Epitrochleoanconeus muscle | |
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Details | |
Origin | Inferior surface of the medial epicondyle of the humerus |
Insertion | olecranon process |
Nerve | Ulnar nerve |
Identifiers | |
Latin | Musculus epitrochleoanconaeus |
Anatomical terms of muscle |
The epitrochleoanconeus muscle (anconeous epitrochlearis muscle, anconeus-epitrochlearis or anconeus sextus) is a small accessory muscle of the arm which runs from the back of the inner condyle of the humerus over the ulnar nerve to the olecranon. The average prevalence of this muscle is 14.2% in healthy individuals. [1]
The epitrochleoanconeus is a short striated muscle which originates on the posterior surface of the medial epicondyle of the humerus. The muscle runs over the ulnar nerve, forms an arch over the cubital tunnel and inserts on the olecranon. It is innervated by the ulnar nerve.
There are cases where there is no structure at all bridging the space occupied by the epitrochleoanconeus. [2] The muscle tends to be hypertrophied when associated with cubital tunnel syndrome. [1]
The presence of the epitrochleoanconeus muscle can lead to ulnar neuropathy, or cubital tunnel syndrome, due to compression of the ulnar nerve. [3] [4] [5] The absence of epitrochleoanconeus muscle or Osborne's ligament can increase the chances of ulnar nerve dislocation. [2]
While there were previous identifications of the epitrochleoanconeus in animal studies, under a variety of names, Gruber (1866) seems to offer the first extensive comparative study involving the epitrochleoanconeus in man. [6] This was shortly followed by several accounts by Wood describing his identification of the muscle during a series of dissections in humans along with comparative studies in other animals. [7] [8]
In animals with a discrete developed epitrochleoanconeus the muscle acts as an adductor of the olecranon and a supinator of the forearm. [9] A variety of names have been given to this muscle in different species including flexor antebrachii ulnaris, epitrochleo-cubitalis and entepicondylo-ulnaris. The epitrochleoanconius is common amongst tetrapods being found in reptiles, amphibians, mammals and birds. [10]
The epitrochleoanconeus is found widely amongst mammals having been characterised in the mid 19th century in a variety of species including two-toed sloth, duck billed platypus and echidna. Galton (1874) gave an overview of the several species characterised at that point and noted that at least 15 species had been figured with the muscle in Cuvier's "Anatomie comparée" of 1855 but that the muscle was given a wide variety of aliases and was not shown in many species where it should have been seen. [9] The muscle is common in lower primates but has been lost as a discrete muscle in apes, although it has reoccurred in chimpanzees. [9] [11]
The ulna or ulnar bone is a long bone in the forearm stretching from the elbow to the wrist. It is on the same side of the forearm as the little finger, running parallel to the radius, the forearm's other long bone. Longer and thinner than the radius, the ulna is considered to be the smaller long bone of the lower arm. The corresponding bone in the lower leg is the fibula.
The radial nerve is a nerve in the human body that supplies the posterior portion of the upper limb. It innervates the medial and lateral heads of the triceps brachii muscle of the arm, as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin.
The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus.
The ulnar nerve is a nerve that runs near the ulna, one of the two long bones in the forearm. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest in the human body unprotected by muscle or bone, so injury is common. This nerve is directly connected to the little finger, and the adjacent half of the ring finger, innervating the palmar aspect of these fingers, including both front and back of the tips, perhaps as far back as the fingernail beds.
Wrist drop is a medical condition in which the wrist and the fingers cannot extend at the metacarpophalangeal joints. The wrist remains partially flexed due to an opposing action of flexor muscles of the forearm. As a result, the extensor muscles in the posterior compartment remain paralyzed.
The cubital tunnel is a space of the dorsal medial elbow which allows passage of the ulnar nerve around the elbow. Persistent compression of the ulnar nerve in the cubital tunnel is known as cubital tunnel syndrome.
The flexor carpi ulnaris (FCU) is a muscle of the forearm that flexes and adducts at the wrist joint.
The olecranon, is a large, thick, curved bony process on the proximal, posterior end of the ulna. It forms the protruding part of the elbow and is opposite to the cubital fossa or elbow pit. The olecranon serves as a lever for the extensor muscles that straighten the elbow joint.
The ulnar canal or ulnar tunnel (also known as Guyon's canal or tunnel) is a semi-rigid longitudinal canal in the wrist that allows passage of the ulnar artery and ulnar nerve into the hand. The roof of the canal is made up of the superficial palmar carpal ligament, while the deeper flexor retinaculum and hypothenar muscles comprise the floor. The space is medially bounded by the pisiform and pisohamate ligament more proximally, and laterally bounded by the hook of the hamate more distally. It is approximately 4 cm long, beginning proximally at the transverse carpal ligament and ending at the aponeurotic arch of the hypothenar muscles.
The medial epicondyle of the humerus is an epicondyle of the humerus bone of the upper arm in humans. It is larger and more prominent than the lateral epicondyle and is directed slightly more posteriorly in the anatomical position. In birds, where the arm is somewhat rotated compared to other tetrapods, it is called the ventral epicondyle of the humerus. In comparative anatomy, the more neutral term entepicondyle is used.
Cubital tunnel syndrome is an entrapment neuropathy, or nerve compression syndrome, a condition caused by compression, traction or friction, of the ulnar nerve at the elbow. Nerve compression is also known as a trapped nerve. The ulnar nerve travels from the shoulder down the length of the arm to the hand. Along its course it may become compressed at several sites. At the elbow the ulnar nerve passes through the cubital tunnel. Ulnar nerve compression most commonly occurs at the level of the cubital tunnel. The ulnar nerve provides motor and sensory innervation to the forearm, and hand and its compression can cause the numbness and other symptoms associated with cubital tunnel syndrome. In many cases the cause is unknown.
The posterior compartment of the forearm contains twelve muscles which primarily extend the wrist and digits. It is separated from the anterior compartment by the interosseous membrane between the radius and ulna.
Ulnar tunnel syndrome, also known as Guyon's canal syndrome or Handlebar palsy, is ulnar neuropathy at the wrist where it passes through the ulnar tunnel. The most common presentation is a palsy of the deep motor branch of the ulnar nerve causing weakness of the interosseous muscles. Ulnar tunnel syndrome is usually caused by a ganglion cyst pressing on the ulnar nerve, other causes include traumas to the wrist and repetitive movements, but often the cause is unknown (idiopathic). Long distance bicycle rides are associated with transient alterations in ulnar nerve function. Sensory loss in the ring and small fingers is usually due to ulnar nerve entrapment at the cubital tunnel near the elbow, which is known as cubital tunnel syndrome, although it can uncommonly be due to compression at the wrist.
Idiopathic ulnar neuropathy at the elbow is a condition where pressure on the ulnar nerve as it passes through the cubital tunnel causes ulnar neuropathy. The symptoms of neuropathy are paresthesia (tingling) and numbness primarily affecting the little finger and ring finger of the hand. Ulnar neuropathy can progress to weakness and atrophy of the muscles in the hand. Symptoms can be alleviated by the use of a splint to prevent the elbow from flexing while sleeping.
Ulnar neuropathy is a disorder involving the ulnar nerve. Ulnar neuropathy may be caused by entrapment of the ulnar nerve with resultant numbness and tingling. It may also cause weakness or paralysis of the muscles supplied by the nerve. Ulnar neuropathy may affect the elbow as cubital tunnel syndrome. At the wrist a similar neuropathy is ulnar tunnel syndrome.
The elbow is the region between the upper arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa, and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; 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. The term elbow is specifically used for humans and other primates, and in other vertebrates it is not used. In those cases, forelimb plus joint is used.
Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by chronic, direct pressure on a peripheral nerve. It is known colloquially as a trapped nerve, though this may also refer to nerve root compression. Its symptoms include pain, tingling, numbness and muscle weakness. The symptoms affect just one particular part of the body, depending on which nerve is affected. The diagnosis is largely clinical and can be confirmed with diagnostic nerve blocks. Occasionally imaging and electrophysiology studies aid in the diagnosis. Timely diagnosis is important as untreated chronic nerve compression may cause permanent damage. A surgical nerve decompression can relieve pressure on the nerve but cannot always reverse the physiological changes that occurred before treatment. Nerve injury by a single episode of physical trauma is in one sense an acute compression neuropathy but is not usually included under this heading, as chronic compression takes a unique pathophysiological course.
Wartenberg's sign is a neurological sign consisting of involuntary abduction of the fifth (little) finger, caused by unopposed action of the extensor digiti minimi.
Injuries to the arm, forearm or wrist area can lead to various nerve disorders. One such disorder is median nerve palsy. The median nerve controls the majority of the muscles in the forearm. It controls abduction of the thumb, flexion of hand at wrist, flexion of digital phalanx of the fingers, is the sensory nerve for the first three fingers, etc. Because of this major role of the median nerve, it is also called the eye of the hand. If the median nerve is damaged, the ability to abduct and oppose the thumb may be lost due to paralysis of the thenar muscles. Various other symptoms can occur which may be repaired through surgery and tendon transfers. Tendon transfers have been very successful in restoring motor function and improving functional outcomes in patients with median nerve palsy.
Osborne's ligament, also Osborne's band, Osborne's fascia, Osborne's arcade, arcuate ligament of Osborne, or the cubital tunnel retinaculum, refers to either the connective tissue which spans the humeral and ulnar heads of the flexor carpi ulnaris (FCU) or another distinct tissue located between the olecranon process of the ulna and the medial epicondyle of the humerus. It is named after Geoffrey Vaughan Osborne, a British orthopedic surgeon, who described the eponymous tissue in 1957.
This article incorporates text in the public domain from page 448 of the 20th edition of Gray's Anatomy (1918)