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Ch14 Elbow/Forearm


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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