Elbow Flashcards

1
Q

List the muscular pathologies in the elbow?

A

Lateral epicondylitis
medial epicondylitis
Distal biceps strain/rupture

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2
Q

List the instability pathologies in the elbow?

A

medial instability (UCL)
lateral instability (RCL)

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3
Q

List the nerve compression injuries in the elbow?

A

PIN syndrome (radial)
Cubital tunnel syndrome (ulnar)
Pronator syndrome (median)

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4
Q

List the fracture pathologies in the elbow?

A

supracondylar
radial head
Intracondylar

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5
Q

List the other pathologies in the elbow?

A

osteochondritis dissecans
osteochondrosis
Myositis ossificans
olecranon bursitis

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6
Q

What do you observe in the elbow examination?

A

Carrying angle

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7
Q

What is the normal carrying angle for males and females?

A

males: 5-10*
females: 10-15*

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8
Q

What is a gun stock deformity?

A

carrying angle is in varus not valgus
Due to radial head deformity

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9
Q

What would you observe in the elbow with olecranon bursitis?

A

edema
effusion
eccymosis
erythema

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10
Q

What other pathologies must you rule out before deciding its an elbow issue?

A

C-spine
shoulder
systemic

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11
Q

What muscle stretch reflex is C5?

A

Biceps

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12
Q

What muscle stretch reflex is C6?

A

Brachioradialis

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13
Q

What muscle stretch reflex is C7?

A

Tricpes

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14
Q

What is the elbow extension test and what does it rule IN?

A

Acute elbow injury
Adults>15
Children 3-15
***Criteria for fracture

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15
Q

What criteria rules out fracture?

A

no history of trauma
injury >72 hours old
neuromuscular disease
previous limited extension

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16
Q

How do you do the elbow extension test?

A

Pt seated, shoulder flexed to 90, elbows extended
involved side has less extension than uninvolved side

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17
Q

What repeated movements can you do in the elbow?

A

open chain with flick
loaded with pt generated overpressure

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18
Q

What is the resting position for the humeroulnar joint?

A

70* elbow flexion, 10*supination

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19
Q

What is the closed pack position for the humeroulnar joint?

A

extension with supination

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20
Q

What is the capsular pattern for the elbow?

A

Flexion limitation >extension

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21
Q

What is the resting position for the radiohumeral joint?

A

full extension and full supination

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22
Q

what is the closed pack position for the radiohumeral joint?

A

elbow flexed 90, forearm supinated 5

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23
Q

What is the capsular pattern for the radiohumeral joint?

A

flexion limitation > extension> supination> pronation

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24
Q

What is the resting position of the superior radioulnar joint?

A

flexion 70, supination 35,

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25
Q

Closed pack position for superior radioulnar joint?

A

5* supination

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26
Q

Capsular pattern for superior radioulnar joint?

A

equal limitation of supination and pronation

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27
Q

Humeroulnar/ humeroradial joint flexion arthrokinematics?

A

anterior roll, anterior slide

28
Q

humeroulnar/ humeroradial joint extension arthrokinematics?

A

posterior roll, posterior slide

29
Q

Proximal radioulnar joint pronation arthrokinematics?

A

anterior roll, posterior slide

30
Q

Proximal radioulnar joint supination arthrokinematics?

A

posterior roll, anterior slide

31
Q

What structures resist valgus stress? (@ 0* elbow extension)

A

Anterior capsule, Ulnar collateral, bony articulation

32
Q

What structures resist valgus stress (@90* elbow extension)

A

Ulnar collateral ligament (54%), bony articulation, anterior capsule

33
Q

What structures resist varus stress?

A

Bony articulation (75%) anterior capsule, radial collateral lig

34
Q

What structures resist distraction @ 0* elbow extension?

A

Anterior capsule (70%)
Ulnar collateral (5%)

35
Q

What structures resist distraction @ 90* elbow extension

A

Mostly primary resistance (UCL)
Minimal resistance (anterior capsule)

36
Q

If a patient has lateral elbow pain how do you assess grip strength?

A

loss of strength will be more apparent with elbow extension

37
Q

Nerve affected in pronator teres?

A

Median n.

38
Q

What nerve is affected in Cubital tunnel syndrome?

A

ulnar n.

39
Q

what nerve is affected in PIN syndroms?

A

Radial n.

40
Q

Diagnostic tests for lateral epicondylitis?

A

Cozens test
Mills test
maudsley test
Pain w/ palpation @ lateral epicondyle

41
Q

Differential diagnosis for lateral epicondylitis?

A

Cervical radiculopathy
PIN

42
Q

Diagnostic cluster for medial epicondylitis?

A

pain with wrist flexion
pain with stretch of wrist flexion
golfers elbow test
pain with palpation of medial epicondyle

43
Q

Differential diagnosis for medial epicondylitis?

A

cervical radiculopathy
Pronator teres syndrome

44
Q

How do you test median nerve pathology?

A

pronator teres test

45
Q

How do you test for ulnar nerve pathology?

A

elbow flexion test
Tinels test

46
Q

How do you test for radial nerve pathology?

A

ULTT
palpation

47
Q

If median nerve is affected what the potential diagnosis?

A

pronator teres
carpal tunnel
anterior interosseous
C6,C7 radiculopathy

48
Q

If ulnar nerve is affected what is the potential diagnosis?

A

Cubital tunnel syndrome
Ulnar Tunnel syndrome
C8-T1 radiculopathy

49
Q

If radial nerve is affected what is the potential diagnosis?

A

PIN
Posterior interosseous
lateral epicondylitis
Cervical radiculopathy

50
Q

Special tests for UCL sprain?

A

valgus stress test
moving valgus stress test

51
Q

Special tests for RCL sprain?

A

varus stress test

52
Q

Special tests for PLRI?

A

pivot shift test

53
Q

Intervention for Lateral epicondylitis?

A

Rest
Mobility: MWM, neuro, tooling
Strength: eccentric, Scapular stability, RC strength
Bracing

54
Q

Intervention for UCL sprain?

A

Rest
Modalities
Increase pain free ROM first
@ 8 weeks: strengthen (throwers ten)
Throwing progression

55
Q

What is the triangle sign?

A

screen for fracture
Usually have elbow flexed

56
Q

What movements are involved in C6 myotome?

A

elbow flexion, wrist extension

57
Q

What movements are involved in C7 myotome?

A

Elbow extension, wrist flexion

58
Q

Your patient is osteoporotic and suffers from a FOOSH, what is the most common fracture location?

A

distal radius and humerus

59
Q

Normal ROM for flexion?

A

130*

60
Q

Normal ROM for extension?

A

10*

61
Q

Normal ROM for pronation?

A

80*

62
Q

Normal ROM for supination?

A

80*

63
Q

End feel for supination and pronation?

A

firm

64
Q

MWM with movement should result in?

A

immediate change in force output
Decreased pain
increased muscle activation

65
Q

Clinical predication rule that an individual may benefit from MWM?

A

Age<49 years
affected pain free grip strength >112 N
unaffected pain free grip strength < 336N