5. Elbow

Question 1

Olecranon bursa

Answer 1

Lies between olecranon process & skin

Question 2

Elbow muscles

Answer 2

Biceps brachii; Brachialis; Brachioradialis; Triceps brachii; Anconeus; Supinator; Pronator teres; Pronator quadratus

Question 3

Biceps brachii innervation

Answer 3

Musculocutaneous

Question 4

Brachialis innervation

Answer 4

Musculocutaneous

Question 5

Brachioradialis innervation

Answer 5

Radial

Question 6

Triceps brachii innervation

Answer 6

Radial

Question 7

Anconeus innervation

Answer 7

Radial

Question 8

Supinator innervation

Answer 8

Radial

Question 9

Pronator teres innervation

Answer 9

Median

Question 10

Pronator quadratus innervation

Answer 10

Median

Question 11

Pronator teres - Location & origin

Answer 11

Proximal; medial origin

Question 12

Pronator quadratus - Location & origin

Answer 12

Distal; medial origin

Question 13

Supinator - Location & origin

Answer 13

Proximal; lateral origin

Question 14

Elbow flexors

Answer 14

Biceps brachii; Brachialis; Brachioradialis

Question 15

Elbow extensors

Answer 15

Triceps brachii; Anconeus

Question 16

Pronators

Answer 16

Pronator teres; Pronator quadratus

Question 17

Supinators

Answer 17

Biceps brachii; Supinator

Question 18

Specific history questions for elbow

Answer 18

Heavy lifting; fall on olecranon

Question 19

Gunstock deformity

Answer 19

Varus angulation of elbow

Question 20

MCL test

Answer 20

Apply valgus stress; (+) = Pain and laxity of MCL

Question 21

LCL test

Answer 21

Apply varus stress; (+) = Pain and laxity of LCL

Question 22

Annular ligment test

Answer 22

Passively pronate & supinate arm > pain; place hand around radial head to stabilize; passively pronate & supinate; (+) = pain disappears with pressure

Question 23

Tennis Elbow Test

Answer 23

Elbow at 90; ask patient to extend wrist & hold; apply resistance; (+) = Pain at lateral epicondyle

Question 24

Lateral epicondylitis

Answer 24

Tennis elbow; tendonitis of wrist extensors;

Question 25

Lateral epicondylitis - S/Sx

Answer 25

S/Sx = pain at lateral epicondyle; DECREASED GRIP STRENGTH; LIFTING GALLON OF MILK PAINFUL

Question 26

Lateral epicondylitis - Mechanism

Answer 26

Overuse of wrist extension

Question 27

Cozen's test

Answer 27

Elbow at 90; passively flex wrist & radially deviate and hold in position; ask pt to actively extend elbow while provider holds wrist in place; (+) = pain at lateral epicondyle

Question 28

Tests for Tennis Elbow/Lateral Epicondylitis

Answer 28

Tennis elbow test; Cozen's Test

Question 29

Common Elbow Fractures

Answer 29

Distal humerus; Proximal ulna; Proximal radius

Question 30

Potential complications of elbow fractures

Answer 30

Damage to brachial a. and/or Median n.

Question 31

Common elbow contusions

Answer 31

Olecranon process (most common); Lateral condyle; Radial head (defensive wound); Biceps & triceps; ulnar n.

Question 32

Elbow dislocation vs. subluxation

Answer 32

Will dislocate but will not sublux

Question 33

Posterior Elbow dislocation - mechanism

Answer 33

Blow to anterior forearm of flexed elbow (posterior dislocation)

Question 34

Anterior Elbow dislocation - mechanism

Answer 34

Blow to posterior upper arm of flexed elbow

Question 35

MCL sprain

Answer 35

Most common elbow lig sprain

Question 36

MCL sprain - mechanism

Answer 36

Mechanism = Hyperextension (FALLING BACKWARD ON OUTSTRETCHED ARM); VALGUS STRESS (BASEBALL PITCHER); hit from outside

Question 37

MCL sprain - S/Sx

Answer 37

S/Sx = Pain, edema, point tenderness; (+) = Valgus stress test

Question 38

LCL Sprain - Mechanism

Answer 38

Mechanism = Hyperextension; Hit from inside

Question 39

LCL Sprain - S/Sx

Answer 39

S/Sx = More edema than MCL; point tender; (+) Varus stress test

Question 40

Annular ligment sprain - Mechanism

Answer 40

Mechanism = Falling on outstretched arm sending force up arm & causing joint to split apart

Question 41

Annular ligament sprain - S/Sx

Answer 41

S/Sx = pain around radial head; edema; MORE COMMON IN KIDS & ELDERLY

Question 42

Radial Head dislocation - Mechanism

Answer 42

Mechanism = Falling on outstretched arm sending force up arm & causing joint to split apart

Question 43

Olecranon bursitis - Mechanism

Answer 43

Mechanism = Fall on flexed elbow (most common); direct blow; Studying on elbow; high recurrence rate

Question 44

Olecranon bursitis - S/Sx

Answer 44

S/Sx = Golfball or baseball size edema; pain possible; calcifications may develop

Question 45

Medial Epicondylitis

Answer 45

Golfer's elbow; tendonitis of wrist flexors; less common than tennis elbow

Question 46

Ulnar Compression Syndrome

Answer 46

Inflammed ulnar nerve

Question 47

Ulnar Compression Syndrome - S/Sx

Answer 47

Pain, numbness, tingling along medial (ulnar) aspect of lower forearm & hand; (+) Tinel sign at ulnar n.

Question 48

Anterior Interosseous Nerve Syndrome

Answer 48

Branch of median n. passing between heads of pronator teres

Question 49

Anterior Interosseous Nerve Syndrome - S/Sx

Answer 49

Paralysis of flexors of index finger & thumb; (+) = Pinch test