Block 1_Elbow

Question 1

What is the order of an elbow exam?

Answer 1

1. General observatory exam
   
   1. Include carrying angle of elbow
2. Lesions, rashes, etc. of elbow
3. Palpation (looking for TART) - BILATERAL!
   
   1. Biceps (move to side for brachialis)
   2. Medial and lateral epicondyles
   3. Olecrenon process
   4. Radial head
   5. Supinator tender point
   6. Pronator tender point
   7. Flexor and extendor compartment (medial and lateral sides of arm)
   8. Distal brachial pulse (just above elbow)
   9. Lymph nodes (posterior aspect of elbow)
   10. Look at venous patterns/disfunction
4. Peripheral Nerve Distribution
   
   1. Inferior lateral nerve to arm
   2. Medial cutaneous nerve to arm
   3. Lateral cutaneous nerve of forearm
   4. Medial cutaneous nerve of forearm
5. ROM (active, passive, strength)
   
   1. Flexion
   2. Extension
   3. Pronation (make fist)
   4. Supination (make fist)

Question 2

What things should be palpated as part of an elbow exam?

Answer 2

1. Biceps (move to side for brachialis)
2. Medial and lateral epicondyles
3. Olecrenon process
4. Radial head
5. Supinator tender point
6. Pronator tender point
7. Flexor and extendor compartment (medial and lateral sides of arm)
8. Distal brachial pulse (just above elbow)
9. Lymph nodes (posterior aspect of elbow)
10. Look at venous patterns/disfunction

Question 3

What are the peripheral nerve distributions to the elbow?

Answer 3

1. Inferior lateral nerve to arm
2. Medial cutaneous nerve to arm
3. Lateral cutaneous nerve of forearm
4. Medial cutaneous nerve of forearm

Question 4

What actions can the elbow do?

Answer 4

• Flexion
• Extension
• Pronation
• Supination

Question 5

Is an anterior fat pad normal or pathologic?

Question 6

Is a posterior fat pad normal or pathologic?

Answer 6

Pathologic.

Question 7

What happens in nursemaid’s elbow? What is the clinical term?

Answer 7

Sudden pulling of the upper limb tears the distal attachment of the anular ligament where it is loosely attached to the radius. Radial head moves distally partially out of the socket formed by the anular ligament. Clinically called subluxation and dislocation of radial head.