Elbow Flashcards

1
Q

Elbow flexion = ? degrees

A

150

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2
Q

Elbow extension = ? degrees

A

0

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3
Q

What is the degree of forearm supination?

A

80 degrees

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4
Q

T or F

Forearm supination and pronation are not the same degrees

A

False

80 degrees for both

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5
Q

T or F

Medial Collateral Ligament test is an adduction stress test

A

False!
Abduction stress test

LCL = adduction stress test

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6
Q

Name the Elbow special tests

A
Medial Collateral Ligament Test 
Lateral Collateral Ligamet Test
Tinel Elbow Sign 
Cozen Test 
Mills Test  aka Evans Maneuver 
Golfers Elbow Test
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7
Q

What + tests indicate Lateral Epicondylitis?

A

Cozen Test

Mills Test

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8
Q

T or F

Golfer’s elbow test indicates if + Neuroma of the ulnar nerve

A

False!

Tinel Elbow indicates neuroma of ulnar nerve
Golfer’s elbow = medial epicondylitis

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9
Q

What is the common name given to Lateral Epicondylitis

A

Tennis Elbow

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10
Q

Instructions for Medial Collateral Ligament Test

A

Patient Seated

Examiner stabilizes the lateral aspect of the arm and places an abduction (valgus) pressure on the medial forearm

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11
Q

+ MCL test indicates?

A

medial collateral ligament instability

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12
Q

Instruction for the Lateral Collateral Ligament Test

A

Patient Seated
Examiner stabilizes the medial aspect of the arm and places an adduction (varus) pressure on the patients lateral forearm

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13
Q

Instruction for Tinel Elbow Sign

A

Patient Seated

With a Taylor reflex hammer, examiner taps over the groove between the medial epicondyles and the olecranon process.

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14
Q

+ Tinel Elbow = ?

A

Pain at the site being tapped and paresthesia in the ulnar nerve distraction area (fingers 4,5)

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15
Q

+ Tinel Elbow indicates?

A

Neuroma of the ulnar nerve

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16
Q

Instructions for Cozen Test

A

Patient Seated
Examiner instructs patient to make a fist and place wrist into extension.
Examiner instructs patient to resist as examiner tries to push extended wrist into flexion.

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17
Q

What is a positive Cozen Test

A

Pain over the lateral epicondyle

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18
Q

What is a confirmation test that can be done if you suspect a + Cozen test?

A

Mills Test

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19
Q

Instructions for Mills Test

A

Patient Seated
Forearm supinated
Ina smooth continuous motion the DC passively maximally flexes the patient’s fingers and wrist. While maintaining wrist and finger flexion, the DC passively extends the patient’s elbow (the forearm is now pronated)

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20
Q

+ Mills Test = ?

A

Pain over the lateral epicondyle

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21
Q

Instruction for Golfer Elbow Test

A

Patient Seated
Examiner instructs patient to extend the elbow and supinate hand. Examiner instructs patient to flex the wrist against resistance.

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22
Q

What is the median nerve distribution?

A

The radial portion of the palm and the palmar surfaces of the thumb, 2nd and 3rd and lateral 1/2 of the 4th digit.

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23
Q

+ for Tinel Wrist Sign

A

Reproduction of pain, tenderness, and/or parasthesia in the median nerve distribution (thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit)

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24
Q

Indicator for Tinel Wrist Sign

A

Median Neuritis, possibly Carpal Tunnel Syndrome

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25
Q

What are some confirmation tests for Tinel Wrist Sign

A

Phalen Test
Reverse Phalen Test
Nerve Conduction Test

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26
Q

+ for Phalen Sign & Reverse Phalen Sign

A

Reproduction of pain, tenderness, and/or parasthesia in the median nerve distribution (thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit)

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27
Q

What does a + Phalen or Reverse Phalen Indicate?

A

Median Neuritis, possibly Carpal Tunnel Syndrome

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28
Q

How long must your patient hold Phalen or Reverse Phalen Sign?

A

Until point of pain or 60 seconds

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29
Q

+ Finkelstein Test

A

Pain distal to the radial styloid process

30
Q

+ Finkelstein indicates?

A

Stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis braves tendons (DeQuervain’s Disease)

31
Q

T or F

you could do Phalen’s Sign to confirm a + Finkelstein Test

A

False!

Blood Testing
MRI

32
Q

Why would you do Bunnel-Littler Test

A

Patient presents with difficulty flexing the PIP

33
Q

+ Bunnel-Littler Test

A
  1. Flexion of the proximal interphalangeal joint cannot be achieved
  2. Flexion of the proximal interphalangeal joint is achieved
34
Q

Indicators for a + Bunnel-Littler Test

A
  1. Joint capsule contracture

2. Tight intrinsic muscles

35
Q

T or F

For the Reticular Test - patient presents with difficulty flexing the PIP

A

False

DIP

36
Q

+ Retinacular Test

A
  1. Flexion of the distal interphalangeal joint cannot be achieved
  2. Flexion of the distal interphalangeal joint is achieved
37
Q

+ Retinacular Test indicates?

A
  1. Joint Capsule Contracture

2. Tight Retinacular Ligament

38
Q

+ Allen Test

A

A delay of more than 10 seconds (Evans 5 sec.) in returning a reddish colour to the hand.

39
Q

What does a + Allen Test indicate?

A

Radial or Ulnar artery insufficiency.

40
Q

T or F

The artery being occluded in Allen Test is NOT the artery being tested.

A

True

41
Q

+ Tinel Wrist Sign

A

Reproduction of pain, tenderness and/or paresthesia in the MEDIAN nerve distribution (thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit.

42
Q

What does a + Tinel Wrist Sign indicate?

A

Median neuritis, possibly carpal tunnel syndrome

43
Q

Reproduction of pain and/or paresthesia in the median nerve distribution area is a positive for what wrist special tests?

A

Tinel Wrist
Phalen Sign
Reverse Phalen Sign

44
Q

What does a + Phalen and Reverse Phalen indicate?

A

Median Neuritis, possibly Carpal Tunnel Syndrome

45
Q

+ Finkelstein Test

A

Pain DISTAL to the radial styloid process.

46
Q

What is the primary function of the elbow complex?

A

To work with the shoulder to position the hand in space.

47
Q

Name the 3 distinct elbow complex articulations

A

The humeroulnar joint
The humeroradial joint
The proximal radioulnar joint

48
Q

T or F

When the elbow is flexed the points at the olecranon and the medial & lateral epicondyles lie in a straight line

A

False

That is when the elbow is EXTENDED

49
Q

What shape do the olecranon and medial and lateral condyles form in flexion?

A

Isoceles Triangle

50
Q

What type of Monteggia Fracture occurs 60% of the time?

A

Type 1

51
Q

T or F

The Humeroulnar Joint is biaxial

A

False

Uniaxial

52
Q

What is the approximate degree of carrying angle in women and in men?

A
Women = 13-16 degrees 
Men = 11-14 degrees
53
Q

The carrying angle is formed by?

A

The hand and the elbow

54
Q

What is the resting, or open packed position for the humeroulnar joint?

A

70 degrees of flexion with 10 degrees of forearm supination

55
Q

T or F

Fractures of the lateral condyle represent 15-17% of paediatric elbow fractures

A

True

56
Q

MOI for most lateral epicondylar fractures is?

A

When a VARUS force is applied to the elbow, causing the extensor muscles and lateral collateral ligament to avulse the lateral condyle.

57
Q

A decrease in the carrying angle is known as?

A

Cubital Varus

58
Q

An aka for Cubital Varus?

A

Gunstock Deformity

59
Q

What is the MOI for a gunstock deformity?

A

Trauma - supracondylar fracture

60
Q

What is the least common elbow fracture in children according to Rogers?

A

I dunno who the fuck Rogers is but apparently he says medial epicondylar 10%

61
Q

T or F

The majority of supracondylar fractures are extension injuries and are due to a fall on an outstretched arm

A

True

62
Q

What is the primary cause of Cubitus Varus

A

Primarily to alignment of the fracture at the time that it is set rather than to epiphyseal injury.

63
Q

T or F

The Humeroradial joint is between the trochlea of the humerus and the concave head of the radius

A

False moihahahaha

Between the capitellum of the humerus and the concave head of the radius.

64
Q

What type of joint is the proximal (superior) radioulnar joint?

A

Uniaxial pivot joint

65
Q

What is the resting, or open packed position for the proximal radioulnar joint?

A

70 degrees of flexion and 35 degrees of forearm supination

66
Q

T or F

The closed packed position for the Proximal Radioulnar Joint is 10 degrees of forearm supination

A

False

5 degrees

67
Q

What ligament forms 80% of the articular surface of the proximal radioulnar joint?

A

Annular Ligament

68
Q

What is the function of the Annular Ligament

A

To maintain the relationship between the head of the radius and the humerus and ulna

69
Q

Pulled elbow aka ________ __________

A

Nursemaids Elbow

70
Q

MOI of a pulled elbow?

A

The result of a sudden pull on the hand of a child ages 2-5 by an impatient adult. The lesion is due to the radial head slipping out from under the annular ligament, trapping the ligament in the radiohumeral articulation.