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Flashcards in KRS421E3Elbow Deck (69):
1

Humeroulnar joint

Trochlear notch of ulna fits into trochlea of humerus
Synovial Joint
Flexion & Extension

2

Radiohumeral joint

Radial head articulates with capitulum of humerus
Synovial joint
Flexion & Extension

3

Radioulnar joint

Radial head articulates with the radial notch (ulna)
Synovial joint
- Pivot type
Pronation & Supination

4

Joint Capsule

Surrounds all 3 elbow articulations
Thin and lax
Allows free movement
Anterior and posterior capsule is protected by muscles
Medially & laterally protected by ligaments

5

UCL: ulnar collateral ligament (3 parts)

Anterior bundle
Posterior bundle
Transverse bundle

6

LUCL:

lateral ulnar collateral ligament

7

RCL:

radial collateral ligament

8

Annular ligament:

at radialulnar joint

9

Oblique cord:

holds radius and ulna together

10

Interosseous membrane

Connects the radius and ulna
Stabilizes against axial wrist forces
Origin for some wrist muscles

11

Olecranon Bursae - Subcutaneous

Lies between the tip of the olecranon and the skin
- common site for bursitis

12

Olecranon Bursae - Subtendinous:

Lies between olecranon & triceps brachii tendon
- common site for bursitis

13

what's the funny bone

ulnar nerve

14

what muscles is the main elbow flexion

brachialis

15

what is your drinking muscles

brachioradialis

16

what's the proximal pronator

pronator teres

17

what's the distal pronator

pronator quadratus

18

which pronates first

pronator quadratus

19

what other muscle helps to supinate

biceps brachii

20

10-13% of population does not have one

palmaris longus, wrist flexion

21

ulnar nerve innervates

flexor carpi ulnaris

22

musculcutaneous nerve

biceps and brachialis

23

radial nerve innervates

Extensors
Triceps
Supinator
Brachioradialis

24

medial nerve innervates

Pronators
Flexors

25

elbow injuries most commonly caused by

throwing, weight lifting
- Technique (or lack of) may lead to poor biomechanics & abnormal stresses

26

Relevent sounds/sensations:
Chronic clicking, popping may indicate

joint instability or possible OCD (osteochondritis dissecans)
Confirmed through diagnostic imaging

27

carrying angle/norms

cubital valgus (normal)
cubital varus
men - 5-10
women - 10-15

28

why is there a carrying angle

not straight because of angle of trochlea

29

inspection of cubital fossa

found on anterior side

Swelling may indicate damage to soft-tissue (distal biceps tendon)
Possible pressure on neurovasulature

30

Compression of radial nerve as it crosses elbow may inhibit

wrist extensors
Drop wrist

31

Cubital recurvatum

Extension beyond 0o common in females
May predispose anterior structure to overuse

32

Flexor muscle mass
inspection

Widens approximately 2-3 inches below elbow

Loss of girth/tone may occur secondary to prolonged disuse related to long term-tendonitis

33

Extensor muscle mass
inspection

Widens approximately 1-2 inches below elbow

Loss of girth/tone may occur secondary to prolonged disuse related to long term-tendonitis or radial nerve involvement

34

cubital fossa formed by

brachioradialis, pronator teres, and line between epicondyles

35

cubital fossa has what structures

Medial n.
Musculotaneous n.
Brachial a.
- Radial and ulnar a.

36

what's the wrist flexor group

palm on forearm
pronator teres
FCR
palmaris longus
FCU

37

palpation of UCL

Elbow flexed to 20-30o
Anterior band palpable as it crosses humerus to ulna
Posterior & transvers bundles not directly palpable (regional)

38

crepitus in capitulum

Crepitis may indicate chonrdomalacia or other bony pathology

39

where's the ulnar nerve

In groove between olocranon & medial epicondyle
Neuro. symptoms?
Flex & extend to determine subluxation

40

flexion of elbow

145-155 degrees

41

extension of elbow

0

42

pronation and supination

about 90

43

UCL sprain swelling present in

anterior, medial, & posterior aspects of elbow

44

UCL palpation

(anterior bundle) may elicit tenderness & crepitus

45

UCL Pain

Mild pain at end rages of AROM & PROM due to pain (ligamentous stretching)
Normal strength (except in more severe cases)

46

what's used to find UCL sprains

valgus stress test

47

UCL chronic instability result in

may result in OCD of radial head / capitulum or traction irritation of ulnar nerve

48

3rd degree UCL sprain often

often surgically reconstructed using palmaris longus graft
“Tommy John”

49

Lateral Ligamentous Injury
pain w/

Signs & symptoms similar to UCL injury
Often result in radiohumeral injury
Pain with pronation/supination

50

what test is used to find lateral ligamentous injury

varus stress test

51

LUCL and RCL injuries caused by

are fairly rare in athletic populations
Traumatic mechanisms (varus load) possible

52

traumatic onset of fractures

FOOSH-A or direct blow

53

what to look for in fractures

Often obvious deformity, significant point tenderness, crepitus, swelling, etc.
Concern for neurovascular impairment

54

what tests are used for fractures?

bump and compression test

55

Epicondylitis

Inflammation of the periosteum & associated tendons resulting from overuse

56

Medial epicondylitis =

overuse wrist flexion
“golfer’s elbow”
“little leaguer’s elbow”
- Avulsion fx of flexor mass

57

Lateral epicondylitis =

overuse wrist extension
“tennis elbow”

58

medial epicondylitis most common in activities involving

swift, powerful snapping of the wrist & pronation of forearm

59

medial epicondylitis insidious onset

overuse/repetitive motions

60

medial epicondylitis signs and symptoms

Pain, swelling over medial epicondyle
Pain during active wrist flexion, passive extension (elbow & wrist), ↓ wrist flexion strength (pain)

61

what's test is used to find medial epicondylitis

medial epicondylitis test

62

what nerve could be affected with medial epicondylitis

ulnar nerve

63

lateral epicondylitis (tennis elbow) most common in what sports

Common in racquet sports & activities involving repetitive eccentric extension movements

64

lateral epicondylitis insidious onset

overuse/repetitive movements

65

lateral epicondylitis signs and symptoms

Pain, swelling over lateral epicondyle
Pain during active wrist extension, passive wrist flexion (extended elbow), ↓ wrist extension strength (pain)

66

what test is used to find lateral epicondylitis

+ Lateral epicondylitis test

67

what nerve could be affected with lateral epicondylitis

radial nerve

68

Distal Biceps Tendon Rupture

Dramatic eccentric load of biceps brachii may result in rupture of distal tendon

69

signs and symptoms of distal biceps tendon rupture

Immediate pain, “pop”, loss of flexion & supination strength
Obvious deformity
Large swelling in cubital fossa, palpable defect