Elbow Flashcards
70* of flexion and 10* supination is ____ position for what joint?
resting position for HU jt
Full extension & supination is closed pack position for what joint?
closed pack for HU jt
Full extension & supination is ___ position for the humeroradial joint?
resting position
What is closed pack position for the humeroradial AND proximal radioulnar jts?
5* supination
What is resting position for the proximal radioulnar joint?
35* supination, 70* flexion
What are the expected aROM for the elbow?
140-150* flexion
0-10* extension
90* supination
80-90* pronation
What is the expected end feel for flexion, and then extension, of the elbow?
flexion: soft tissue approximation
extension: bony end feel
What is expected end feel for supination and pronation of the forearm?
supination: firm/capsular
pronation: hard/bony
Excessive cubitus valgus would be greater than… and cubitus varus would measure….
30*
-5* medially
Closed pack position for the humeroulnar joint is resting position for the ___ joint.
humeroradial
The humeroradial joint and the proximal radioulnar joint have what in common?
closed pack position (5* supination)
Intra-articular swelling at the elbow is usually most apparent between the…
lateral epicondyle, radial head and olecranon
Medial epicondylitis primarily involves which muscles?
pronator teres, FCR
also sometimes PL, FCU, FDS
When does lateral epicondylitis usually show up?
24-72 hours - insidiously after an unaccustomed activity
very commonly related to knitting or cashier work
Which muscle is most commonly injured related to lateral epicondylitis?
ECRB
What is: usually a spiral fracture of the radial shaft at the RUJ, possibly with ulnar nerve lesion
Galeazzi fracture
What is: fracture of the ulna with associated dislocation of the radial head, usually d/t a direct blow to the anterior forearm
Monteggia fracture
Where is the Arcade of Frohse?
fibrous band between the two heads of the supinator muscle
What causes the monkey/ape hand deformity? What is it?
Impingement of median nerve
Wasting of thenar eminence (thumb falls back in line with fingers), inability to abduct or oppose thumb
Where is Guyon’s canal? What runs through it?
between pisiform and the hook of Hamate
ulnar nerve
Claw hand deformity would be a consequence of ____ nerve compression, which commonly occurs either in the ____ or _____.
ulnar nerve
cubital tunnel or Guyon’s canal
What is the ligament of Struthers?
band of connective tissue extending from the humerus to the supracondylar ridge that increases likelihood of median nerve compression
Normal carrying angle for men is between __-__, normal carrying angle for women is usually __-__
males: 5-10*
females: 10-15*
Describe a gunstock deformity
Elbow carrying angle becomes -15* (hand is more medial - increased varum)
What homecare would you recommend for olecranon bursitis?
avoid the area
ice/cold compress
educate on activities that may irritate the bursa
What is Nursemaid’s Elbow? What ligament does it challenge?
dislocation of the radial head due to a traction injury
the oblique ligament
What would you use to differentiate between ligament sprains of the elbow vs. other pathologies?
ligament stress tests
What is a Galeazzi fracture?
fracture of the radial shaft at the radioulnar joint usually d/t FOOSh injury
may also involve ulnar nerve lesion
What is a Monteggia fracture? What is the usual MOI?
fracture of the ulna with associated anterior dislocation of the radial head and possible wrist injury
direct blow to forearm
What are possible sites of entrapment for the radial nerve?
supinator
Arcade of Frohse (supinator arch)
What sites can the median nerve become entrapped?
pronator teres syndrome
ligament of Struthers (in 1% of population, increasing risk of median nerve impingement)
With traction injuries, ensure you consider ____. With FOOSH injuries, ensure you consider _____.
traction: ligaments!
FOOSH: olecranon, trochlea/trochlear notch, radial head/capitulum
What is Little Leaguers’ Elbow?
What is usually affected?
Repetitive strain injury to medial epicondyle (m/c in children)
If a ‘pop’ felt in throw: ulnar collateral ligament
Pop & weakness in elbow: distal biceps strain/rupture
What are the boundaries of the cubital fossa?
pronator teres
brachioradialis
an imaginary line crossing between both epicondyles
Where is the dermatome for C7?
middle finger
