Elbow Flashcards
(46 cards)
Concept->Proxial stability determines distal function or distal function determines proximal stability?
-Proximal stability determines distal function
Concept->Full examination is based on what? Give an example.
- Full examination is based on regional interdependence
- And so, it is vital to examine above and below a joint and consider the upper extremity as a kinetic chain of function (going to the trunk). Even if the patient does not report a scapular deficiency as a possible source of elbow dysfunction it is very helpful for clinicians to keep an eye on the big picture.
The elbow joint frequently exhibits pathology leading to what?
hypomobility
Humero-ulnar joint: LPP, CPP, and capsular pattern
LPP: 70 flexion, 10 supination
CPP: Full extension, full supination
Capsular pattern: flexion > extension
Humero-radial joint: LPP, CPP, and capsular pattern
LPP: full extension, full supination
CPP: 90 flexion, 5 supination
Capsular pattern: flexion > extension
Prox Radio-ulnar joint: LPP, CPP, and capsular pattern
LPP: 70 flexion, 35 supination
CPP: maximum, pronation restriction or supination (double-check this one)
Capsular pattern: equal pronation/supination
In order, name the 4 tests and measures for the elbow
1) Observation; static and dynamic posture
2) AROM, PROM, end feel
3) Resisted isometrics
4) MMT
For the tests and measures OBSERVATION, name 5 things you’re checking for and briefly explain them
1) overall posture-cspine, scapulothoracic, thoracic, GH, pelvis etc……. (region interdependence)
2) position of elbow - normal carrying angle(frontal plane: the angle is formed by long axis of humerus to ulna with a fully extended elbow), cubitus varus(Gunstock deformity: reversal of the carrying angle as a result of a medial humeral condyle fx or bony overgrowth in lateral condyle) or valgus
3) triangular alignment–med/lateral epicondyles and tip of olecranon – bony alignment
Inverted equilateral triangle.
Altered alignment: prominent olecranon=posterior subluxation (typically due to a direct, high force trauma FOOSH)
4) edema/joint effusion - joint effusion easiest to assess in the triangular space (from a lateral perspective) between radial head, tip of olecranon, and lateral epicondyle
5) olecranon bursitis-extra capsular - warm, boggy, edematous at tip of olecranon
Surface relationship: radius to humerus
concave to convex
Surface relationship: radius to ulna
convex to concave
Surface relationship: ulna to humerus
concave to convex
With elbow joint play, what 3 things are we accessing?
1) Quantity
2) Quality
3) End-feel
Joint Play: Distal Radioulnar jt: Position of arm, convex/concave, name direction glides and indications
1) 10’ supination
2) Concave-distal radius, Convex-distal ulna
3) Anterior/Ventral glide-pronation, Posterior/dorsal glide-supination
Joint Play: Proximal Radioulnar jt: Position of arm, convex/concave, name direction glides and indications
1) 35’ supination, 70’ flexion
2) Convex –radial head, concave –notch for radius on ulna
3) Ventral or anterior glide of radius:
indication: supination
Dorsal or posterior glide of radius:
indication: pronation
Joint Play: Radiohumeral jt: Position of arm, convex/concave, name direction glides and indications
1) full supination and extension
2) concave – radius, convex – capitulum of humerus
3) Dorsal or posterior glide of radius:
indication: extension
Ventral or anterior glide of radius
indication: flexion
Joint Play: Ulnohumeral jt: Position of arm, convex/concave, name direction glides and indications
1) 10’ supination, 70’ flexion
2) Concave – olecranon fossa of ulna; Convex – trochlea of humerus
3) indication: overall joint play
Name the 2 tests for ligamentous stability
1) Varus stress
2) Valgus stress
Varus stress test-What does it test?
lateral collateral ligament
Varus stress test-What are the positive signs?
1) Laxity
2) Pain
3) End feel
4) Quality
Varus stress test-Method?
elbow flexed 20 -30 degrees , apply adduction force to distal segment
Valgus stress test-What structure does it test?
Medial collateral ligament
Valgus stress test-What are the positive signs?
1) Laxity
2) Pain
3) End feel
4) Quality
Valgus stress test-Method?
Elbow flexed 20-30 degrees, apply abduction force
Name the 3 types of structure specific tests
1) Ligamentous Stability
2) Musculotendinous Integrity
3) Peripheraol Nerve Integrity
