These veins are equipped with numerous valves and are adjacent in pairs to the arteries of the same name. The exception is deep vein of the thigh, v. profunda femoris. The course of the deep veins and the areas from which they carry blood correspond to the branches of the arteries of the same name: anterior tibial veins, vv. tibidles anteriores; posterior tibial veins, vv. tibiales posteriores; fibular veins; vv. peroneae (fibularesj; popliteal vein, v. poplitea; femoral vein, v. femoralis, etc.

Exists three kava-kaval anastomosis:

1. Through the superior epigastric vein (v.epigastrica superior) (internal thoracic vein system) and the inferior epigastric vein (v.epigastrica inferior) (internal iliac vein system). Anterior wall of the abdomen.

2.Through the azygos (v.azygos) and semi-gypsy (v.hemiazygos) vein (superior vena cava system) and lumbar veins (vv. lumbales) (inferior vena cava system). Posterior abdominal wall

3.Through the dorsal branches of the posterior intercostal veins (superior vena cava system) and tributaries of the lumbar veins (inferior vena cava system). Inside the spinal canal and around the spinal column.

4.Glossopharyngeal nerve, its branches, their anatomy, topography, areas of innervation.

glossopharyngeal nerve, n. glossopharyngeus, is a mixed nerve and is formed by sensory, motor and secretory (parasympathetic) fibers. Sensitive nerve fibers end on the cells of the nucleus of the solitary tract, motor fibers begin from the nucleus ambiguus, and autonomic ones begin from the lower salivary nucleus.

The glossopharyngeal nerve leaves the medulla oblongata with 4-5 roots behind the olive next to the roots of the vagus and accessory nerves and, together with these nerves, goes to the jugular foramen. In the jugular foramen, the nerve thickens, forms a small sensitive upper node, ganglion superius, and at the exit from this foramen, in the area of ​​the petrous fossa, there is a larger lower node, ganglion inferius. These nodes contain the cell bodies of sensory neurons. The central processes of the cells of these nodes are sent to the medulla oblongata to the sensitive nucleus of the glossopharyngeal nerve (nucleus of the solitary tract), and the peripheral processes as part of its branches follow to the mucous membrane of the posterior third of the tongue, to the mucous membrane of the pharynx, middle ear, to the carotid sinus and glomerulus. Coming from the jugular foramen, the nerve passes behind the internal carotid artery, and then passes to its lateral surface, located between this artery and the internal jugular vein. Further, bending in an arc, the nerve goes down and forward between the stylopharyngeus and styloglossus muscles and penetrates into the root of the tongue, where it divides into the terminal lingual branches, rr. lingudles. The latter go to the mucous membrane of the posterior third of the back of the tongue.

The following lateral branches arise from the glossopharyngeal nerve:

1. The tympanic nerve, n. tympanicus, emerges from the lower ganglion of the glossopharyngeal nerve and is directed into the tympanic canal of the temporal bone through the lower opening of this canaliculus. Having entered through the canaliculus and the tympanic cavity, the nerve divides into branches that form the tympanic plexus, plexus tympanicus, in the mucous membrane. The carotid-tympanic nerves also approach the tympanic plexus, pp. caroticotympanici, from the sympathetic plexus on the internal carotid artery. A sensitive tubal branch, M. tubaris, extends from the tympanic plexus to the mucous membrane of the tympanic cavity and the auditory tube. The terminal branch of the tympanic nerve is the lesser petrosal nerve, n. petrosis minor, containing preganglionic parasympathetic fibers, exits the tympanic cavity onto the anterior surface of the pyramid of the temporal bone through the cleft of the lesser petrosal nerve, passes along the groove of the same name, then leaves the cranial cavity through the lacerated foramen and enters into the ear node.

2. The sinus branch, sinus carotid, goes down to the bifurcation of the common carotid artery, where it innervates the carotid sinus and the carotid glomerulus.

3. Pharyngeal branches, rr. pharyngei, go to the lateral wall of the pharynx, where, together with the branches of the vagus nerve and the branches of the sympathetic trunk, they form the pharyngeal plexus.

4. The motor branch of the stylopharyngeal muscle, musculi stylopharyngei, goes forward and innervates the stylopharyngeal muscle.

5. Almond branches, rr. tonsitlares, are separated from the glossopharyngeal nerve before it enters the root of the tongue and are directed to the mucous membrane of the palatine arches and palatine tonsils.

6. Connecting branch (with the auricular branch of the vagus nerve), r. communicans, joins the auricular branch of the vagus nerve.

Ticket 49
1. Hip joint. Shape, structure. Joint muscles, their innervation, vascularization.
2. Endocrine glands classification. Branchiogenic group.
3. Lymphangion. Outflow of lymph from the uterus and ovaries.
4. Vagus nerve.

1.Hip joint: structure, shape, movements; the muscles that produce these movements, their blood supply and innervation. X-ray image of the hip joint.

Hip joint, articuldtio coxae, formed by the acetabulum of the pelvis and the head of the femur.

The articular capsule of the hip joint on the pelvic bone is attached around the circumference of the acetabulum so that the latter is located inside the joint cavity.

Inside the cavity there is a ligament of the head of the femur, lig. capitis femoris. On the one hand, it is attached to the fossa of the head of the femur, on the other, to the pelvic bone in the area of ​​the acetabulum notch and to the transverse ligament of the acetabulum.

Outside, the capsule is strengthened by three ligaments: the iliofemoral ligament, lig. iliofemorale, pubofemoral ligament, lig. pubofemorale, ischiofemoral ligament, lig. ischiofemorale.

Hip joint refers to a type of spherical - cup-shaped joint, articuldtio cotylica.

Movement is possible in it around three axes. Flexion and extension are possible around the frontal axis of the hip joint.

Due to movements around the sagittal axis in the hip joint, abduction and adduction of the lower limb occurs in relation to the midline.

The head of the femur rotates around the vertical axis in the hip joint. Circular movement is also possible in the joint.

On X-rays of the hip joint, the head of the femur has a rounded shape. At its medial surface there is a noticeable depression with rough edges - this is the fossa of the head of the femur. The X-ray joint space is also clearly defined.

Iliopsoas muscle, m. iliopsoas. Function: flexes the thigh at the hip joint. Innervation: plexus lumbalis. Blood supply: a. iliolumbalis, a. circumflexa ilium profunda.

gluteus maximus muscle, m. gluteus maximus

Innervation: n. gluteus inferior.

Blood supply: a. glutea inferior, a. glutea superior, a. circumflexa femoris medialis.

gluteus medius muscle, t. gluteus medius,

gluteus minimus, t. gluteus minimus,

Innervation: n. gluteus superior.

Blood supply: a. glutea superior, a. circumflexa femoris lateralis.

Tensor fascia lata, t. tensor fasciae latae,

Innervation: n. gluteus superior.

Blood supply: a. glutea superior, a. circumflexa femoris lateralis.

Quadratus femoris muscle, t. quadrdtus femori

Innervation: n. ischiadicus.

Blood supply: a. glutea inferior, a. circumflexa femoris medialis, a. obturatoria.

Obturator externus muscle, i.e. obturator externus.

Innervation: n. obturatorius.

Blood supply: a. obturatoria, a. circumflexa femoris iateralis.

2.Branchiogenic endocrine glands: thyroid, parathyroid glands, their topography, structure, blood supply, innervation.

Thyroid, glandula thyroidea, an unpaired organ, is located in the anterior region of the neck at the level of the larynx and upper trachea and consists of two lobes - the right lobe, lobus dexter, and the left lobe, lobus sinister, connected by an isthmus. The gland lies superficially. In front of the gland are the sternothyroid, sternohyoid and omohyoid and partly the sternocleidomastoid muscles, as well as the superficial and pretracheal plates of the cervical fascia.

The posterior surface of the gland covers the lower parts of the larynx and the upper part of the trachea from the front and sides. Isthmus thyroid gland, isthmus glandulae thyroidei, connecting the lobes is located at the level of II and III tracheal cartilages. The posterolateral surface of each lobe of the thyroid gland is in contact with the laryngeal part of the pharynx, the beginning of the esophagus and the anterior semicircle of the common carotid artery lying behind.

The pyramidal lobe, lobus pyratnidalis, extends upward from the isthmus or from one of the lobes and is located in front of the thyroid cartilage.

The mass of the thyroid gland is 17 g. Outside thyroid covered with a connective tissue membrane - a fibrous capsule, cdpsula fibrosa, which is fused with the larynx and trachea. Connective tissue septa - trabeculae - extend into the gland from the capsule, dividing the gland tissue into lobules, which consist of follicles. The walls of the follicles are lined from the inside with cubic-shaped epithelial follicular cells, and inside the follicles there is a thick substance -

colloid. The colloid contains thyroid hormones, consisting mainly of proteins and iodine-containing amino acids.

Blood supply and innervation.

The right and left superior thyroid arteries (branches of the external carotid arteries) approach the upper poles of the right and left lobes, respectively. The right inferior thyroid artery (from the thyroid-cervical trunks of the subclavian arteries) approaches the lower poles of the right and left lobes. The branches of the thyroid arteries form numerous anastomoses in the capsule of the gland and inside the organ. Venous blood from the thyroid gland flows through the superior and middle thyroid veins into the internal jugular vein, and through the inferior thyroid vein into the brachiocephalic vein.

The lymphatic vessels of the thyroid gland drain into the thyroid, preglottic, pre- and paratracheal lymph nodes. The nerves of the thyroid gland originate from the cervical nodes of the right and left sympathetic trunks (mainly from the middle cervical node), run along the vessels, and also from the vagus nerves.

Epithelial body

Doubles superior parathyroid gland, glandula parathyroidea superior, and inferior parathyroid gland, glandula parathyroidea inferior, are rounded bodies located on the posterior surface of the lobes of the thyroid gland. The number of these bodies is on average 4, two glands behind each lobe of the thyroid gland: one gland at the top, the other at the bottom. The parathyroid (parathyroid) glands differ from the thyroid gland in being lighter in color (pale pinkish in children, yellowish-brown in adults). Often the parathyroid glands are located at the point where the inferior thyroid arteries or their branches enter the thyroid tissue. The parathyroid glands are separated from the surrounding tissues by their own fibrous capsule, from which connective tissue layers penetrate into the glands. The latter contain a large number of blood vessels and divide the parathyroid glands into groups of epithelial cells.

The parathyroid hormone parathyroid hormone (parathyroid hormone) is involved in the regulation of phosphorus-calcium metabolism.

Blood supply and innervation. The blood supply to the parathyroid glands is carried out by the branches of the superior and inferior thyroid arteries, as well as the esophageal and tracheal branches. Venous blood flows through the veins of the same name. The innervation of the parathyroid glands is similar to that of the thyroid gland.

3.Principles of the structure of the lymphatic system (capillaries, vessels, trunks and ducts, their general characteristics). Pathways for the outflow of lymph from regions of the body into the venous bed.

Lymphatic system, systema tymphaticum, includes capillaries branched in organs and tissues, lymphatic vessels and lymphatic trunks, ducts through which lymph flows from the place of its formation to the confluence of the internal jugular and subclavian veins, forming venous angle on the right and left in the lower parts of the neck. Together with lymph, metabolic products and foreign particles are removed from organs and tissues.

Along the path of lymphatic vessels from organs and parts of the body to trunks and ducts there are numerous The lymph nodes related to the organs of the immune system. According to the structure and functions in lymphatic system allocate lymphatic capillaries (lymphocapillary vessels), they are absorbed from tissues colloidal solutions proteins; tissue drainage is carried out in addition to the veins: absorption of water and crystalloids dissolved in it, removal of foreign particles from tissues (destroyed cells, microbial bodies, dust particles).

By lymphatic vessels The lymph formed in the capillaries, together with the substances it contains, flows to the lymph nodes corresponding to a given organ or part of the body, and from them to the large lymphatic vessels - trunks and ducts. Lymphatic vessels can serve as pathways for infection and tumor cells to spread.

Lymphatic trunks And lymphatic ducts- these are large collector lymphatic vessels through which lymph flows from areas of the body to the venous angle or to the terminal sections of these veins.

Lymph flowing through the lymphatic vessels to the lymphatic trunks and ducts passes through the lymph nodes, nodi lymphatici, which perform barrier-filtration and immune functions. Lymph flowing through the sinuses of the lymph nodes is filtered through loops of reticular tissue; it receives lymphocytes formed in the lymphoid tissue of these organs.

Pathways for the outflow of lymph into the venous bed:

Lymph from each part of the body, passing through the lymph nodes, is collected in the lymphatic ducts, ductus lymphatici, and lymphatic trunks, triinci lymphatici. There are six such large lymphatic ducts and trunks in the human body. Three of them flow into the left venous angle (thoracic duct, left jugular and left subclavian trunks), three into the right venous angle (right lymphatic duct, right jugular and right subclavian trunks).

The largest and main lymphatic vessel is the thoracic duct, ductus thoracicus. Through it, lymph flows from the lower extremities, walls and organs of the pelvis, abdominal cavity, and the left half of the chest cavity. From the right upper limb, lymph collects into the right subclavian trunk, truncus subclavius ​​dexter, from the right half of the head and neck - into the right jugular trunk, truncus jcgularis dexter, from the organs of the right half of the thoracic cavity - into the right bronchomediastinal trunk, truncus bronchomedlastlnalls dexter, flowing into the right lymphatic duct, ductus lymphaticus dexter, or independently into the right venous angle. From the left upper limb, lymph flows through the left subclavian trunk, truncus subclavlus sinister, from the left half of the head and neck - through the left jugular trunk, truncus jugularis sinister, and from the organs of the left half of the thoracic cavity - into the left bronchomediastinal trunk, truncus bronchomedlastlnalis sinister.

Anatomy and topography of lymphatic vessels and regional lymph nodes of the lower limb.

On the lower limb, there are superficial lymphatic vessels lying above the superficial fascia, and deep lymphatic vessels located next to deep-lying blood vessels (arteries and veins), as well as popliteal and inguinal lymph nodes.

Superficial lymphatic vessels are formed from the capillary networks of the skin and subcutaneous base and form medial, lateral and posterior groups on the lower limb. Lymphatic vessels of the medial group originate in the skin of the I, II, III fingers, the dorsum of the medial edge of the foot, the medial and posteromedial surfaces of the leg, and then are directed along the great saphenous vein to the superficial inguinal lymph nodes. Lymphatic vessels of the lateral group are formed in the area of ​​the IV and V fingers, the lateral part of the dorsum of the foot and the lateral surface of the lower leg. Somewhat lower knee joint they join the vessels of the medial group. Lymphatic vessels of the posterior group begin in the skin of the plantar surface of the lateral edge of the foot, the heel region, and then, accompanying the small saphenous vein, reach the popliteal lymph nodes, nodi lymphatici popliteales, which are located in the middle or lower parts of the popliteal fossa near the popliteal artery and vein.

Deep lymphatic vessels lower limbs are formed from lymphatic capillaries of muscles, joints, bursae and vaginas, bones and nerves, accompany large arteries and veins of the leg and thigh and are directed to the deep inguinal lymph nodes. The deep lymphatic vessels of the foot and leg also drain into the popliteal lymph nodes.

Inguinal lymph nodes, nodi lymphatici inguinales, to which the lymphatic vessels of the lower limb, external genitalia, skin of the lower part of the anterior abdominal wall, and gluteal region are directed, are located in the area of ​​the femoral triangle, slightly below the inguinal ligament. The nodes lying on the superficial plate of the fascia lata of the thigh are superficial inguinal lymph nodes, nodi lymphatici inguinales superficiales. The upper subgroup of these nodes is located in a chain along the inguinal ligament, slightly below it. Lymph nodes of the middle subgroup lie on and around the cribriform fascia, and the nodes lower subgroup- on the superficial layer of the fascia lata of the thigh, where it forms the lower horn of the subcutaneous fissure in this fascia.

The deep inguinal lymph nodes, nodi lymphatici inguinales profundi, are non-permanent nodes. They are located in the iliopectineal groove near femoral arteries and veins. The most superior of these nodes lies in the deep femoral ring, on the medial semicircle of the femoral vein. The efferent lymphatic vessels of the inguinal lymph nodes are directed through the vascular lacuna of the thigh into the pelvic cavity, to the external iliac lymph nodes.

Ovaries- n. lymphatici lumbales.

- Uterus- n. lymphatici lumbales, sacrales, iliaci interni (lymph nodes: lumbar, sacral, internal iliac).

4.The vagus nerve, its branches, their anatomy, topography, areas of innervation.

Vagus nerve, n. vagus, is a mixed nerve. Its sensory fibers end in the nucleus of the solitary tract, motor fibers begin from the nucleus ambiguus, and autonomic fibers begin from the posterior nucleus of the vagus nerve. The fibers provide parasympathetic innervation to the organs of the neck, chest and abdominal cavities. The fibers of the vagus nerve carry impulses that slow down the heartbeat, dilate blood vessels, constrict the bronchi, increase peristalsis and relax the intestinal sphincters, causing increased secretion of the glands of the gastrointestinal tract.

Topographically, the vagus nerve can be divided into 4 sections: head, cervical, thoracic and abdominal.

Head office The vagus nerve is located between the beginning of the nerve and the superior ganglion. The following branches depart from this department:

1. The meningeal branch, g. meningeus, departs from the superior node and goes to the dura mater of the brain in the posterior cranial fossa, including the walls of the transverse and occipital sinuses.

2. The auricular branch, g. auricularis, starts from the lower part of the superior node, penetrates the jugular fossa, where it enters the mastoid canal of the temporal bone. Innervates the skin of the posterior wall of the external auditory canal and the skin of the outer surface of the auricle.

Cervical region:

1. Pharyngeal branches, rr. pharyngei, go to the wall of the pharynx, where they form the pharyngeal plexus, plexus pharyngeus. The pharyngeal branches innervate the mucous membrane of the pharynx, constrictor muscles, and muscles of the soft palate, with the exception of the muscle that strains the velum palatine.

2. Upper cervical cardiac branches, rr. cardldci cervicales superiores enter the cardiac plexuses.

3. The superior laryngeal nerve, p. laryngeus superior, departs from the lower ganglion of the vagus nerve, runs forward along the lateral surface of the pharynx and at the level of the hyoid bone is divided into external and internal branches. The external branch, g. externus, innervates the cricothyroid muscle of the larynx. The internal branch, g. internus, accompanies the superior laryngeal artery and, together with the latter, pierces the thyrohyoid membrane. Its terminal branches innervate the mucous membrane of the larynx above the glottis and part of the mucous membrane of the root of the tongue.

4. Recurrent laryngeal nerve, p. laryngeus recurrens, The final branch of the recurrent laryngeal nerve is the lower laryngeal nerve, p. laryngealis inferior, innervates the mucous membrane of the larynx below the glottis and all the muscles of the larynx, except the cricothyroid. There are also tracheal branches, esophageal branches, and lower cervical cardiac branches that go to the cardiac plexuses.

Thoracic region- the area from the level of origin of the recurrent nerves to the level of the esophageal opening of the diaphragm. Branches of the thoracic vagus nerve:

1. Thoracic cardiac branches, rr. cardiaci thoracici, are directed to the cardiac plexuses.

2. Bronchial branches, rr. bronchidles, go to root of the lung, where together with the sympathetic nerves they form pulmonary plexus, plexus pulmonalis, which surrounds the bronchi and, together with them, enters the lung.

3. Esophageal plexus, plexus esophageus, is formed by the branches of the right and left vagus nerves (trunks), connecting to each other on the surface of the esophagus. Branches extend from the plexus to the wall of the esophagus.

Abdominal represented by the anterior and posterior trunks, which emerge from the esophageal plexus.

1. Anterior vagus trunk, truncus vagalis anterior. From this vagus trunk the anterior gastric branches, gg. gdstrici anteriores, as well as hepatic branches, g. hepatici, running between the leaves of the lesser omentum to the liver.

2. The posterior vagus trunk, truncus vagalis posterior, passes from the esophagus to back wall stomach, runs along its lesser curvature, gives off posterior gastric branches, rr. gdstrici posteriores, as well as celiac branches, rr. coeliaci. The celiac branches go down and back and reach the celiac plexus along the left gastric artery. Fibers go to the liver, spleen, pancreas, kidney, small intestine and colon.

Ticket 51
1. internal base of the skull, opening and their contents. development of the cranium
2.external structure of the liver, topography. gallbladder structure, topography, ways of bile excretion
3. brachial artery
4.development of the brain vesicles.reticular formation, lateral, medial loop.

1.Characteristics of the inner surface of the base of the skull, foramina and their purpose.

Inner base of the skull basis cranii interna, has a concave uneven surface, reflecting the complex topography of the lower surface of the brain. It is divided into three cranial fossae: anterior, middle and posterior.

Anterior cranial fossa, fossa cranii anterior, is formed by the orbital parts of the frontal bones, on which cerebral eminences and finger-like depressions are well defined. In the center, the fossa is deepened and filled with a cribriform plate of the ethmoid bone, through the openings of which the olfactory nerves (1st pair) pass. In the middle of the cribriform plate the cock's comb rises; in front of it are the foramen cecum and the frontal crest.

Middle cranial fossa, fossa cranii media, much deeper than the anterior one, its walls are formed by the body and large wings sphenoid bone, the anterior surface of the pyramids, the scaly part of the temporal bones. In the middle cranial fossa one can distinguish central part and lateral.

On the lateral surface of the body of the sphenoid bone there is a well-defined carotid groove, and near the top

The structure of the joints helps the free movement of a person, prevents friction and self-destruction, and is part of all bones of the body, except the hyoid. More than 180 types of joints are known by shape; they are distinguished: cup-shaped, spherical, cylindrical, condylar, flat, ellipsoidal and saddle-shaped. According to the type of joints, they are divided into synovial and facet joints. By structure - simple, complex, complex and combined.

The bones intersect at the joints and slide smoothly. The degree of regulation of movement or braking depends on the size of the surface, the type and number of ligaments and muscles. Bone protrusions limit range of motion. The ulnar fibrous joint connects the shoulder and forearm, resembling a hinge made of tubular bones, which covers a bag of two layers with liquid. The system is fixed by elastic ligaments and muscles. The mechanism of the movable combination bends, extends, and rotates the forearm.

What bones form the elbow joint? The elbow consists of three tubular, triangular, cylindrical bones.

The humerus belongs to the skeleton of the upper arm, the radius and ulna - from the bend of the elbow to the beginning of the hand. The body of the humerus is called the diaphysis, the edges are called the epiphyses, proximal and distal. In the upper part, the diaphysis becomes round and towards the distal epiphysis it becomes triangular.

The ulna is a paired bone of the forearm, which is formed by three edges: anterior, posterior and lateral and two epiphyses. The neck lies in front between the body and the upper end. The upper edge of the elbow continues with the olecranon process. Below there is a head with an articular surface for connection with the wrist. The head of the articular circle articulates outside the radius. On inside The styloid process lies on the head.

The radius is a triangular, paired bone in the forearm, it is immobile. The upper end forms a circumferential head with a flat articular fossa for articulation with the head of the humeral condyle. The inner pointed edge is directed towards the ulna. The tendons of the shoulder are attached to the lower part of the head - the neck.

Anatomy of the elbow

The anatomy of the human elbow joint is studied. Let's look at the structure of the elbow joint of the human hand with drawings and photos in detail.

What bones form the humeral-ulnar joint? This is the mechanism of the screw joint of the humerus and ulna. The trochlear joint moves along one axis in a range of 140º. The humeral spherical joint is vertically and frontally compared with the circumference of the humerus and the fossa of the head of the radius. The radioulnar joint consists of the circumference of the radius and the notch of the ulna. Cylindrical joints move on a circular axis.

Muscles, ligaments, blood vessels, and nerve endings of the elbow form a coordinated principle of operation. The articular capsule is attached to the sides and front, unites and fixes independent joints.

Hyaline cartilage covers the articular surface of the epiphyses, resembles a smooth, matte surface, without nerve endings. Blood vessels are absent in cartilage. Nutrition comes from joint fluid. Cartilage consists of water - 70-80%, organic compounds - 15% and minerals - 7%.

Important! It is necessary to maintain water balance for the health of joint mechanisms.

The anterior and posterior part of the capsule consists of folds and bursa, it is thin with a synovial membrane, affects the smoothness of movements and protects the joints without a cartilaginous shell. Articular ligaments and an interosseous membrane protect the capsule on the sides. The main attachment is on the humerus. Damage and inflammation of the membrane lead to the development.

Ligamentous apparatus

The anatomy of the ligaments in planes forms the complex shape of the elbow joint, which supports the joints. Connective tissues make up the fixation of the device. The structure is dominated by strengthening collagen fibers.

Elastic ligaments intertwine the joint capsule on the sides. There are no ligament capsules in front and behind. The secret of the inner layer of the cuff is synovium, it reduces friction. Inhibition and guidance of ligaments maintain integrity and functionality.

Ligaments are divided into the following types:

• ulnar and radial collateral ligaments;
• the annular and quadrate ligaments, the interosseous membrane complement the articulation and create through
• holes supply blood and innervation to the joint.

The tendons attach to the heads of the radius. Muscle strengthens the ligamentous apparatus.

Muscular frame

The musculature of the elbow runs along the shoulder and forearm. Muscle tissue protects human joints.

The coordinated actions of the muscles make extension and flexion movements at the elbow, turns with the palm up, and circular rotations of the shoulder to the outside. The flexor apparatus of the forearm is divided into two types: anterior and posterior.

Anterior shoulder muscles:

• brachialis muscle - the lower region of the humerus, flexes the forearm;
• biceps biarticular muscle - supinator of the forearm, bends the elbow.

Posterior shoulder muscles:

• triceps muscle - lies on back side shoulders, triple thickening extends the shoulder and forearm;
• elbow muscle - extensor function.

Muscles of the elbow joint:

• The pronator teres is responsible for the flexion and position of the forearm;
• flat long muscle, similar to a spindle;
• flexor carpi ulnaris;
• The palmaris longus muscle looks like a spindle, an elongated tendon. Flexes a limb;
  the superficial flexor of the middle phalanges of the fingers consists of four tendons and is directed to the fingers;
• brachioradialis - rotates the forearm;
• extensor carpi radialis longus - extends and partially abducts the hands;
• extensor carpi radialis brevis with less rotation;
• extensor carpi ulnaris, a muscle that extends the wrist;
• extensor digitorum;
• supinator muscles - in the forearm.

A person does not move his arm if the elbow muscles are damaged.

Blood supply

Blood flows to joints and muscles through a network of arteries. The connection diagram is complex. Networks of the brachial, radial and ulnar veins provide blood supply and drainage along the surface of the joint capsule.

Eight branches supply blood to the elbow area. The main nutrients enter the joint along with the bloodstream in a timely manner. The veins and branches fill the bones, muscles and joints with oxygen, vitamins and minerals. The arterial network is susceptible to vascular injuries. Negative point: heavy bleeding is difficult to stop.

The brachial artery continues the axillary artery and gives the following branches:

• superior ulnar collateral;
• inferior ulnar collateral;
• deep brachial artery, gives off branches: middle collateral, radial
• collateral, deltoid.

The radial artery departs from the brachial artery into the cubital fossa, goes below along the anterior surface of the pronator teres, then to the middle of the brachioradialis muscle, between it and the pronator teres, and then along the flexor carpi radialis.

Along the artery there are 11 branches:

• radial recurrent artery;
• superficial palmar branch;
• palmar carpal branch;
• dorsal carpal branch.

Ulnar artery - continuation of the brachial vein, it passes through the cubital fossa under the pronator teres, accompanied by the ulnar nerve, then penetrates the palm.

Branches of the ulnar artery:

Nerve fibers

The nerve fibers of the elbow are responsible for sensitivity and movement of the fingers. Three nerve processes provide nutrition to the muscles that make movements at the joints of the elbow:

• radial nerve and median- pass along the front side of the elbow;
• ulnar- long nerve of the brachial plexus. The fibers of the 7th and 8th cervical vertebrae arise from the brachial plexus and pass inside the back of the arm to the fingers.

Nerve fibers become pinched in the elbow and Guyon's canal of the wrist joint. The nerve trunk runs along the tendon-bone canals. Inflammation leads to pinching. Sensory and motor fibers cause numbness, pain and limited movement when the nerve is damaged. Carpal tunnel syndrome develops when bones, cartilage or tendons are deformed.

An inflamed muscle, ligament or new soft tissue formation pinches the nerve fibers, as they lie superficially and are accessible to external influences. Shooting, pain and numbness reach the fingers when the elbow strikes. Impaired motor function and nutrition lead to muscle atrophy and gradual changes in the hand.

Atrophy and loss of muscle movement in the forearm and hand are a consequence of damage to the nerve above the middle third of the forearm. Injury to Guyon's canal results in weakness in the fingers. Seeing a doctor and starting treatment will help avoid complications.

The consequences of a pinched nerve lead to disability, pain and ultimately to surgery.

Conclusion

Joints perform motor functions in the human body. The life of an individual is full of movements in everyday life, at work and in sports. Athletes protect their elbows with special pads. Disruption of a complex bone structure, regardless of age and situation, worsens the quality of life. A person needs the prevention of arthrosis, arthritis, osteochondrosis.

Walking, running, alpine skiing, and swimming help fight excess weight and keep muscle tissue in good shape. Blood circulation in the tissues fills the cartilage tissue with essential nutrients and prevents destruction. Maintaining proper nutrition, treatment infectious diseases, strengthening the musculoskeletal system, as well as regular examinations by doctors will eliminate surgical intervention.