Elbow

Question 1

70* of flexion and 10* supination is ____ position for what joint?

Answer 1

resting position for HU jt

Question 2

Full extension & supination is closed pack position for what joint?

Answer 2

closed pack for HU jt

Question 3

Full extension & supination is ___ position for the humeroradial joint?

Answer 3

resting position

Question 4

What is closed pack position for the humeroradial AND proximal radioulnar jts?

Answer 4

5* supination

Question 5

What is resting position for the proximal radioulnar joint?

Answer 5

35* supination, 70* flexion

Question 6

What are the expected aROM for the elbow?

Answer 6

140-150* flexion
0-10* extension
90* supination
80-90* pronation

Question 7

What is the expected end feel for flexion, and then extension, of the elbow?

Answer 7

flexion: soft tissue approximation
extension: bony end feel

Question 8

What is expected end feel for supination and pronation of the forearm?

Answer 8

supination: firm/capsular
pronation: hard/bony

Question 9

Excessive cubitus valgus would be greater than… and cubitus varus would measure….

Answer 9

30*

-5* medially

Question 10

Closed pack position for the humeroulnar joint is resting position for the ___ joint.

Answer 10

humeroradial

Question 11

The humeroradial joint and the proximal radioulnar joint have what in common?

Answer 11

closed pack position (5* supination)

Question 12

Intra-articular swelling at the elbow is usually most apparent between the…

Answer 12

lateral epicondyle, radial head and olecranon

Question 13

Medial epicondylitis primarily involves which muscles?

Answer 13

pronator teres, FCR

also sometimes PL, FCU, FDS

Question 14

When does lateral epicondylitis usually show up?

Answer 14

24-72 hours - insidiously after an unaccustomed activity

very commonly related to knitting or cashier work

Question 15

Which muscle is most commonly injured related to lateral epicondylitis?

Answer 15

ECRB

Question 16

What is: usually a spiral fracture of the radial shaft at the RUJ, possibly with ulnar nerve lesion

Answer 16

Galeazzi fracture

Question 17

What is: fracture of the ulna with associated dislocation of the radial head, usually d/t a direct blow to the anterior forearm

Answer 17

Monteggia fracture

Question 18

Where is the Arcade of Frohse?

Answer 18

fibrous band between the two heads of the supinator muscle

Question 19

What causes the monkey/ape hand deformity? What is it?

Answer 19

Impingement of median nerve

Wasting of thenar eminence (thumb falls back in line with fingers), inability to abduct or oppose thumb

Question 20

Where is Guyon’s canal? What runs through it?

Answer 20

between pisiform and the hook of Hamate

ulnar nerve

Question 21

Claw hand deformity would be a consequence of ____ nerve compression, which commonly occurs either in the ____ or _____.

Answer 21

ulnar nerve

cubital tunnel or Guyon’s canal

Question 22

What is the ligament of Struthers?

Answer 22

band of connective tissue extending from the humerus to the supracondylar ridge that increases likelihood of median nerve compression

Question 23

Normal carrying angle for men is between __-__, normal carrying angle for women is usually __-__

Answer 23

males: 5-10*
females: 10-15*

Question 24

Describe a gunstock deformity

Answer 24

Elbow carrying angle becomes -15* (hand is more medial - increased varum)

Question 25

What homecare would you recommend for olecranon bursitis?

Answer 25

avoid the area ice/cold compress educate on activities that may irritate the bursa

Question 26

What is Nursemaid's Elbow? What ligament does it challenge?

Answer 26

dislocation of the radial head due to a traction injury the oblique ligament

Question 27

What would you use to differentiate between ligament sprains of the elbow vs. other pathologies?

Answer 27

ligament stress tests

Question 28

What is a Galeazzi fracture?

Answer 28

fracture of the radial shaft at the radioulnar joint usually d/t FOOSh injury may also involve ulnar nerve lesion

Question 29

What is a Monteggia fracture? What is the usual MOI?

Answer 29

fracture of the ulna with associated anterior dislocation of the radial head and possible wrist injury direct blow to forearm

Question 30

What are possible sites of entrapment for the radial nerve?

Answer 30

supinator | Arcade of Frohse (supinator arch)

Question 31

What sites can the median nerve become entrapped?

Answer 31

pronator teres syndrome ligament of Struthers (in 1% of population, increasing risk of median nerve impingement)

Question 32

With traction injuries, ensure you consider ____. With FOOSH injuries, ensure you consider _____.

Answer 32

traction: ligaments! FOOSH: olecranon, trochlea/trochlear notch, radial head/capitulum

Question 33

What is Little Leaguers' Elbow? | What is usually affected?

Answer 33

Repetitive strain injury to medial epicondyle (m/c in children) If a 'pop' felt in throw: ulnar collateral ligament Pop & weakness in elbow: distal biceps strain/rupture

Question 34

What are the boundaries of the cubital fossa?

Answer 34

pronator teres brachioradialis an imaginary line crossing between both epicondyles

Question 35

Where is the dermatome for C7?

Answer 35

middle finger