| 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
|
HHS Shrek
