Session 3 Lecture Notes

Question 1

What are the 3 joints that make up the elbow joint?

Answer 1

1. Ulnohumeral
2. Radiohumeral
3. Radioulnar

Question 2

Of the three joints that make up the shoulder - which is the only one that provides extension and flexion? (rather than supination and pronation)

Answer 2

The ulnohumeral joint

Question 3

What is the carrying angle?

Answer 3

The angle that your elbow flexes and extends at - it is slightly angled away from the body to ensure that your clear your hips when walking/swinging arms

Question 4

What is the difference in carrying angle between cubitus varus and cubitus valgus?

Answer 4

Cubitus varus = decreased carrying angle (only a cosmetic problem)
Cubitus valgus = increased carrying angle (this can lead to damage to the ulnar nerve)

Question 5

What are the 3 ligament complexes of the elbow?

Answer 5

1. Medial collateral (3 parts)
2. Lateral collateral (2 parts)
3. Annular

Question 6

What is the fad pad sign?

Answer 6

It is a sign that there is fluid within the elbow joint cavity - clue that there may be a fracture as a fracture causes bleed (which collects in elbow joint cavity and raises the fat pad away from the elbow)

Question 7

At the elbow joint what degrees can flexion and extension allow?

Answer 7

-5 (slight hyperextension) to 140 degrees

Question 8

Which nerve innervates biceps brachii?

Answer 8

Musculocutaneous

Question 9

Which nerve innervates brachialis?

Answer 9

Musculocutaneous

Question 10

Which nerve innervates brachioradialis?

Answer 10

Radial nerve

Question 11

Which 3 muscles are involved with flexion at the elbow joint?

Answer 11

1. Biceps brachii
2. Brachialis
3. Brachioradialis

Question 12

Which 2 muscles are involved with extension at the elbow?

Answer 12

1. Triceps brachii

2. Aconeus

Question 13

Which 2 muscles are involved in supination at the elbow?

Which is most dominant

Answer 13

1. Biceps brachii (most dominant)

2. Supinator

Question 14

What happens to movement at the elbow if biceps brachii is damaged?

Answer 14

Will not lose much function of extension/flexion as brachialis is the main muscle involved in this
You will however lose ability to supinate as supinator can only do this a little (mostly biceps brachii)

Question 15

What nerve innervates supinator muscle?

Answer 15

Radial nerve

Question 16

What 2 muscles are involved in pronation of the elbow?

Answer 16

1. Pronator quadratus

2. Pronator teres

Question 17

What two movements of the elbow involve muscles innervated by the median nerve?

Answer 17

Flexion and pronation

Question 18

The radial nerve innervates muscles that provide what movement at the elbow joint?

Answer 18

Extension (as well as supinator which provides a little supination)

Question 19

Name 5 muscles (involved in either pronation or flexion at the elbow joint) that originate from medial epicondyle

Answer 19

1. Flexor carpi ulnaris
2. Palmaris longus
3. Flexor carpi radialis
4. Pronator teres
5. Flexor digitorum superficialis

Question 20

Which 3 deep flexor and pronator muscles are innervated by the anterior interosseous nerve?
Which nerve does this branch from?

Answer 20

1. Pronator quadratus
2. Flexor digitorum profundus
3. Flexor pollicis longus

Question 21

What form the contents of the cubital fossa? (lateral to medial)

Answer 21

REALLY NEED BEER TO BE AT MY NICEST:
Radial nerve
Biceps tendon
Brachial artery 
Median nerve

Question 22

Name the 8 carpal bones

Answer 22

SOME LOVERS TRY POSITIONS THAT THEY CAN'T HANDLE
Proximal row (lateral to medial):
Scaphoid
Lunate
Triquetral 
Pisiform 
Distal row (lateral to medial):
Trapezium
Trapezoid
Capitate
Hamate

Question 23

What are the top 2 most common dislocations?

Answer 23

1. Shoulder joint

2. Elbow joint

Question 24

What direction is a dislocation in the elbow most common?

Answer 24

Posteriorly (bone pushed out towards the back)

Question 25

If you have dislocated your elbow what else must have been damaged?

Answer 25

Your soft tissue - ligaments and joint capsule (as these hold the joint in position)

Question 26

Give 4 types of initial management for elbow dislocation

Answer 26

1. Pain relief 2. Sling or splint 3. NVT assessment (nerve vessel tendon) 4. X-ray

Question 27

Name 3 types of definite management of elbow joint

Answer 27

1. Re-x-ray to check for concentric reduction - making sure the trochlea is sitting within the trochlea notch 2. Closed reduction (force to put the joint back in place 3. Re-NVT assessment

Question 28

What neurovascular checks can you do following a suoracondylar fracture?

Answer 28

1. OK sign 2. Radial pulse 3. Capillary return (warmth and colour to hand) 4. Paraesthesaie (tingling sensation)

Question 29

What is the difference between a displaced and a non displaced fracture?

Answer 29

``` Displaced = bones are not aligned with one another (fragments have moved) Non-displaced = break in bone but it has not fragmented/ separated ```

Question 30

What is most common elbow fracture? | On X-ray what could you look for to confirm a fracture?

Answer 30

Radial head/neck fracture | Look for fat pad sign = displacement of fat pad to due effusion of blood from broken bone

Question 31

What is a pulled elbow? | When is this most common?

Answer 31

The radial head is pulled out of position and the annular ligament becomes trapped underneath In young children it is most common (2-5 years)

Question 32

What is the most common inflammatory arthropathy?

Answer 32

Elbow joint

Question 33

What is the difference between lateral and medial elbow tendinopathy and the group of muscles it affects?

Answer 33

Medial elbow tendinopathy = affects the flexors | Lateral elbow tendinopathy = affects the extensors

Question 34

With what disease is a rheumatoid module most likely to occur?

Answer 34

Rheumatoid arthritis

Question 35

What is olecranon bursitis?

Answer 35

Inflammation of the bursa of the elbow joint

Question 36

What is gouty tophi? | What can it lead to?

Answer 36

A disorder of nucleic acid metabolism leading to hyperuricaemia (a build up of sodium urate crystals) This can lead to urate crystal deposition

Question 37

What is a fracture of the distal radius often confused with?

Answer 37

A fracture of the wrist

Question 38

What is an intraarticular fracture?

Answer 38

A fracture which crosses into a joint | It is associated with cartilage damage

Question 39

What is a colles' fracture?

Answer 39

A DORSALLY displaced fracture of the distal radius

Question 40

What is a Smith's fracture?

Answer 40

A PALMAR displacement of the distal radius

Question 41

What is the most common carpal bone to be fractured? | Where would the pain present?

Answer 41

The scaphoid | Pain/tenderness in the anatomical snuff box

Question 42

Why is there a risk of necrosis following a scaphoid fracture?

Answer 42

Because only 25% of the blood supply is not articular - after a break this is the only blood supply received

Question 43

What causes cubital tunnel syndrome?

Answer 43

Compression of the ulnar nerve at the cubital tunnel (inside of the elbow) near the "funny bone"