elbow Flashcards
(32 cards)
ROM in degrees
flexion = 145-150deg
extension = 0 to -10 deg (0 is avg)
pronation = 90deg
supination = 90deg
goniometer helps measure
joints and mvmnts
flex/tension = humeroulnar and humeroradial joints
pro/supination = proximal radioulnar joint
ligaments of the elbow
UCL/ulnar collateral lig = collection of 3 bundles
- anterior bundle most injured
LCL/radial (lateral) collateral lig = from lateral epi to annular lig
annular lig = proximal radial head, surrounds head and neck…allows pro/supination
accessory lateral collateral ligament
muscles and actions
flexors = biceps, brachialis, brachioradialis
extensors = triceps, anconeus
pronation = pronator teres, pronator quadratus
supination = supinator, biceps
interosseous membrane
connects radius and ulna, site of muscle attachment and allows vessel passage
techniques to open membrane for inc mvnt after periods of immobilization
elbow nerves
musculocutaneous = c5-c7, supplies flexors
median = c5-t1, palmar hand
ulnar = c8-t4, 4th and 5th digits plus ulnar hand
- travels thru cubital tunnel
radial = c5-t1, largest branch…posterior forearm
brachial artery
blood supply to glexors
branches into ulnar and radial arteries
arm contusion
vulnerable bcs lack of padding
chronic blows –> dev ectopic bone
tackler’s exostosis: bone formation on bone…spur bcs of rep blows
myositis ossificans
periostitis/inflamed periosteum
fibrostitis/inflamed connective tissue and muscle
olecranon bursitis
septic: scraped when fall on elbow, obv from heat coming from joint
- also from cuts in other body parts where bacteria enters
- ASAP MEDICAL ATTENTION
- trace redness w marker to see spread
aseptic bursitis: assoc w rheumatoid and crystal-induced gout
MOI = fall on flexed elbow, can be chronic i.e. cont pressure
S/S = tender, swollen, rupture, goose egg
- cannot reach full flexion bcs tension over bursa
elbow sprain
MOI = FOOSH, valgus/varus force
- often bcs of repetitive forces that tear ligaments
S/S = pt tender, instability w stress tests
varus stress test
valgus stress test
tommy john
UCL reconstruction surgery using palmaris longus
anterior capsulitis
MOI = hyperextension, fall
S/S = diffuse, anterior elbow pain after traumatic episode, DEEP TENDERNESS w palpation
must rule out pronator teres strain and median nerve entrapment
proximal radial head dislocation
assoc w immature annular ligament
MOI = longitudinal traaction of extended and pronated upper arm
- swinging kid by arms
S/S = cannot pro/supinate w/o pain
immobilize w 3-6 wks in flexion
ulnar dislocation
peaks in teenage years
MOI = hyperextension, sudden and violent unidirectional valgus force
S/S = snap/crack, severe pain, rapid swelling, TOTAL FUNCTION LOSS w deformity
911 call bcs risk of shock and dec pulse
terrible triad
posterior elbow dislocation
coronoid process fracture
radial head fracture
biceps brachii rupture
MOI = sudden eccentric load
S/S = tender, distal tendon not palpable…bruising of antecubital fossa, weak flexion and supination
90%+ ruptures occur proximally
triceps brachii rupture
MOI = direct blow to posterior elbow, uncoordinated triceps contraction during fall
most occur distally at elbow jt
- 80% involve olecranon avulsion
S/S = palpable defect in tendon or step deformity off olecranon
- partial tear = weak extension
- full tear = no extension
compartment syndrome
swelling increases pressure w/in compartments, compresses vessels w/in
- bcs fascial sheets are inextensible
often a secondary condition
S/S = RAPID onset, swelling and bruising, absence of distal pulse
- sensory changes, paralysis
- PAIN AT REST, pain w inc stretching of muscles in compartment
- pain WORSENS OVER TIME, compared to fractures which improve
limb threatening
chronic exertion compartment syndrome
an overuse injury…inc BF and temporary symptoms i.e. tingling
symptoms resolve w rest as circulation normalizes, not medical emergency
medial epicondylitis
aka golfer’s elbow
- chronic
MOI = valgus force, repetition
medi epi is a common flexor origin
S/S = gradual onset, pain at med epi, inc pain when use forearm
- rarely swells
- dec extension, weak wrist flexors
tests:
resisted flexion, resisted pronation
passive elbow and wrist extension
treatment
- PIER = pressure, ice, elevate, rest
- inc ROM, inc musc flexion
- balance musc groups
lateral epicondylitis
aka tennis elbow, overuse
lateral epicondye = common extensor origin
MOI = eccentric loading of extensors during deceleration
S/S = pain at lat epi, dec extension and flexion
tests:
passive stretch of wrist extensors
resisted extension and radial deviation
little league elbow
growth plates at proximal radius head, lateral and medi epicondyles
compressive forces on lateral side, stretching/tensile forces on medial aspect
cubital tunnel syndrome
ulnar nerve entrapment
sensitive to press, stress, trauma
medial 1/2 arm, 5th and 1/2 4th digit
pronator syndrome
median nerve entrapment
compression via hypertrophy
i.e. pronator teres, aggravated by pronation
