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MSK PCE > Elbow complex > Flashcards

Elbow complex Flashcards

(50 cards)

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1
Q

What are the main joints of the elbow?

A

Ulnohumeral joint
Radiohumeral joint
Proximal radioulnar joint

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2
Q

What are the main ligaments at the ulnohumeral joint and radiohumeral joint?

A

Ulnar collateral ligament (medial support)

Radial collateral ligament (lateral support)

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3
Q

What ligament supports the proximal radioulnar joint?

A

Annular ligament

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4
Q

Degrees for normal carrying angle?

A

Men = 5-10
Women = 10-15

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5
Q

Excessive cubitus valgus angle?

A

30 degrees

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6
Q

Cubitus varus angle?

A

-5 degrees

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7
Q

Gun stock deformity?

A

-15 degrees

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8
Q

What are the grades of ligament sprains?

A

Grade 1 (micro tear) = min swelling and pain, no ligament laxity

Grade 2 (partial tear) = mod swelling, ecchymosis (bruising) and pain, increased ligament laxity but firm end feel

Grade 3 (complete tear) = significant swelling, ecchymosis and pain, gross laxity, no end feel

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9
Q

Ulnar collateral ligament?

A

Fan shaped (anterior, posterior, transverse portions)

Restrains valgus

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10
Q

UCL tear etiology

A

valgus stress (acute or chronic)

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11
Q

UCL tear signs and symptoms

A

instability with valgus stress
may have heard “pop”
pain
localized tenderness
joint effusion
limited ROM

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12
Q

Valgus stress test

A

Special test UCL tear

elbow needs to be at 20-30 degrees flexion to bias UCL

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13
Q

UCL tear interventions

A

Strengthening (forearm flexors and pronators)
Bracing (medical strapping elbow)
Activity modification
Correct faulty technique
Decrease pain
Decrease swelling
Restore ROM

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14
Q

UCL tear surgery

A

Tommy Johns = ligament reconstruction (hamstring graft) following grade 3 tear

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15
Q

Elbow dislocations?

A

Posterior (ulna moves back)
Anterior (ulna moves forward)
Lateral (ulna lateral)
Medial (ulna medial)
Divergent

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16
Q

Elbow posterior dislocation

A

Most common elbow dislocation (olecranon/ulna moves posteriorly)
Disruption UCL and RCL
Often involves # radial head/coronoid process
Impairment of vascular supply

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17
Q

What to check after elbow dislocation?

A

Distal pulses

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18
Q

Nursemaid’s elbow

A

Subluxation of radial head = common among YOUNG children

Longitudinal traction with wrist in PRONTATION

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19
Q

Nursemaid elbow signs and symptoms

A

Child refusing to move arm
Arm is held at side in slight flexion

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20
Q

Nursemaid elbow intervention

A

Reduction of radial head = hyper-pronation or supination/flexion maneuver

can also perform compressive manipulation on radius with arm in supination

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21
Q

Olecranon bursitis

Study These Flashcards
A

Inflammation of olecranon bursa

Etiology = trauma, pressure, infection
S&S’s = swelling, redness
Interventions PT = activity modification, ice, compression
Interventions Medical = NSAIDs, corticosteroids injection, aspiration/draning, antibiotic, bursectomy

22
Q

Lateral epicondylitis/epicondylosis/tennis elbow

Study These Flashcards
A

degenerative changes to wrist extensor tendons inserting into LATERAL EPICONDYLE of humerus (common extensor origin)

Involves EXTENSOR CARPI RADIALIS BREVIS tendon

23
Q

Epidemiology tennis elbow

24
Q

Tennis elbow risk factors?

Study These Flashcards
A

repetitive use
poor technique
heavy racquet
heavy ball
small grip

25
Lateral epicondylitis signs and symptoms
Pain resisted wrist extension Pain lateral epicondyle palpation or near Pain stretching wrist extensors Decreased wrist extension and grip strength Aching pain - insidious onset, radiating from lateral epicondyle
26
Later epicondylitis special tests
Cozen's test Mills test Maudsleys test
27
Lateral epicondylitis differential diagnosis?
C5-C6 cervical radiculopathy Radial nerve entrapment Musculocutaneous nerve tunnel syndrome Supraspinatus referral Radial head # Radiohumeral synovitis
28
Tennis elbow interventions PT
Strengthening - eccentric Stretching Mobilizations Cross-friction massage Pain modalities (pulse, US, ice, compression) Activity modification Bracing
29
Tennis elbow interventions medical
NSAIDs Corticosteriod injection
30
Medial epicondylitis/Golfer's elbow
Degenerative changes to the wrist flexor tendons inserting into the MEDIAL EPICONDYLE of the humerus (COMMON FLEXOR ORIGIN)
31
Golfer's elbow epidemiology, etiology, signs and symptoms
Epidemiology = > 35 years Etiology = repetitive use S&Ss = Tender palpation at or near medial epicondyle, pain with resisted wrist flexion, pain resisted pronation, pain gripping, pain stretching wrist flexors, decreased wrist flexion, pronation and grip strength, aching pain (radiating from medial epicondyle to proximal forearm flexor muscles), insidious onset
32
Medial epicondylitis special tests
Reverse Mills/Medial epicondylitis test Resisted wrist flexion Resisted pronation
33
Medial epicondylitis interventions PT
Cross friction massage Mobilizations Stretching Pain modalities Activity modification Strengthening (eccentrics)
34
Medial epicondylitis interventions medical
Corticosteriod injection NSAIDs
35
Elbow peripheral nerve injuries
Ulnar Radial Median
36
Median nerves
C6-C8, T1
37
Humerus supracondylar process syndrome site of entrapment?
Under ligament of STRUTHERS
38
Median nerve injuries
Humerus Supracondylar process syndrome Pronator syndrome Anterior interosseus nerve syndrome
39
Pronator syndrome site of entrapment?
Between two heads of pronator teres muscle
40
Anterior interosseous nerve syndrome
AIN branch of median nerve Site of entrapment: between 2 heads of pronator teres muscle May occur with forearm # PINCH DEFORMITY
41
Ulnar nerves
C7,C8,T1
42
Cubital tunnel syndrome (ulnar nerve)
site of entrapment = cubital tunnel or between 2 heads of FLEXOR CARPI ULNARIS MUSCLE
43
Cubital tunnel special tests
Cubital tunnel compression test Tinnels test at elbow Elbow flexion test
44
Ulnar nerve interventions
PT management = nerve flossing Medical = NSAIDs, corticosteroids, ulnar nerve transposition surgery
45
Radial nerves
C5-C8, T1
46
Radial tunnel syndrome
Entrapment of the posterior interosseus nerve (branch of radial nerve) Site of entrapment 1. between 2 heads of supinator (Arcade of Frohse) 2. entrance of radial tunnel anterior to radial head 3. near brachioradialis and ECRL\ 4. between ulnar half of the ECRB tendon and fascia 5. at distal border of supinator
47
What does radial tunnel syndrome mimic?
Tennis elbow
48
Entrapment site superficial branch of radial nerve?
Under the tendon of the brachioradilis muscle
49
Radial nerve entrapment interventions?
Nerve mobilisations
50
Radial nerve entrapment medical management
NSAIDs corticosteroids radial tunnel release surgery

MSK PCE (15 decks)

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