ELBOW Flashcards
(128 cards)
1
Q
what are the movement dx for the elbow
A
tissue impairment
nerve entrapment
wrist ext with pronation wrist flexion with pronation hypomobility elbow flexion syndrome valgus syndrome elbow extension syndrome
H E E F F V
2
Q
acute tissue injury in the inflammed state would be what mvmt dx
A
tissue impairment
3
Q
explain wrist extension with pronation syndrome
A
the wrist extensors and pronators are overused.
there is LATERAL elbow px.
px with gripping
associated with scap abd
4
Q
dx related to wrist extension/prontation syndrome
A
lateral epicondylitis
LCL sprain
extensor sprain
5
Q
what nerve can be stressed with repetitive elbow flexion
A
ulnar
6
Q
wrist flexion with pronation syndrome, px is usually where
A
medial elbow
7
Q
explain wrist flexion with pronation syndrome
A
overuse of wrist flexors and pronators
medial elbow px
8
Q
pathologies assct. with wrist flexion and pronation syndrome
A
medial epicondylitis
flexor strains
9
Q
medial epicondylitis is aka
A
golfer’s elbow
10
Q
lateral epicondylitis is aka
A
tennis elbow
11
Q
fractures, dislocation, recent surgery (but not in acute inflammatory stage) would be what mvmt sx dx
A
elbow hypomobility
12
Q
with hypomobility, ____ is lost the most
A
elbow flexion
13
Q
explain elbow flexion syndrome
A
repetitive elbow flexion causes numbness or tingling in the hand
there is usually sensory loss before motor
can result in CLAW hand
14
Q
what muscle is often tight with elbow flexion syndrome
A
FCU
15
Q
what pathologies are related to elbow flexion syndrome
A
cubital tunnel syndrome
ulnar nerve irritation
16
Q
valgus stress syndrome usually causes a tight
A
pronator teres
17
Q
pathologies assct. with valgus syndrome
A
MCL sprain ol. bursitis could be med. epicondylitis (if valgus stress caused) triceps tendon valgus extension overload syndrome
18
Q
explain elbow extension syndrome
A
there is post elbow px at end range ext
there can be elbow hyper or hypo ext
19
Q
what dx are assct with elbow ext syndrome
A
ol. bursitis
triceps
post fxs or dislocations
20
Q
if issue is throbbing px, you have to look into possible
A
nerve entrapment
21
Q
wrist flexors originate at the
A
medial epicondyle
22
Q
brachioradialis origin
A
humerus
23
Q
brachioradialis axn
A
flex
pronates
supinates
24
Q
pronator teres runs from ___ to ___
A
ulna to radius
25
brachioradialis N
radial
26
most wrist flexors are ___ N
median (except FCU is ulnar)
27
active supination causing sx to the elbow (lat), why would this make sense
one of the origins is lateral epicondyle (if person has lateral epicondylitis, active supination can cause sx)
also, radial N entrapment can flare with supination
28
4 muscles that may show weakness dt radial N entrapment (the kind that has motor sx)
extensor digatorum
Abductor PL
and EPL/Brevis
29
one very simple thing to tx nerve entrapment
if there is a specific muscle that is entrapping, stretch it to take off compression
30
simple concept to tx strain
stretch the side (or muscle) that is strained
| strengthen the antagonist muscle
31
N to the pronators
median
32
N to supinator
radial
33
N to extensors of wrist
radial
34
wrist extensors origin is the
lateral epicondyle
35
if pt lacks supination, what may be too tight
antagonists (pronators)
36
during ext, ulna moves ____
Ulna moves laterally during extension, due to articular groove and distal medial aspect
37
normal carrying angle men
| women
men 5-15
| women 15-20
38
this resists valgus force
MCL or UCL
39
the two bands of the MCL and what they resist
ant - flex and ext
| post - flexion only
40
resting position HU joint
70 degrees of flexion, with 10 degrees of supination
41
closed packed HU joint
full ext and supination
42
capsular pattern HU joint
flexion is more limited
43
the ___ Ligg provides a sling around the radial head
annular
44
HR joint resting position
Full extension and forearm supination
45
HR joint closed packed
90 degrees of elbow flexion and 5 degrees of supination
46
HR joint capsular pattern
Flexion > extension, equal limitation of pronation and supination is observed
47
proximal RU joint open pack
70 degrees of flexion and 35 degrees of forearm supination
48
proximal RU joint capsular
pronation = supination, minimal to no loss of motion, with pain at the end ranges of pronation and supination
49
these structures provide stability to distal RU joint
Interosseus membrane
Articular disc
Anterior radioulnar ligament
Posterior radioulnar ligament
50
annular lig and interossei provide stability to the ___RU joint
proximal
51
Ulnar abduction occurs with ___ and ___
pronation and ext
52
ulnar adduction occurs with ___ and __
sup and flexion
53
arc of motion is ___ to ___
30 - 130
54
ulnar nerve goes through the ___
cubital tunnel
55
___ and ___ cause stress on the ulnar nerve
flexion and valgus
56
ulnar nerve sensation loss would be felt where
pinky and wring finger (palmar and dorsal sides)
57
where is median nerve sensation loss
palmar side of thumb, then digit 2 and 3
58
median nerve trapped at forearm is ___
| median nerve trapped at wrist is___
forearm - pronator teres syndrome
| wrist - carpal tunnel
59
radial N sensory loss is where
lateral, post forearm
| backside of hand and forearm
60
carrying angle over 25 is considered
cubital valgus
61
post interosseus N issues are associated with more motor or sensory
motor
62
post interosseus N issues will manifest how
will have probs with thumb ext or MCP ext. (thumb abd or digit extensors)
63
epicondylitis vs algia
itis infers that there is current inflammation, algia is preffered over itis
64
which is more common lateral or medial epicondylitis
lateral
65
main muscle involved in lateral epicondylitis
ED
66
repetitive wrist extension and/or grasping that causes
| Dull ache at rest, sharp pain at lateral epicondyle with lifting
lat epicondylitis
67
deep friction massage is a good tx for
epicondylitis
68
2 main muscles for medial epi
FCR and pronator teres
69
cubital tunnel syndrome, there are motor changes with
adductor pollicis
70
epiphisitis of medial epicondyle
LLE (little leaguers elbow)
71
LLE (little leaguers elbow) sx
Loss of full extension of elbow
| Pain with resisted flexion
72
why is there px with resisted flexion with LLE
bc the flexors originate at medial epcicondyle
73
Affects growth, ossification centers in children
Begins as degeneration or necrosis of capitellum (lateral humerus) and followed by regeneration, recalcification (similar to legg calve perth of hip)
panners disease
74
if you suspect panners, never do a ____ force
valgus
75
Loss of blood supply as a result of traumatic injury like compression forces. (lateral compressive force)
Has popping and clicking
osteochondritis dissecans
76
biceps rupture is usually (prox or distal)
distal (from quick forceful contraction)
77
dorsal side of hand is mostly ___ N
radial (not including distal fingers)
78
what is cubital tunnel syndrome
ulnar nerve compression distal to the medial epicondyle
79
cubital tunnel syndrome can sometimes present with
claw hand
80
repetitive elbow ____ causes cubital tunnel
flexion
81
weak pinch grasp is indicative of
cubital tunnel
82
parathesia in thumb, index and middle finger
median N
83
radial tunnel syndrome vs radial N compression by supinator
radial tunnel syndrome is at the elbow (compressed at radial head)
if it is compressed by supinator it is called post Int. N compression
Post interosseus - motor sx
radial tunnel syndrome - sensory sx
84
radial tunnel syndrome presents with sensory sx where
back of forearm
85
what is typically torn in a disclocated elbow (radial head)
annular lig
86
tommy john surgery is for
MCL
87
ext valgus overload syndrome involves what structures
compression of olecranon on the humerus
88
where is px with ext valgus overload syndrome
post elbow (AROM ext PROM pronation)
89
most common elbow injury in adults
radial head fx
90
most common elbow fx in children
supracondylar
91
pronators are ___ N
median
92
numbness and tingling at 4th and 5th digit think
cubital tunnel syndrome
93
Pain in the volar (palmar) aspect of forearm into the index and middle finger; parasthesia in thumb, index finger, middle finger aggravated with activity
pronator teres syndrome
94
tenderness distal to lateral epicondyle and motor sx to the extensors of thumb or digits
post interosseus N issues
95
medial glide of HU joint helps with
flexion and add
96
lateral glide of HU joint helps with
ext abd
97
medial gap of HU joint helps with
flex
ext
pron
98
lateral gap of HU joint helps with
flex
ext
pron
99
HR joint dorsal/post glide helps with
ext (these you are on the radial head)
100
HR volar/ant glide helps with
flexion (you are on the radial head)
101
Proximal RU joint post glide helps with
pronation
102
proximal RU joint ant glide helps with
supination
103
Distal Radioulnar joint post glide helps with
supination (and flex/ext of wrist)
104
Distal RU joint ant glide helps with
pronation (and flexion/ext of wrist)
105
normal elbow flexion is
140
106
normal elbow ext is
0
107
normal supination
80
108
normal pronation
80
109
at the end of shoulder elevation, explain clavicle
30-40 degrees of posterior clavicular axial rotation and 30-40 degrees of calvicular elevation
110
2 forms of radial nerve entrapment
radial tunnel - no motor loss (px at lat epi and rad. head)
| post int. - px is distal, there are motor sx to finger/thumb extensors and add PL
111
open packed pos for prox RU
70 flexion 35 sup
112
open packed for distal RU
10 sup
113
HR distraction helps with
pro and ext
114
mvmt dx lateral epicondylitis or extensors issue
wrist ext with pronation
115
ulnar nerve issues at elbow is what mvmt dx
elbow flexion syndrome
116
olecranon bursitis is what mvmt dx
elbow ext syndrome (which is really px that is caused by end range elbow ext)
117
so cubital tunnel presents with both sensory and ___
motor
sensory to ulnar N distritubtion
motor to adductor pollicis
118
list the 7 hand muscles innervated by ulnar nerve
```
Adductor pollicus
FCU
ABD DM
Flexor DM
OPP DM
3 and 4 lumbricals
interossei
```
119
Pain over lateral elbow during gripping activities
lat epicondylitis or radial N
120
numbness tingling to ulnar nerve distal to ulna itself think
cubital tunnel syndrome
121
post interosseius N is a branch of
radial - does all extensors and snuff box
122
both gap mobs help with
FEP
123
list the nerve pathologies (all)
radial - radial tunnel syndrome (at radial head) sensory sx
- post interosseius issues (at supinator) motor sx to
forearm extensors
Median - carpal tunnel syndrome at wrist
- pronator teres syndrome at forearm
Ulnar - cubital tunnel syndrome at elbow
- tunnel of guyon at hand
124
for HR glides, you MUST be (their position)
fully extended and supinated
125
for HR post glide they are
full palm up/supine
126
for HR ant glide they are
thumb up, elbow straight
127
what does a lateral HU glide facilitate
ext and abd
128
panners is on what side
lateral elbow
