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KNPE 331 > Lecture 12 > Flashcards

Lecture 12 Flashcards

1
Q

What type of joint is the elbow joint

A

-hinge joint

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2
Q

What is the 3 joints of the elbow joint

A

-ulnohumeral joint
-radiohumeral joint
-proximal radioulnar joint

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3
Q

What are the elbow ligaments

A

-ulnar (medial) collateral ligament
-radial (lateral) collateral ligament

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4
Q

Joints of the wrist and hand

A

-radioulnar joint
-midcarpal joints
-carpometacarpal joint
-metacarpalphalangeal joint
-proximal interphalangeal joint
-distal interphalangeal joint

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5
Q

Ligaments of the wrist and hand

A

-collateral ligaments of wrist and fingers
-collateral ligaments of fingers
-intercarpal ligament
-triangular fibrocartilage complex (TFCC)

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6
Q

What are the intercarpal ligaments

A

-dorsal
-palmar

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7
Q

What is the triangular fibrocartilage complex (TFCC)

A

-complex made up of load beaing triangular fibrocartilage artciular disc and ligaments on medial aspect of wrist

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8
Q

What does the TFCC do

A

-disperses axial load from carpals to ulna

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9
Q

What is TFCC thickened by

A

-ulnar collateral ligament medially

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10
Q

What is the TFCC a major stabilizer of

A

-ulnocarpal joint
-distal radioulnar joint

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11
Q

Nerves of the elbow and wrist to note

A

-ulnar nerve
-median nerve

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12
Q

What are the elbow flexors

A

-biceps brachii
-brachialis
-brachioradialis

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13
Q

What are the heads of the biceps

A

-long head
-short head

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14
Q

What is another movement of the long head of biceps other than elbow flexion

A

-shoulder flexion

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15
Q

What are the elbow extensors

A

-triceps brachii
-anconeus

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16
Q

Where does the common flexor tendon originate

A

-medial epicondyle

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17
Q

Where does the common extensor tendon originate

A

-lateral epicondyle

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18
Q

What are the major structures that run through the carpal tunnel

A

-flexor tendons
-median nerve

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19
Q

What are the ROM of elbow

A

-flexion
-extension
-pronation
-supination

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20
Q

What are the ROM of the wrist

A

-flexion
-extension
-radial deviation
-ulnar deviation

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21
Q

What are the ROM of the digits

A

-flexion
-extension
-adduction
-abduction
-1-5th opposition/reposition

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22
Q

What is lateral epicondylitis known as

A

-tennis elbow

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23
Q

MOI tennis elbow

A

-overuse of forearm extensors

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24
Q

What sports are tennis elbow common in

A

-tennis
-squash
-badminton

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25
What muscles are tennis elbow common in
-extensor carpi radialis longus -extensor carpi radialis brevis
26
What are the signs and symptoms of tennis elbow
-TOP common extensor origin -pain and weakness with wrist extension
27
Acute management of tennis elbow
-stretch wrist extensors in elbow extension and flexion -PIER -tennis elbow brace -eccentric strengthened program for forearm extensors
28
What is medial epicondylitis known as
-golfers elbow
29
MOI golfers elbow
-overuse of wrist flexors
30
What sports are golfers elbow common in
-golfers -pitchers
31
What muscles are most commonly affected by golfers elbow
-flexor carpi radialis -pronator teres
32
Signs and symptoms of golfers elbow
-TOP common flexor origin -pain and weakness with wrist flexion
33
Acute care of golfers elbow
-stretch forearm flexors -PIER
34
MOI ruptured biceps
-sudden lengthening of contracting muscle (eccentric) -sudden load when lifting or catching a heavy load
35
Where is ruptured biceps most common
-distal tendon
36
Signs and symptoms of ruptured biceps
-popeyes muscle balled up -bruising -pain near insertion of biceps into radial tuberosity -pain and weakness with elbow flexion and supination
37
Acute management of ruptured biceps
-PIER -pressure pad to approximate ends -shorten biceps in sling to remove tension -surgical repair
38
MOI dequervains syndrome tenosynovitis
-overuse of thumb due to gripping/wringing
39
What is dequervains syndrome tenosynovitis
-inflammation of the tendons and sheath around the thumb tendons
40
Signs and symptoms of dequervains syndrome tenosynovitis
-pain over tendons of thumb -weakness in thumb -abduction or extension -pain with gripping
41
What sport is dequarvains syndrome tenosynovitis common in
-golf
42
Special test for dequarvains syndrome tenosynovitis
-finkelstein test
43
Acute management of dequarvains tenosynovitis
-PIER -thumb spica brace
44
What can happen to dequarvains tenosynovitis if left untreated
-can progress to thickening/scarring -reduced ROM
45
MOI elbow hyperextension injuries
-FOOSH -sometimes with an added external force
46
Signs and symptoms of elbow hyperextension injuries
-anterior elbow pain -swelling from ligament/capsule sprain and/or muscle sprain -posterior elbow pain from osteochondral lesion
47
What do you need to rule out in an elbow hyperextension injury
-olecranon fracture
48
Acute management of elbow hyperextension injury
-PIER -shorten injured tissues -sling -tape job
49
MOI ulnar collateral ligament sprains of elbow
-FOOSH -overuse by repeat valgus force on the elbow
50
Signs and symptoms of ulnar collateral ligament sprains of elbow
-pain and laxity in medial elbow joint -can include ulnar nerve symptoms
51
Special test for ulnar collateral ligament sprains of elbow
-valgus stress test
52
Who is ulnar collateral ligament sprains of elbow common in
-pitchers due to repeat high velocity force
53
What surgery is used for ulnar collateral ligament sprains of elbow
-tommy john surgery
54
What does tommy john surgery do
-reconstructs UCL using a graft tendon from palmaris longus, semitendonosus or gracilis
55
MOI collateral ligament sprains of the wrist
-FOOSh -forced forearm rotation
56
What ligament is affected with valgus force
-ulnar collateral ligament
57
What ligament is affected with varus force
-radial collateral ligament
58
Signs and symptoms of collateral ligament sprains of the wrist
-pain -swelling and instability of medial (UCL) or lateral (RCL) aspect of wrist
59
Special test for UCL
-valgus stress test
60
Special test for RCL
-varus stress test
61
Acute management of collateral ligament sprains of the wrist
-PIER -wrist wrap
62
What is UCL sprain of the thumb known as
-skiers thumb -gamekeepers thumb
63
MOI UCL sprain thumb
-traumatic or overuse hyperabduction of the thumb
64
Traumatic MOI UCL sprain thumb
-skiers thumb -thumb gets caught -FOOSH -catching ball
65
Overuse MOI UCL sprain thumb
-gamekeepers thumb -repeat gripping/twisting
66
What can UCL sprain thumb also result in
-avulsion fracture
67
Signs and symptoms of UCL sprain thumb
-pain -swelling and instability at 1st MCP joint
68
When is surgery recommended for UCL sprain thumb
-for instability to stabilize joint -prevents osteoarthritis longer term
69
Acute management for UCL sprain thumb
-PIER -possible x ray to rule out avulsion -brace for healing -tape for RTP
70
What ROM do you want to limit with a thumb tape job
-hyperextension -abduction
71
Acute MOI TFCC tear
-FOOSH -forced forearm rotation
72
Overuse MOI TFCC tear
-repetitive wrist motions
73
Signs and symptoms of TFCC tear
-medial wrist pain -pain with ulnar deviation and loading through wrist -popping/clicking -wrist weakness
74
Special test for TFCC tear
-TFCC compression test
75
Acute management of TFCC tear
-PIER -brace as heals -anti-inflam injections if needed -surgery for persistent instability
76
MOI elbow dislocations
-FOOSH
77
Signs and symptoms of elbow dislocations
-deformity -pain -holding elbow -tingling/numbness -shock
78
Acute care for elbow dislocations
-stabilize -splint -monitor/treat for shock -ER/EMS -reduction under sedation
79
MOI elbow fractures
-direct trauma -fall
80
Signs and symptoms of elbow fractures
-pain -unable or unwilling to move elbow
81
Acute care for elbow fractures
-splint -monitor for shock -ER for xrays/surgery
82
MOI colles fracture
-FOOSH
83
What happens with a colles fracture
-distal radius gets displaced posteriorly
84
Signs and symptoms of colles fracture
-dinner fork deformity -pain -numbness
85
Acute management of colles fracture
-splint -monitor for shock -emerge for xrays -surgery if unable to align
86
MOI scaphoid fracture
-FOOSH
87
Signs and symptoms of scaphoid fracture
-TOP of anatomical snuffbox
88
Why does scaphoid have a reduced ability to heal
-scaphoid has poor blood supply
89
MOI metacarpal and finger fractures
-axial compression (jammed) -direct trauma -being stepped on
90
Signs and symptoms of metacarpal and finger fractures
-localized pain -swelling -unable to grip
91
Acute care of metacarpal and finger fractures
-buddy tape to stabilize -SAM splint
92
What may happen with metacarpal and finger fractures
-avulsion fractures (tendon pulls off piece of bone)
93
MOI cyclist palsy
-compression from handlebars
94
Signs and symptoms of cyclist palsy
-tingling/numbness/nerve pain -decreased muscle strength of 5th digit -hand cramping
95
Who is cyclist palsy common in
-new cyclists -distance cyclists
96
Prevention of cyclist palsy
-avoid hyperextension of wrist on handlebars -proper bike fit
97
Acute care of cyclist palsy
-PIER -splint -may require NSAIDS
98
MOI carpal tunnel syndrome
-overuse of wrist flexor tendons causing pressure on median nerve within carpal tunnel
99
Signs and symptoms of carpal tunnel syndrome
-burning/tingling/numbness in anterior wrist and hand (along median nerve distribution- digits 1-3 and 1/2 of 4) -decreased grip strength
100
Acute care for carpal tunnel syndrome
-bracing -PIER -anti-inflam treatment -proper ergonomic set up -steroid injection sometimes -surgery
101
What does surgery for carpal tunnel syndrome do
-open up tunnel if conservative treatment unsuccessful

KNPE 331 (12 decks)

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