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