Elbow and Forearm Injuries

Question 1

the elbow is composed of \_\_ synovial joints surrounded by
\_\_ capsule(s)

Answer 1

3; 1

Question 2

What are the three synovial joints that surround the elbow?

Answer 2

radiohumeral, humeroulnar, radioulnar

Question 3

Elbow - stability & power in ___ and hand positioning & function in ___

Answer 3

CKC; OKC

Question 4

The elbow is second to ____ for dislocations associated with overuse injuries

Answer 4

shoulder

Question 5

the humeroulnar is a ___ joint that performs?

Answer 5

hinge- flexion and extension

Question 6

the humeroradial is a ___ joint that performs?

Answer 6

gliding - flexion and extension

Question 7

the proximal radioulnar is a ___ joint that performs?

Answer 7

pivot - pronation and supination

Question 8

The elbow has more ___ support and less ___ support then the shoulder.

Answer 8

boney; ligamentous

Question 9

ligaments of the elbow? (5)

Answer 9

• ulnar (medial) collateral
• radial (lateral) collateral
• annular
• quadrate ligament
• oblique cord

Question 10

bursae of the elbow?

Answer 10

olecranon

Question 11

Neurovascular support is very close to the elbow joint, what does this mean with regard to injury?

Answer 11

injury can more easily cause impingement or cut off blood flow

Question 12

“angle between humerus and ulna (arm in anatomical position)”

Answer 12

carrying angle

Question 13

the carrying angle of the elbow is __-__ degrees

Answer 13

10-15

Question 14

the carrying angle is greater in what gender?

Answer 14

females

Question 15

chronic injuries to elbow? (2)

Answer 15

repetitive motions or incorrect mechanisms - eg. throwing

Question 16

4 components of injury prevention about the elbow?

Answer 16

1. protective equipment
2. physical conditioning
3. proper equipment
4. proper skill technique

Question 17

why do you have to make sure you treat the whole arm when working with an injured arm?

Answer 17

the elbow is in the middle of the arm so you must treat above and below

Question 18

Olecranon bursitis is an ___ injury - what is it?

Answer 18

acute - big swelling right on the point of the elbow

Question 19

Tennis elbow is a chronic elbow injury to the ____ epicondylitis

Answer 19

lateral

Question 20

Golfer’s elbow is a chronic elbow injury to the ____ epicondylitis

Answer 20

medial

Question 21

“inflammation of the common tendon”

Answer 21

epicondylitis

Question 22

Etiology:

• Result of direct blow or repetitive blows
  
  • May develop myositis ossificans

Answer 22

elbow contusions

Question 23

Signs and Symptoms:

• Swelling (rapidly after irritation of bursa or synovial membrane); localized pain; bruising; ↓ROM.
• May have paraesthesia (numbness – usually down arm)

Answer 23

elbow contusions

Question 24

management for elbow contusions?

Answer 24

RICE for at least 24 hours, and if severe, refer for x-ray

Question 25

Etiology for Olecranon bursitis?

Answer 25

can be acute or chronic - caused via direct blow, repetitive pressure, and friction

Question 26

Signs and symptoms of olecranon bursitis?

Answer 26

Pain, swelling, and point tenderness; limited ROM especially flexion

Question 27

management for olecranon bursitis?

Answer 27

RICE, compression pad, NSAIDs, may need to be aspirated

Question 28

Etiology: | Movement beyond normal ROM; sudden eccentric loading; repetitive microtears

Answer 28

elbow strain

Question 29

Signs & Symptoms: | -Point tenderness in muscle or MTJ; swelling, bruising, possible deformity; pain with active & resisted motions

Answer 29

elbow strains

Question 30

management for elbow strains?

Answer 30

RICE, sling in severe cases

Question 31

Etiology: | -FOOSH (hyperextn); valgus or varus (driving out from the inside) force; repetitive forces

Answer 31

elbow sprain

Question 32

Signs and Symptoms: | -Joint tenderness; painful ROM; laxity with stress tests; swelling; ↓ROM

Answer 32

elbow sprain

Question 33

management for elbow sprain?

Answer 33

- RICE, tape, brace or sling; NSAIDs | - Surgery may be necessary (Tommy John surgery – have either avulsed the medial side or completely torn it

Question 34

Etiology – FOOSH forcing hyperextn; severe twist while flexed Bones may be displaced A/P or laterally

Answer 34

elbow dislocation

Question 35

Signs and Symptoms: - Swelling, severe pain, disability, deformity; snapping or cracking sensation - Possible neurovascular complications - May involve radial head fracture

Answer 35

elbow dislocation

Question 36

What direction of elbow dislocation is the most common?

Answer 36

posterior - if it is anterior then it usually means the elbow is broken

Question 37

Management for elbow dislocation? (4)

Answer 37

- cold and pressure immediately - transport to hospital for reduction - monitor neurovascular function - strengthening exercises for shoulder and hand

Question 38

What is a possible complication with an elbow dislocation?

Answer 38

myositis ossificans

Question 39

A FOOSH often fractures what part of the humerus? What type of deformity can this result in?

Answer 39

humerus above condyles or between condyles - may result in gunstock deformity

Question 40

repetitive or sudden contraction of flexor-pronator group can cause what?

Answer 40

elbow avulsion fracture "little league elbow"

Question 41

"a permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers"

Answer 41

Volkmann's contracture - elbow fracture

Question 42

Etiology: - Repetitive microtrauma to insertion of extensor muscles of lateral epicondyle; tendinosis without inflammation - Incorrect racquet or grip size, or string tension too high; poor technique; eccentric loading of extensors during deceleration phase

Answer 42

lateral epicondylitis

Question 43

``` Signs and Symptoms: -Aching pain in region of lateral epicondyle after activity -Pain worsens and weakness in wrist and hand develop -Elbow has decreased ROM; pain w/ resistive wrist extension ```

Answer 43

lateral epicondylitis

Question 44

Management: Management -RICE, NSAID’s & rest -ROM exercises, deep friction massage; mobilization and stretching in pain free ranges -Use of a counter force or neoprene sleeve – trying to give the epicondyle a break -Mechanics and skills training in order to avoid recurrence

Answer 44

lateral epicondylitis

Question 45

Etiology: - Repeated forceful flexion of wrist and extreme valgus torque of elbow - May involve pronator teres, flexor carpi radialis and ulnaris, and palmaris longus tendons - Can be associated with ulnar nerve neuropathy

Answer 45

medial epicondylitis

Question 46

Signs & Symptoms: - Pain produced with forceful flexion or extension - Point tenderness and mild swelling - Passive movement of wrist seldom elicits pain, but active movement does

Answer 46

medial epicondylitis

Question 47

Management: - Sling, rest, cryotherapy or heat through ultrasound - Analgesic and NSAID's - Curvilinear brace below elbow to reduce elbow stressing - Severe cases may require splinting and complete rest for 7-10 days

Answer 47

medial epicondylitis

Question 48

In upper body rehab, restoration of proprioception and balance can be worked on through what type of exercises?

Answer 48

closed-chain

Question 49

Muscular endurance, strength, and power work in upper body rehab can be worked on using what type of exercises?

Answer 49

PNF-resisted and open-chain exercises

Question 50

In upper body rehab, what can be used to supply the load?

Answer 50

opposite hand