Lecture 6--Elbow Arthrology

Question 0

Is an outward angulation of a distal segment

Answer 0

Valgus

Question 1

There are at least ____ muscles that cross the elbow, but only one acts exclusively at the elbow, this is _____.

Answer 1

15

Brachialis.

Question 2

Is an inward angulation of a distal segment–distal segments go in.

Answer 2

Varies

Question 3

Natural valgus angle, distal segment more lateral than proximal and the joint appears at an angle.

Answer 3

Carrying angle

Question 4

Articulations of the elbow

Answer 4

Humeroulnar
Humeroradial
Proximal radioulnar

Question 5

What are the ligaments of the elbow joint

Answer 5

Radial collateral ligament

Ulnar collateral ligament

Question 6

Is a lateral strong fan shaped ligament. It goes from the lateral epicondyle of the humerus and blends distally with the annular ligament of the radius.

Answer 6

Radial collateral ligament

Question 7

Reinforces the capsule and resists varus (medial to lateral) stress

Answer 7

Radial collateral ligament

Question 8

Triangular shaped ligament with three different bands. It goes from the medial epicondyle of the humerus to the coronoid process and olecranon of the ulna.

Answer 8

Ulnar collateral ligament

Question 9

What are the three different bands of the ulnar collateral ligament

Answer 9

Anterior cord is the strongest
Posterior is fan like and is the weakest
Oblique or transverse band exists to deepen the socket.

Question 10

This ligament resists valgus stress at the elbow.

Answer 10

Ulnar collateral ligament

Question 11

What happens if you have a constant valgus stress?

Answer 11

Tendinitis. The length changes and it gets looser, and you get inflammation markers which kicks off the healing process but you don’t get healing you get inflammation cycle. Eventually you can get fraying and possible rapture.

Question 12

Describe tommy john surgery

Answer 12

Named for originating patient.
Performed by team physician frank Jobe in 1974
Transplant of long tendon from elsewhere in the body and woven in a figure 8 through drilled holes in the medial epicondyle and lateral aspect of the coronoid process. Full rehab is a year for pitchers and six months for other field players with no throwing motions. One third of active mlb players have had this surgery done.

Question 13

What happens during pitching

Answer 13

There is a big lateral thrust against the wrist to the elbow and it causes a gap. There is valgus force while pitching.

Question 14

Works to contain tendons and keep them from bowstringing

Answer 14

Extensor retinaculum

Question 15

Anterior and distal thickening at the same level as the extensor retinaculum

Answer 15

Palmar carpal ligament

Question 16

Thickening just distal and deep to the palmar carpal ligament. Forms the carpal tunnel

Answer 16

Flexor retinaculum

Question 17

Is the interosseous membrane continuous with the antebrachial fascia?

Answer 17

Nope

Question 18

Collagen fibers predominately pass from the radius to the ulna inferiority and obliquely

Answer 18

Interosseous membrane

Question 19

What is the function of the interosseous membrane

Answer 19

Connects bones without hindering pronation/supination, transfers closed chain forces from the radius to the ulna, and provides attachment space for forearm musculature.

Question 20

What are the contents of the anterior compartment of the forearm

Answer 20

Flexor/pronator muscles of the forearm

Most vascular and neural elements

Question 21

Rule of the anterior compartment of the forearm

Answer 21

All of the flexors and pronators are Innervated by the median nerve except 1.5 by the ulnar nerve.

Question 22

What’s in the posterior compartment of the forearm

Answer 22

Extensor/supinator muscles

Has less vascular and neural elements

Question 23

All muscles in the posterior compartment of the forearm are Innervated by the

Answer 23

Radial nerve

Question 24

What are the cubital fossa borders

Answer 24

Roof-- subcutaneous tissue and deep fascia and bicipital aponeurosis Superior-- line connecting medial and lateral epicondyles of the humerus. Medial-- pronator teres Lateral-- brachioradialis Floor-- Brachialis and supinator

Question 25

Contents of the cubital fossa

Answer 25

Veins (cephalic, basilic, median, and cubital), biceps brachii tendon, brachial artery, median nerve.

Question 26

Describe the cubital tunnel

Answer 26

Enclosed by the medial epicondyle of the humerus, olecranon of the ulna, tendinous origin of the flexor Carpi ulnarks muscle, the floor includes elements of the joint capsule like the mcl and capsular fibers.

Question 27

Contents if cubital tunnel

Answer 27

The ulnar nerve and it is very exposed. It is the funny bond

Question 28

What is in guyon's canal

Answer 28

Ulnar nerve and artery

Question 29

What are the articulations of the carpus

Answer 29

Radio carpal Intercarpal Carpometacarpal

Question 30

The radio carpal joint excludes what bone

Answer 30

The pisiform

Question 31

What plane do abduction and adduction of the thumb happen in

Answer 31

Sagittal

Question 32

Articulations of the metacarpus

Answer 32

Carpometacarpal Intermetacarpal Metacarpophalangeal

Question 33

Describe boxers fracture

Answer 33

The fifth metacarpal has a fracture. 92% we're males and over 60% were from intentional punches.

Question 34

Articulations of the phalanges

Answer 34

Metacarpophalangeal | Interphalangeal

Question 35

The median nerve passes between the two heads of what muscle as it enters the forearm?

Answer 35

Pronator teres

Question 36

Radial artery lies lateral to what tendon

Answer 36

Flexor Carpi radialis tendon

Question 37

Is the flexor Carpi radialis in the carpal tunnel

Answer 37

No, it passes within its own synovial sheath in a separate compartment formed by the flexor retinaculum on the lateral side of the wrist.

Question 38

The palmaris longus is absent in

Answer 38

About 14% of people

Question 39

What two muscles pass superficial instead of deep to the flexor retinaculum?

Answer 39

Palmaris longus and flexor carpi ulnaris

Question 40

At the wrist the median nerve lies lateral to what tendon

Answer 40

Palmaris longus tendon

Question 41

The ulnar nerve passes between the two proximal insertions of what muscle

Answer 41

Flexor Carpi ulnaris

Question 42

At the wrist the ulnar nerve and artery pass laterally to what tendon

Answer 42

Flexor Carpi ulnaris tendon

Question 43

Describe guyon's canal

Answer 43

The medial border is the pisiform so the tendon insets on the pisiform and neural and vascular structures are just lateral to that. The ulnar nerve and artery are in here. Abductor pollicis longus and extensor pollicis brevis form the lateral border.

Question 44

The median nerve and ulnar artery enter the forearm by passing between the humeroulnar and radial heads of what muscle

Answer 44

Flexor digitorum supeficialis

Question 45

The anterior interosseous nerve and artery descend between what muscles

Answer 45

Flexor digitorum profundus and flexor pollicis longus

Question 46

Flexor pollicis longus is ____ to the flexor digitorum profundus

Answer 46

Lateral

Question 47

What is the only muscle that attaches only to the radius on one end and only to the ulna on the other

Answer 47

Pronator quadratus

Question 48

Anterior interosseous artery pierces the interosseous membrane at the proximal border of what muscle

Answer 48

Pronator quadratus

Question 49

Describe golfer's elbow

Answer 49

If there is too much stress to the musculature, it can cause medial epicondyle tendinitis. From the top of the swing you throw your elbow down and create stress in the musculature.

Question 50

What are the two branches of the ulnar artery that anastomose with branches of the brachial artery?

Answer 50

Anterior ulnar recurrent--> inferior ulnar collateral artery Posterior ulnar recurrent--> superior ulnar collateral artery