5. Elbow Flashcards
Olecranon bursa
Lies between olecranon process & skin
Elbow muscles
Biceps brachii; Brachialis; Brachioradialis; Triceps brachii; Anconeus; Supinator; Pronator teres; Pronator quadratus
Biceps brachii innervation
Musculocutaneous
Brachialis innervation
Musculocutaneous
Brachioradialis innervation
Radial
Triceps brachii innervation
Radial
Anconeus innervation
Radial
Supinator innervation
Radial
Pronator teres innervation
Median
Pronator quadratus innervation
Median
Pronator teres - Location & origin
Proximal; medial origin
Pronator quadratus - Location & origin
Distal; medial origin
Supinator - Location & origin
Proximal; lateral origin
Elbow flexors
Biceps brachii; Brachialis; Brachioradialis
Elbow extensors
Triceps brachii; Anconeus
Pronators
Pronator teres; Pronator quadratus
Supinators
Biceps brachii; Supinator
Specific history questions for elbow
Heavy lifting; fall on olecranon
Gunstock deformity
Varus angulation of elbow
MCL test
Apply valgus stress; (+) = Pain and laxity of MCL
LCL test
Apply varus stress; (+) = Pain and laxity of LCL
Annular ligment test
Passively pronate & supinate arm > pain; place hand around radial head to stabilize; passively pronate & supinate; (+) = pain disappears with pressure
Tennis Elbow Test
Elbow at 90; ask patient to extend wrist & hold; apply resistance; (+) = Pain at lateral epicondyle
Lateral epicondylitis
Tennis elbow; tendonitis of wrist extensors;
Lateral epicondylitis - S/Sx
S/Sx = pain at lateral epicondyle; DECREASED GRIP STRENGTH; LIFTING GALLON OF MILK PAINFUL
Lateral epicondylitis - Mechanism
Overuse of wrist extension
Cozen’s test
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
Tests for Tennis Elbow/Lateral Epicondylitis
Tennis elbow test; Cozen’s Test
Common Elbow Fractures
Distal humerus; Proximal ulna; Proximal radius
Potential complications of elbow fractures
Damage to brachial a. and/or Median n.
Common elbow contusions
Olecranon process (most common); Lateral condyle; Radial head (defensive wound); Biceps & triceps; ulnar n.
Elbow dislocation vs. subluxation
Will dislocate but will not sublux
Posterior Elbow dislocation - mechanism
Blow to anterior forearm of flexed elbow (posterior dislocation)
Anterior Elbow dislocation - mechanism
Blow to posterior upper arm of flexed elbow
MCL sprain
Most common elbow lig sprain
MCL sprain - mechanism
Mechanism = Hyperextension (FALLING BACKWARD ON OUTSTRETCHED ARM); VALGUS STRESS (BASEBALL PITCHER); hit from outside
MCL sprain - S/Sx
S/Sx = Pain, edema, point tenderness; (+) = Valgus stress test
LCL Sprain - Mechanism
Mechanism = Hyperextension; Hit from inside
LCL Sprain - S/Sx
S/Sx = More edema than MCL; point tender; (+) Varus stress test
Annular ligment sprain - Mechanism
Mechanism = Falling on outstretched arm sending force up arm & causing joint to split apart
Annular ligament sprain - S/Sx
S/Sx = pain around radial head; edema; MORE COMMON IN KIDS & ELDERLY
Radial Head dislocation - Mechanism
Mechanism = Falling on outstretched arm sending force up arm & causing joint to split apart
Olecranon bursitis - Mechanism
Mechanism = Fall on flexed elbow (most common); direct blow; Studying on elbow; high recurrence rate
Olecranon bursitis - S/Sx
S/Sx = Golfball or baseball size edema; pain possible; calcifications may develop
Medial Epicondylitis
Golfer’s elbow; tendonitis of wrist flexors; less common than tennis elbow
Ulnar Compression Syndrome
Inflammed ulnar nerve
Ulnar Compression Syndrome - S/Sx
Pain, numbness, tingling along medial (ulnar) aspect of lower forearm & hand; (+) Tinel sign at ulnar n.
Anterior Interosseous Nerve Syndrome
Branch of median n. passing between heads of pronator teres
Anterior Interosseous Nerve Syndrome - S/Sx
Paralysis of flexors of index finger & thumb; (+) = Pinch test
