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SCS Prep > Elbow > Flashcards

Elbow Flashcards

(56 cards)

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1
Q

Brachialis

A

C5-C6, musculoskeletal

C7-C8, radial

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2
Q

Radial

A

C7-C8

brachiorad, triceps, supinator, anconeus

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3
Q

PT

A

C6-C7

median

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4
Q

Varus/Valgus

A

LCL/MCL

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5
Q

Pinch Grip Test

A

entrapment of ant IO nerve

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6
Q

Tinel’s Sign

A

ulnar nerve compromise

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7
Q

Lateral Epicondylagia (tests)

A

Cozen’s Sign (resisted wrist ext), Mill’s Test (passive ext stretch, wrist/elbow)

Maudsley’s - resisted middle finger ext

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8
Q

MCL involvement (tests)

A

Milking sign, moving valgus

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9
Q

LCL involvement (tests)

A

Chair sign

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10
Q

Pitch Type/Age

A 
fastball (8-10)
change up (10)
curveball, knuckleball (14)
slide, forkball, splitter (16-18)
screwball (17-18)
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11
Q

Pitch Count/Rest Days

A

21-35 (1)
36-50 (2)
51-65 (3)
66 (4)

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12
Q

Little League Elbow

A

possibilities: med epi frag/avul, delayed or accel apop growth of med epi, forms osteochondritis/rosis

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13
Q

Panner’s Disease (CET)

A

AVN of capitellum
C - not associated w/ trauma, common 7-12 yo
E - stiffness, pain at let elbow
T - rest

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14
Q

OCD (CET)

A

art cart separates from subchondral bone
C - repetitive trauma
E - pain at lat elbow, pop, swell, lock
T - conservative unless loose bodies (surgery)

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15
Q

Lat Epi (CET)

A

C - tennis elbow, excessive gripping (ECRB sometimes indicated)
E - Cozen and Mill, dec grip strength
T - conservative

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16
Q

Med Epi (CET)

A

C - golfer’s elbow, too much elbow flex on trailing arm w/ follow through, repeated use or chronic strain (FCR, PT, FCU indicated)
E - pain medially, swelling, passive wrist ext (pain)
T - conservative

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17
Q

Med Epi Apop (CET)

A

C - repetitive stress w/ throwing, 9-12 yo most common
E - pain at med elbow, dec strength
T - rest, conservative

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18
Q

Volkmann’s Contracture (CET)

A

C - ischemic contracture from brachial artery injury, major complication of elbow injury
E - pain in forearm that increased with passive finger ext, cessation of brachial/radial pulses
T - referral to MD

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19
Q

PT Syndrome (CET)

A

C - entrapment of median nerve due to edema and hypertrophy
E - neuropathy, sensory, and motor deficits
T - anti-inflammatories, rest, possible surgery

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20
Q

MCL bundles

A

ant (tight ext, loose flex)

post (tight flex, loose ext)

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21
Q

MCL injury (CET)

A

C - repetitive valgus stresses, valgus loads during throwing
E - pain medially, dec strength, milking sign, moving valgus
T - docking technique - surgery focus on ant bundle

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22
Q

MCL Reconstruction

A

Wk 1-4

  • ROM 40-90 wk 1-3, 30-105 wk 4
  • splint 50-60 wk 1

Wk 4-6
- ROM 15-115, pain free iso, scap stab

Wk 12-16
- begin plyo, light forearm/wrist strengthening

Mo 4-9

  • interval throwing 4 mo, batting 5 mo
  • throwing off mound 9 mo
  • pitch competitively 1 yr
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23
Q

Flexor Contracture (loss of ext) (CET)

Study These Flashcards
A

C - most often result of valgus ext overload syndrome, osteophytes may develop and prevent ext
E - restricted ROM, pain at end range
T - LLLD, stretching, jt mobs, dynamic splinting at night

24
Q

Heterotrophic Ossification (CET)

Study These Flashcards
A

C - direct trauma, surgical intervention
E - swelling, hyperemia, loss of motion
T - surgical excision

25
Dislocation of Elbow (CEIT)
C - FOOSH, severe trust in flexed position, 90% post E - hemorrhage, swelling, severe pain, I - A/P, lat, oblique T - elbow splint 5-7 days in hinged elbow brace 30-90; inc 10-15 per week, PROM avoided full flex 6-12 weeks, full ext 3-5 mo
26
OCD Capitellum (CET)
C - osteochondral injury, loose bodies E - MRI best T - non-op, arthroscopic
27
Olecranon Bursitis (CET)
C - superficial nature makes it more susceptible to chronic injury or direct blows E - pain, swelling, pt tender T - protect with padding
28
Monteggia Fx
dislocation of prox RU jt w/ forearm fx
29
Nightstick Fx
at midpoint of ulna
30
Galenzzi Fx
dislocation of ulnar head w/ fx of distal radius
31
Nursemaid's Elbow
dislocation of radius common from when child pulled up by hand
32
CRITOE
``` capitellum radial head internal/med epi trochlea olecranon external/lat epi ```
33
Tendinitis
Lat Epi - ECRB (wrist ext uln dev), EDC, ECRL (wrist ext rad dev), ECU - shear stress Med Epi - PT (pro elbow flex), FCR (wrist flex rad dev) - tension overload Bi/Tri - shear stress and tendon overload
34
Pitching and Tendinitis
``` Lat epi/LCL - decal/follow through Med epi/PT - late arm cocking/early accel UCL/ulnar nerve lesion - cocking Tri tendinitis/avulsion - accel/decel Radial/median nerve lesion - accel/decel ```
35
Affected vs Healthy Arm
limited active wrist flex/ext, passive pro
36
Biceps
secondary flexor, greatest torque 80-100 flex | active during elbow flex except when pro
37
Brachialis
primary flexor, 100 flex | unaffected by forearm/sh position
38
Triceps
primary ext, 90 flex | LH affected by shoulder
39
Tennis
Serve - ticeps, PT(accel/decal), ECC of biceps/sup - taping/mvmt retrain - proper control of elbow ext/pro Groundstroke - high ECRB, ERCL, EC - backstroke (ECRB and biceps) - avoid wrist flex on impact short backswing = greater impact
40
Stages of Tendon Healing
Inflam (1-7 days) - rest, protect, control inflame Prolif (1-2 weeks) - controlled stretching/ROM Maturation (1-2 mo) - controlled stretching and strengthening (avoid disuse/atrophy) Fibrosis - repeated inflame episodes leading to scarring of tendon
41
Lat Epi Non-Op
acute - steroid injection if unresponsive to modalities subacute - ecc chronic - plyo
42
Lat Epi Post-Op
day 3 - gentle painfree ROM day 17 - 80% ROM, light activity only day 18-21 - submax isos, antigravity wrist no pain wk 3-6 - RTC, elbow scap stab, aerobic, light stretch wk 8-12 - UE plyo, CKC added RTP 4 mo conservative fails, pain 6-12 mo after onset; 3+ failed injections
43
Med Epi Non-Op
RTP 8-10 weeks similar to lat epi - focus on flex/pro throwers at wk 6 Post-Op RTP 3-4 mo
44
Bi Ten Non-Op
RTP 8-10 weeks splint elbow 90 flex and neutral forearm, 3 weeks PREs 8 weeks
45
Bi Ten Post-Op
splint elbow 90 flex, sup forearm 6 weeks ``` Wk 3 - passive elbow flex/sup, active elbow ext 30 deg, A/PROM pro/sup Wk 4- passive wrist and shoulder Wk 6 - DC splint Wk 7 - AAROM/PROM elbow flex; PRE Wk 10-12 - ECC, throwing 3 mo - plyo 6 mo - contact sports ```
46
Tri Ten Non-Op
splint elbow 45 | PREs 8 weeks
47
Tri Ten Post-Op
splint elbow 45, 3 weeks wk 3 - ROM (AROM inc 20-30 deg/week) wk 6 - PRE 3 mo - RTP
48
Joint Integrity Tests
Valgus Stress - UCL ant Milking - UCL complex Moving Valgus - UCL complex (best Sn, Sp; max pain 90 deg) Varus - LCL, annular O'Driscoll - P/L rot instability, LCL ulnar, rot sublux/dislocation of UH jt
49
UCL Info
provocation or valgus stress | FCR, FCU, and PT deficits
50
UCL Non-Op
4-6 weeks, normal; start plyo, throwing/throwers wk 6 interval throwing wk 12 RTP 14-16 wks
51
UCL Post-Op
Phase I - Wk 1-3 - post splint 1-2 weeks, hinge brace 30-100 (15-115 wk 3), submax sh isos, wrist flex/ext (wk 2) Phase II - Wk 4-8 - 10-120 (inc 5-10 per week), isotonics (no ER) wk 6 - 0-130, add ER Phase III Wk 9-13 - plyo, ECC elbow flex/ext - PNF, RTC, scap stab, sh arom isotonics - throwers ten Phase IV Wk 14-26 - interval warm up throwing program - fastball at 75% before breaking pitches - RTP 22-28 wks pitch from mound 9 mo, competitively 1 yr
52
Radial Tunnel Syndrome
Entrapment - radiocapitaller jt, tender ECRB origin, supinator (fibrous distally) - distal tri, mid/post hum (spiral groove), sup head of supinator, ECRB/L and brachiorad surgery after 12 wks pain - sig tender with resisted middle finger ext, along course of supinator Post-op - grip wk 4, PRE 6, plyo 8, sports 10
53
Cubital Tunnel Syndrome
cocking phase Entrapment - FCU, FDC, retroepicondylar groove Non-Op - volar splint, elbow 30-40 deg flex 6- 8 wks; avoid repetitive elbow flex/ext, full elbow flex - PRE wk 6 Post-Op - post splint 60 flex, neutral forearm - isos 3 weeks; AROM wk 3, PRE 7th, throwers 9th, RTP 12
54
Stages of Fx Healing
``` Inflammation (1-7 days) - fx frag moving freely Soft Callus (3 wks) - angulation at fx site can still occur Hard Callus (3-4 mo) - frag united firmly by new bone Remodeling (after) - fx united solidly ```
55
Splinting
Inflam - support tissues, prevent overstretch Prolif - gentle stretch/inc ROM, prevent loss of align Mat - provide support chronic jt lax/lig injury, traction to correct contracture Static - I Serial Static - IPM Static Progressive - late I, PM Dynamic - late I, P, early M
56
Throwing
Wind up to Stride - low load = uncommon for injuries - elbow flex (ISO to ECC), wrist/finger ext (ISO to CON) Cocking to Accel - pelvis vs trunk rot early - valgus stresses begin (flex/pro mass; pro resist valgus, tri ISO elbow flex) late - max valgus (olecranon impinges vs groove/fossa = loose bodies) ``` Decel to Follow through - ECC loads to decal arm SH complex GH vs scap elbow complex - PT, bi, sup, brach - ECC (brach, biceps, sup, wrist ext) CON (PT, wrist flex) ```

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