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Ch14 Elbow/Forearm
Elbow/Forearm
| Question | Answer |
|---|---|
| What are the three nerves that run through the elbow/forearm? | Ulnar, Median, Radial |
| What are the two main reasons for acute injury to the elbow? | High load stress on elbow when arm is outstretched or planted away from body. |
| What are two activities that could lead to acute injury in elbow? | High stress produced when weight lifting and throwing. |
| What kind of injuries will be attributed to low level repetitive stress? | Tendinitis, Neuritis |
| When dealing with an injury what are the risk factors that should first come to mind that might cause an elbow injury? | Level of activity (# of Throws), time span, changes in throwing technique |
| Overuse injuries may be attributed to what three things? | Improper technique, Poor elbow biomechanics, Weak muscles |
| What are four factors that we should question the athlete about when dealing with a overuse elbow injury? | changes in technique, Changes in equipment, Increases in intensity, Increase in duration of play |
| With an elbow that chronically locks, clicks, or pops during movement what could we expect? | Osteochondritis dessicans or an Unstable joint |
| IF the patient is having pain with seasonal activity what could that be attributed to? | poor conditioning |
| If they have had pain or referred pain from the cervical spine in the past what must you do? | Further investigate previous trauma, paresthesia or strength loss |
| When we inspect the anterior elbow what are the two things we should look at? | carrying angle, cubital fossa |
| What is carrying angle? | When the body is in anatomical position the position of the ulna/radius on the humerus. |
| What are the normal carrying angle ranges for men/women? | 10-15 degrees valgus in women, 5-10 degrees valgus in men. |
| When we inspect the medial elbow what are the two things we should look at? | medial epicondyle, Flexor muscle group |
| When we inspect the lateral elbow what are the three things we should look at? | Alignment of wrist & forearm, Cubital recurvatum, Extensor muscle mass |
| When we inspect the posterior elbow what are the three things we should look at? | Bony alignment, olecranon process, bursae sac |
| What are the four things we palpate when palpating the cubatal fossa? | biceps brachi, brachial artery, median nerve, musculocutaneous nerve |
| What are the four muscles we palpate when we palpate the flexor muscle group. | pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris |
| What four things do we palpate on the medial side of the elbow. | ulna, medial epicondyle, medial supracondylar line, Ulnar collateral ligament |
| What seven things do we palpate on the lateral side of the elbow. | radius, lateral epicondyle, Lateral Supracondylar Line, Radial Head, Radial collateral ligament, Annular ligament, Brachioradialis |
| What six things do we palpate on the posterior side of the elbow. | Olecranon process, olecranon fossa, triceps, supinator, ulnar nerve, wrist extensors. |
| What are the three wrist extensors? | extensor carpi radialis brevis, extensor carpi radialis longus, brachioradialis |
| What ligamentous test tests for medial ligament laxity? | valgus stress test |
| What ligamentous test tests for lateral ligament laxity? | varus stress test |
| Gross laxity with varus stress test is indicative of what? | annular ligament instability and possible RCL as well. |
| How do you perform Tinel's sign? | tap on the ulnar or radial nerve |
| what should be the result of Tinel's sign? | burning sensation in the hand |
| How do you test for Lateral epicondylitis? | forearm pronated and fingers flexed, resist wrist extension while palpating the lateral epicondyle |
| What is a positive test for the Posterolateral Rotatory Instability Test? | Elbow will subluxate as it is extended and can be felt to relocate as it is flexed |
| What is the Posterolateral Rotatory Instability Test indicative of ? | Indicative of chronic instability of the elbow |
| MOI of Ulnar Collateral Ligament Sprain(2)? | valgus loading of the humeroulnar joint, Direct force to lateral elbow |
| MOI of Radial Collateral Ligament Sprain? | Varus forces placed on the lateral elbow ligaments |
| Why is injury to Radial Collateral Ligament rare? | due to protection from varus forces from the body |
| MOI of Lateral Epicondylitis(3)? | Repeated forceful eccentric contractions of the wrist extensors, Radial deviation, Supination |
| MOI of Medial Epicondylitis(2)? | Repeated, forceful flexion or pronation of the wrist |
| What is little leaguer's elbow? | avulsion of the common tendon from attachment site |
| MOI of Distal Biceps Tendon Rupture? | Eccentric loading of the bicep brachii when the elbow is extended |
| MOI of Osteochondritis Dessicans? | due to increased valgus loading over time which compresses the radial head & capitellum during overhead throwing |
| Nerve trauma presents with dysfunction where(3)? | wrist, hand, & fingers |
| What are the signs or symptoms of Nerve trauma(3)? | Paresthesia, decreased grip strength, & inability to actively extend the wrist |
| The ulnar nerve is predisposed to what? | Concussive forces due to its relatively superficial state |
| Acute trauma to the ulnar nerve can present with what symptoms(2)? | burning sensation in medial forearm, little finger, & ringer finger / decreased strength of finger flexor muscles |
| Chronic trauma to the ulnar nerve can present with what symptoms(2)? | hand will deviate radially during flexion / clawhand position |
| What is clawhand position? | inability to make a fist due to lack of flexion in the 4th & 5th DIP joints |
| Most likely way to injure the Radial nerve(2)? | Deep lacerations of the elbow / fractures of humerus or radius |
| How many and name the branches of the Radial nerve? | two / deep branch & superficial branch |
| trauma to the deep branch of the radial nerve results in how much sensation loss? | None |
| Trauma to the superficial branch of the radial nerve results in sensations loss where? | posterior forearm and hand |
| What does radial tunnel syndrome mimic? | lateral epicondylitis (after pain persists for more than 6 months) |
| What is Pronator Teres Syndrome? | When a branch of the median nerve is compressed by the pronator teres. |
| How do you know if someone has Pronator Teres Syndrome? | inability to pinch their thumbs and index fingers together |
| what are the three types of compartments in the forearm? | Volar, dorsal, & mobile compartments |
| What is compromised if you have forearm compartment syndrome? | Circulation & neurologic function of the hand |
| MOI of Forearm Compartment Syndrome? | Increased pressure due to hypertrophic muscles, hemorrhage, or fractures |
| MOI of an Elbow dislocation? | Axial force through the forearm while the elbow is slightly flexed |
| MOI of an Supracondylar Fractures? | fall directly onto a flexed elbow or a hyperextension mechanism |
| MOI of an Olecranon Process Fractures? | Direct blow / falling on a flexed elbow |
| What is something to think about when dealing with a proximal Radial & Ulnar Fracture? | compromise of the neurovascular supply to the wrist & hand |
Created by:
shsuman152
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