table, figures and new

Question 1

What non MSK can refer pain to the elbow?

Answer 1

1. acute MI
2. pancoast tumour
3. esophageal motor disease

Question 2

What non MSK can cause elbow pain?

Answer 2

1. Gout/pseuodogout
2. Septic arthtitis
3. hemarthrosis
4. soft tissue abscess
5. cellulitis
6. reactive athritis
7. CA

Question 3

What are the gender differences in carrying angle

Answer 3

females 13-16

males 11-14

Question 4

What are the greater and lessor sigmoid notch of the ulna

Answer 4

greater - articular surface of the proximal unla with the trochlea of the humerus
lessor - articular surface of the proximal ulna with the radial head

Question 5

What are the three fossae of the distal humerus

Answer 5

1. radial
2. coraonoid
3. olecranon

Question 6

How much of the radial head articulates with the ulnar

Answer 6

1. 240 degrees articulates as some point during pronation and supination
2. the ramaining 140 degrees is the “safe zone” for surgery

Question 7

What muscle attaches to the coronoid process

Answer 7

brachialis

Question 8

What is the oblique cord of the elbow

Answer 8

thickening of the fascia of the supinator extending from the medial side of of the proximal ulnar just past the biceps insertion on the radius

Question 9

Describe the mechanics of the forearm interosseus membrane

Answer 9

1. constructed of a central band and several accessory bands
2. distributes load from radius to ulna during weight bearing
3. peak strain in neutral forearm position
4. dictates ulnar movement

Question 10

What joints does the elbow capsule surround

Answer 10

All three elbow joints

Question 11

At what point is the elbow joint most lax

Answer 11

70-90

Question 12

what are the parts of the UCL and when are the tight in the ROM

Answer 12

1. anterior - anterior - full extension to 60 - posterior 60 to 120
2. posterior - 90 flexion
3. transverse

Question 13

What the parts of the LCL of the elbow and when are they tensioned

Answer 13

1. annular ligmaent
2. radial portion
3. ulnar portion

tensioned in flexion and extension and into supintion

Question 14

Describe the attachments of the radial portion of the LCL of the elbow

Answer 14

• lateral epicondyle

- annular ligament

Question 15

Supinator is most closely associated with which ligmemt of the wlbow

Answer 15

• radial portion of the LCL

- oblique cord

Question 16

Which anterior elbow flexor has thee greatest mechanical advatage?

Answer 16

brachioradialis

Question 17

what muscle make up the “mobile wad”

Answer 17

1. ECRB
2. ED
3. EDM
4. ECU

Question 18

What muscle it the primary supinator

Answer 18

biceps

Question 19

What are the main aterial structures of the elbow

Answer 19

1. brachial
2. radial
3. ulnar

Question 20

Is supination greater in elbow extension or flexion

Answer 20

flexion

Question 21

what is the primary stabilizer for varus and valgus stress at 0 and 90 degree elbow flexion

Answer 21

vlagus - 0 degree - ECL, ant cap and bone about same
valgus - 90 degree - UCL primary followed by bone and capsuel
Varus - 0 degree - BONE, ant cap, RCL
varus - 90 degre - BONE slight cap and RCL

Question 22

what are the risk factors for developing lateral elbow tendinopathy

Answer 22

• 35-50
• female
• high work levels
• low social support at work
• strenuous categories of work

Question 23

What is Mill’s test

Answer 23

• flexion of the fingers and wrist
  -extension of elbow and shoulder
  production of elbow pain

Question 24

Risk facotres for medial elbow pain

Answer 24

1. men and women equal
2. dominate arm
3. “forceful work’

Question 25

Risk factors for biceps tendon rupture

Answer 25

male, 4th-6th decade, anabolic steriod use

Question 26

Describe basics of the bicep rupture repair

Answer 26

- highest risk for re-rupture is 3 weeks - full PROM by 4 weeks - strengthening starts 6-8 weeks - unrestricted activity 8-16 weeks

Question 27

What are the most common senarios leading the varus instability of the elbow

Answer 27

1. complex elbow dislocation 2. varus elbow stress 3. iatrongenic causes

Question 28

What is a posterolateral rotatory instability (PLRI)?

Answer 28

the proximal radius and ulna externally rotate together as a unit in relation to the humerus causing posterior subluxation or dislocation of the radial head relative to the capitellum, without associated instability of the proximal radioulnar joint

Question 29

What is Varus posteromedial instability?

Answer 29

elbow instabiltiy associated with subluxation of the elbow resulting in RCL avulsion and fracture of the anteriomedial tip of the coronoid

Question 30

What is best way to approach Varus posteromedial instability

Answer 30

surgery

Question 31

what is the most common mechanism of injury for PLRI?

Answer 31

combination of axial compression, valgus stress, and supination

Question 32

How long she shoulder abudction be avoided with RCL is repaired

Answer 32

4-6 weeks

Question 33

What are the phases of throwing?

Answer 33

1. wind-up 2. stride 3. arm cocking 4. arm acceleration 5. arm deceleration 6. follow through

Question 34

UCL strains typically occur in what part of the throwing phases

Answer 34

cocking to acceleration

Question 35

What special test would you use to confirm PLRI?

Answer 35

lateral pivot shift - Supine with the shoulder passively flexed past 90.° The elbow begins in extension, the examiner applies axial compression through the ulna and radius towards the humerus with a supination and valgus force causing the elbow to subluxate at ~40° - 70° of elbow flexion. If the patient allows the passive examination to continue, then an observable clunk occurs with continued flexion as the elbow reduces.

Question 36

medial elbow differential diagnosis

Answer 36

``` 1. c spine C7-T1 2 TOS 3. shoulder MSK 4. ulnar nerve 5. medial elbow instability 6. medial tendinosis 7. posteromedial impingement/valgus etension overload syndrome ```

Question 37

how should you brace a person with an LCL and MCL deficient elbow

Answer 37

1. LCL put them in pronation 2. MCL put inte in supination 3. both mid range

Question 38

Normal return to sport time from follow ostechondritis dissicans injury

Answer 38

6 months