ch18: upper arm, elbow, forearm

Question 1

elbow flexor vs elbow extensor force production

Answer 1

extensor moment arm shorter than flexor

elbow ext must gen more force to produce same amount of jnt torque

more comrpession force during extension vs flexion

Question 2

moving valgus stress test

Answer 2

sh abd 90
start elbow full y flexed
AT pasively bring into elbow ext while applying a valgus pressure

+ve if pain reproduced
most painful arc 70-120deg

= deep ant bundle of the mcl have been damaged which may lead to chronic valgus ext overload

Question 3

milking test

Answer 3

pt seated elbow 90deg, abd 90deg
AT bring into sh ext rot by pulling pt thumb
+ve= pain on medial elbow = UCL

Question 4

cozens tests

Answer 4

tennis elbow test
- stabilize flexed elbow and palpate lateral epicondyle
- pt then makes fist and pronates
- then pt tries to radially deviate and ext wrist whilt AT applies resistance
+ve: severe pain over lat epicondyle = extensor tendinitis

Question 5

variations of extensor tendinitis test

Answer 5

• passive stretching of extensor muscles while palpating lat epicondyle
• AT also pronats forearm and extends the elbow
• discomfort w/ extensor digitorum
• distal resistance applied to 3rd digit w/ wrist ext

Question 6

medial epicondylitis

Answer 6

• flexed elbow stabilized against the body and forearm supinated
• AT palpates medial epicondyle
• resisted wrist and elbow extension
  +ve= pain over medial epicondyle

Question 7

tinel sign for ulnar neuritis

Answer 7

• cubital tunnel tapped on the posteromedial side of the elbow
  +ve; tingling down ulnar aspect of the forearm into medial half of the fourth finger and fifth finger

Question 8

elbow flexion test

Answer 8

• pt felx elbow completly and holds for 5min
  +ve; tingling or numbness in the ulnar nerve distribution pattern of the forearm and hand
  = ulnar neuritis, ulnar nerve entrapped in the cubital tunnel

Question 9

test for pronator teres syndrome

Answer 9

• elbow flexed 90deg
• clinician strongly resists forearm pronation while elbow is extended
  +ve: tingling or paresthesia in median nerve distribution of forearm and hand

Question 10

pinch grip test

Answer 10

• pt instructed to pinch tip of index finger and thumb.
• normal = tip to tip
  +ve: pulp-to-pulp
  = ant interosseous n. (median nerve extension) may be entrapped at the elbow as it passes btw the 2 heads of pronator teres

Question 11

cause of olecranon bursitis

Answer 11

• fall on a flexed elbow
• constantly leaning on ones elbow
• repetitive pressure and friction
• repetitive flexion and extension
• infection

Question 12

septic bursitis possible cause

Answer 12

• infection of distant site
• paronychia, cellulitis of the hand, forearm infection

Question 13

nonseptic bursitis causes

Answer 13

crystalline deposition disease
- rheumatoid involvement
- atopic dermatitis

Question 14

s/s septic bursitis

Answer 14

traditional signs of infection
- malaise,
-fever,
-pain,
-localized heat,
- restricted motion
- tenderness
- swelling at elbow

Question 15

anterior capsulitis

Answer 15

anterior jnt pain caused by hyperextension usually is attributed to acute rather then chronic
- repetitive throwing

Question 16

s/s ant capsulitis

Answer 16

• diffuse ant elbow pain presents after trauma
• deep tenderness on palpation
• nerve entrapment
• ## NTB of thumb and index

Question 17

nursemaid elbow
pulled-elbow syndrome

Answer 17

elbow dislocation caused by longitudinal traction of and extended and pronated uppe extremity

Question 18

elbow dislocation

Answer 18

• most common traumatic injury to elbow
• immature annular lig
• allows radial head to migrate out

Question 19

terrible triad of the elbow

Answer 19

• elbow dislocation
• radial head and coronoid process fx

Question 20

rupture of the biceps brachii incidence

Answer 20

3% distal end

Question 21

rupture of triceps brachii and the elbow

Answer 21

80% involv olecranon avulsion

Question 22

compartment syndrome

Answer 22

2 compartments
ant: wrist and finger flexors
post: wrist and finger ext
- often secondary to forearm fx, postischemic edema, excessive muscular exertion

Question 23

little league elbow

Answer 23

• vulnarable medial humeral apophyseal growth plate in pediatric pt
• partial or complete avulsion fx of medial epicondyle

Question 24

two most involed tendon in medial epicodylitis

Answer 24

• pronator teres
• flexor carpi radialis

Question 25

osteochondritis dissecans

Answer 25

unusual complication of repetitive stress to the skeletal immature elbow - mechanism: lateral compressive forces exerted during throwing - can damage radial head, capitellum - leading cause of permanent elbow disability in ado athletes -

Question 26

panner disease

Answer 26

- most common cause of chronic lateral elbow pain - encompasses the entire capitellum in athletes younger than 10y/o - pain resolve with rest - associated with osteochondritis cond

Question 27

volkmann contracture

Answer 27

supracondylar fx complication - ischemic necrosis of the forearm muscles

Question 28

nightstick fx

Answer 28

direct blow to the forearm that fc the ulna

Question 29

risk for fx in gymnast

Answer 29

leather grips - when it catches and the forearm wraps around the bar causing multiple fx