Elbow/forearm

Question 1

humeroulnar joint

Answer 1

convex trochlea of humerus and concave trochlear notch of ulna
ulna moves lat during ext due to articular groove and distal med aspect

Question 2

carrying angle

Answer 2

men-5-15

women 15-20

Question 3

medial collateral ligament

Answer 3

UCL
resists valgus force
ant band- taut flex/ext
post-aut flex

Question 4

HU resting position

Answer 4

70 degrees flex, 10 degrees supination

Question 5

HU closed

Answer 5

full ext and full supination

Question 6

HU capsular pattern

Answer 6

much more limitation in flex than ext

Question 7

HR resting

Answer 7

full ext and forearm sup

Question 8

HR closed

Answer 8

90 elbow flex and 5 degrees of supination

Question 9

HR capsular pattern

Answer 9

flex> ext, equal limitation of pronation and supination is observed

Question 10

proximal RU joint

Answer 10

resting- 70 degrees flex, 35 supination
closed- 5 degrees supination
capsular pattern- pronation=supination, minimal to no loss of motion with pain at the end ranges of pro and sup

Question 11

distal RU

Answer 11

closed- 5 sup
loose- 10 sup
capsular pattern- pronation=supination, full range with pain at end ranges

Question 12

ulnar ? occurs with ? and ?

Answer 12

ulnar abduction occurs with pronation and ext

ulnar adduction occurs with supination and flexion

Question 13

functional arc of motion

Answer 13

30-130 degrees

Question 14

Ulnar N

Answer 14

goes through flexors and pronators
medial epicondyle goes through cubital tunnel
sensation to 4th and 5th finger and medial arm

Question 15

median N

Answer 15

carpal tunnel pain
ant to elbow
FDS,FDP, pronator
palmar part 1,2,3 and fingernails of dorsal
entrapped in forearm leads to pronator teres problems

Question 16

radial N

Answer 16

most frequently injured N associated with fractures of humerus
lateral arm- ext and sup
can be misdiagnosis as lateral epi
numbness and tingling
motor and sensory loss
pain with resisted finger
tender lateral epi
radial tunnel- closer to radial head, SENSATION loss
Post interosseus- MOTOR loss, MCP or thumb ext, compressed at arcade of Frohse (supinator)

Question 17

cubitus valgus

Answer 17

excessive angulation of carrying angle >25

can irritate ulnar N

Question 18

cubitus varus

Answer 18

decreased carrying angle

Question 19

lateral epi

Answer 19

tennis elbow
4-7 times more common than medial epic
often ED,ECRB involved
repetitive wrist ext or grasp
dull ache at rest, sharp pain at lateral epic with lifting
resisted wrist ext causes PAIN
rule out C spine
radial head mobility
soft tissue mob
deep friction massage

Question 20

medial epi

Answer 20

golfers elbow
tendinitis of wrist flexors
often FCR and pronator teres
wrist FLEX and PRONATION

Question 21

little leaguers elbow

Answer 21

epiphysis of medial epicondyle
gradual onset
forceful pronation (throwing)
 loss of full ext
pain with resisted flex

Question 22

panners disease

Answer 22

affects growth, ossification centers
necrosis of capitulum of humerus laterally followed by regeneration and reclassification
7-12 yo
self limiting
nontraumatic
no locking/catching
loss of 5-20 ext
may take up to 3 years

Question 23

osteochondritis dissecans

Answer 23

arterial injury with subsequent bone necrosis resulting from increased radiohumeral LAT compression forces
causes-ischemia, trauma, predisposition
high risk- boy baseball pitchers and girl gymnastics
limited AROM and PROM ext
CLICKING/LOCKING
pain with sup/pro
6 months

Question 24

arthritis

Answer 24

most common arthritis in elbow is RA
lab tests differentiate from bursitis
want to work on strength and ROM

Question 25

biceps tendon rupture

Answer 25

most common distal rupture
quick forceful biceps contraction
usually occurs in males 50 yo
weak elbow flex strength and supination
ecchymosis in antecubital fossa

Question 26

cubital tunnel syndrome

Answer 26

ulnar N compression distal to med epirepetitive motion increases inflammation and traction forces caused by elbow flex causes compression
looks like med epic
parathesias 4th and 5th dorsally
worse at night
weak pinch grasp
claw hand

Question 27

pronator teres syndrome

Answer 27

median N compression
parasthesia in thumb, index finger, middle finger aggravated with activity
pain volar aspect of forearm
NOT NOCTURNAL
possible dislocation
weakness in forearm muscles
neg phalanes test
pain with resistance pronation, elbow flex and wrist flex
splint 90/slight forearm pronation/wrist flex

Question 28

subluxation/dislocation

Answer 28

subluxation of radial head- PULLED elbow (kids) annular lig is torn when arm ext and pronated
torn surface slips into radiohumeral joint and gets trapped
posterior dislocation- ulna and radius are displaced post to the humerus
caused by fall on outstretched hand with elbow extended
rapid edema
N injury common

Question 29

MCL instability

Answer 29

post trauma FOOSH
overuse
forceful elbow ext , valgus stress, pronation
overhead athletes and pitchers
medial pain
pop at time of injury
tender
gradual onset
aggravated by throwing
hypermobile
want to immobilize and modify activity
surgical-tommy johns (12 months)

Question 30

extension valgus overload syndrome

Answer 30

compression of the olecranon of the ulna against the humerus with a values stress
flexion contracture and painful active ext
post pain with passive elbow pronation, values, ext
rest, NSAIDS, correct mechanics, eccentric strengthening

Question 31

radial head fracture

Answer 31

MOST common elbow injury in adults
typically from fall
start active motion 7-10 days since immobilization can lead to perm loss of motion

Question 32

olecranon fx

Answer 32

usually avulsion
FOOSH
ORIF

Question 33

supracondylar fx

Answer 33

MOST common elbow fx in children

hyperext or fall on flexed elbow