ch18: upper arm, elbow, forearm Flashcards
(29 cards)
elbow flexor vs elbow extensor force production
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
moving valgus stress test
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
milking test
pt seated elbow 90deg, abd 90deg
AT bring into sh ext rot by pulling pt thumb
+ve= pain on medial elbow = UCL
cozens tests
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
variations of extensor tendinitis test
- 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
medial epicondylitis
- flexed elbow stabilized against the body and forearm supinated
- AT palpates medial epicondyle
- resisted wrist and elbow extension
+ve= pain over medial epicondyle
tinel sign for ulnar neuritis
- 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
elbow flexion test
- 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
test for pronator teres syndrome
- elbow flexed 90deg
- clinician strongly resists forearm pronation while elbow is extended
+ve: tingling or paresthesia in median nerve distribution of forearm and hand
pinch grip test
- 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
cause of olecranon bursitis
- fall on a flexed elbow
- constantly leaning on ones elbow
- repetitive pressure and friction
- repetitive flexion and extension
- infection
septic bursitis possible cause
- infection of distant site
- paronychia, cellulitis of the hand, forearm infection
nonseptic bursitis causes
crystalline deposition disease
- rheumatoid involvement
- atopic dermatitis
s/s septic bursitis
traditional signs of infection
- malaise,
-fever,
-pain,
-localized heat,
- restricted motion
- tenderness
- swelling at elbow
anterior capsulitis
anterior jnt pain caused by hyperextension usually is attributed to acute rather then chronic
- repetitive throwing
s/s ant capsulitis
- diffuse ant elbow pain presents after trauma
- deep tenderness on palpation
- nerve entrapment
- ## NTB of thumb and index
nursemaid elbow
pulled-elbow syndrome
elbow dislocation caused by longitudinal traction of and extended and pronated uppe extremity
elbow dislocation
- most common traumatic injury to elbow
- immature annular lig
- allows radial head to migrate out
terrible triad of the elbow
- elbow dislocation
- radial head and coronoid process fx
rupture of the biceps brachii incidence
3% distal end
rupture of triceps brachii and the elbow
80% involv olecranon avulsion
compartment syndrome
2 compartments
ant: wrist and finger flexors
post: wrist and finger ext
- often secondary to forearm fx, postischemic edema, excessive muscular exertion
little league elbow
- vulnarable medial humeral apophyseal growth plate in pediatric pt
- partial or complete avulsion fx of medial epicondyle
two most involed tendon in medial epicodylitis
- pronator teres
- flexor carpi radialis
