Elbow

Question 1

Humeroulnar joint type

Answer 1

hinge

Question 2

Humeroulnar joint - open chain vs. closed chain (roll/glide)

Answer 2

roll/glide in SAME direction = open chain

roll/glide OPP = closed chain

Question 3

Humeroulnar joint - closed packed

Answer 3

full extension and supination

Question 4

Humeroradial joint - type

Answer 4

Ball and shallow socket

Question 5

Humeroradial joint - close packed

Answer 5

90 flex and supination

Question 6

Active ROM

Answer 6

135-145 with supination

Question 7

Carrying angle

Answer 7

Arm in full ext, lat deviation of ulnar with respect to humerus
Usually 10-15 degrees

Question 8

Capsule

Answer 8

Loose
Humeroulnar
Humeroradial
Proximal radioulnar

Question 9

Medial collateral ligament - taut in ___, resists ___

Answer 9

Taut in ext ant
Taut in flex post
Resists valgus deviation and IR/ER

Question 10

Lateral collateral ligament - resists ____

Answer 10

Resists varus deviation and IR/ER

Question 11

Annular ligament - resists

Answer 11

lateral and distal subluxation of radius

Is very strong

Question 12

Proximal radioulnar close packed

Answer 12

full ext and 5 supination

Question 13

Distal radioulnar close packed

Answer 13

5 supination

Question 14

Dislocation is typically

Answer 14

posterior
humerus moves forward into forced hyperextension
FOOSH

Question 15

Second degree damage with elbow dislocation

Answer 15

Clips coronoid proccess at brachialis attachment
could fracture
would be painful with resisted flex
often associated MCL injury or radial head fracture

Question 16

Complete elbow disloation

Answer 16

Anterior capsule is disrupted
brachialis is torn or significantly stretched
humerus sits in front of coronaoid process

Question 17

Partial elbow dislocation

Answer 17

Perched
Less capsular/ligamentous injury
humerus sits on top of coronoid process

Question 18

Nursemaids elbow

Answer 18

Often in kids
sublux or dislocate radioulnar joint
head of humerus slips out of the ligament

Question 19

Valgus stress test

Answer 19

MCL
Elbow in 20-30 flex and full forearm supination
gap jt at elbow

Question 20

Varus stress test

Answer 20

LCL
elbow in 20-30 flex and full supination
gap jt at elbow

Question 21

Hyperextension test

Answer 21

pos if 10 degrees of hyperextension

Question 22

Medial collateral ligament reconstruction - elbow dislocation from

Answer 22

forceful valgus stress
repetitive trauma (baseball throwing)

Question 23

Medial collateral ligament reconstruction - graft from

Answer 23

Palmaris longus

extensor hallicus longus

Question 24

Radial head fracture - type 1

Answer 24

non displaced

Question 25

Radial head fracture - type II

Answer 25

displaced, require ORIF, brief immobilzation

Question 26

Radial head fracture - TYpe III

Answer 26

Displaced, require ORIF, need stabiliztion of elbow and excision of fragments full ROM rarely returns

Question 27

Lateral epicondylitis/algia

Answer 27

Algia - until have diagnosis of itis | pain at lateral elbow - could be from radial head fracture or entrapment of radal nerve

Question 28

At elbow - where does radial nerve get trapped

Answer 28

Between supinator and extensor carpi radialis brevis

Question 29

Lateral epicondylitis is usually from what muscle

Answer 29

extensor carpi radialis brevis

Question 30

Lateral epicondylitis - tests

Answer 30

Will have pain with resisted wrist extnesion, tendernes at extenors pos coffe cup sign (grip, ext, rad dev)

Question 31

Mills test

Answer 31

Palpate lateral epicondyle while simultaneously pronating pt forearm flex pt wrist fully with ulnar deviation and extend their elbow (+) if pain over lateral epicondyle

Question 32

Maudleys test

Answer 32

Resist pt extension of middle finger distal to PIP, stressing extensor digitorum (+) if pain reroduced (Lateral epicondylitis)

Question 33

Medial epicondylitis

Answer 33

Inflammation of wrist felxors | Pain with resisted wrist flex and pronation

Question 34

Medial epicondylitis test

Answer 34

Palpate medial epcondyle while supinating pt forearm, extending elbow, and extending wrist fully with radial deviation (+) if pain reproduced

Question 35

Median nerve compression = where

Answer 35

At elbow - pronator teres and interosseous region (flexor pollicis longus) Carpal tunnel at wrist

Question 36

Median nerve compression - paresthesias where

Answer 36

Thumb and 2nd and 3rd fingers

Question 37

Radial nerve compression - where

Answer 37

At elbo w- posterior interosseous region (supinaotr, extensor radialis brevis)

Question 38

Radial nerve compression - paresthesias where

Answer 38

post aspect fo hand, esp middle finger

Question 39

Ulnar nerve compression - where

Answer 39

At cubital tunnel and Guyons tunnel (hook of hamate and pisiform)

Question 40

Ulnar nerve compression - paresthesias

Answer 40

Ulnar aspect of hand and ring finger

Question 41

Tinels sign

Answer 41

ulnar n - tap at cubital tunnel

Question 42

Wartenbergs sign

Answer 42

Ulnar Passively spread fingers and ask pt to bring fingers together Pos if unable to adduct 5th finger back to others

Question 43

Elbow flexion test

Answer 43

Ulnar n traction in cubital tunnel Completely flex elboes and hold for 5 min POs if tingle in ulnar distribution (can also be median though)

Question 44

Pronator teres test

Answer 44

Median Sit with elbow flexed 90 PT try to supinate and exten pt elbow as pt resists (tries to flex elbow and pronate) Pos if tingle in median nerve distribtuon

Question 45

Pinch grip test

Answer 45

Anterior interosseous n (innervated quadratus, FPL, FDP) Pt tries to pinch tups of thumb and 2nd finger togehter Pos if unable to touch fingers together - they will bring pads together insterad If unable to flex IP of 2nd digit suspect median nerve involvement