elbow Flashcards
list types of elbow pain
soft tissue lesions
neuropathies
Inflammatory Rheumatic Diseases
Traumatic Painful Conditions
Instabilities
Ulnar nerve impingement leads to?
cubital tunnel syndrome
Radial nerve entrapment leads to?
posterior interosseous nerve syndrome
Median nerve entrapment leads to?
pronator teres syndrome
give examples of traumatic painful conditions
Collateral ligament injury
Anterior capsule rupture
Biceps and triceps tendon rupture
give examples of instabilities
Medial instability
Posterolateral instability
It is often seen as a result of repetitive pronation and supination movements of the forearm while the elbow is in extension
it is related to which condition?
Lateral epicondylitis (Tennis Elbow)
The extensor carpi radialis brevis (ECRB) tendon begins as a ?
micro-tear at the adhesion site.
which tendons have similar microtears injuries?
Extensor carpi radialis longus (ECRL) and extensor carpi ulnaris (ECU)
Pain in the lateral epicondyle region adjacent to the inner elbow
true or false?
false, outer
Wrist and finger extension against resistance, wrist flexion with forced supination, pain increases with forced elbow extension in tennis elbow
true or false?
true
for tennis elbow:
Often spread to the forearm and shoulder
It is dependent of elbow movements and has significant limitation of motion in the elbow
true or false?
false, independent of elbow motion and has no significant limitation of motion in the elbow
what is the test for elbow tennis?
The patient’s forearm is stabilized and the fist is requested to extend the wrist.
Then, with the other hand, the wrist is flexed from the dorsal of the fist. If the patient has a tennis elbow, he / she hears a sudden and severe pain in the lateral epicondyle, the common origin of the wrist extensors
Golfer’s Elbow or Baseball pitcher is related to which epicondyle?
medial epicondyle
Medial epicondylitis is related to overuse of the extensor / supinatorr mass
true or false?
false
flexor,pronator mass
Flexor carpi radialis and pronator teres are the most affected muscles in?
medial epicondylitis
pain increases during handshakes with medial epicondylitis
true or false?
true
for medial epicondylitis is most often with 20-50 years
for lateral epicondylitis is most often with 30-50 years
true or false?
true
list location of pain with medial epicondylitis
forearm flexor face medially of the elbow
medial epicondyle by palpation
flexion of wrist versus resistance when the elbow is extended
pronation of wrist against resistance
grip strength isn’t lost in medial epicondylitis
true or false?
false, is lost
how to test medial epicondylitis?
increasing pain in the medial elbow while forearm pronation and wrist flexed
Anti-inflammatory modalities
resting
Movement protection
Strengthening
Splinting (for reducing tendon tension)
are all?
conservative treatment for medial epicondylitis
patient education and increasing muscle strength and endurance for?
POSTOPERATIVE TREATMENT for medial epicondylitis
what is the goal therapy for medial and lateral epicondylitis?
Pain reduction
Lat. Epicondylitis: Ext. Origin of muscles
Med. Epicondylitis: Flexor and pronator
Correction of chronic inflammatory process
Correction of strength and tension of the affected muscle and tendon complex
Prevention of recurrence
Resistant wrist ext.u, passive wrist flex. And pain in the palpation of the origin of the extensor muscle group. Radial tunnel symptoms can be accompanied. in?
lateral epicondylitis
Pain in the palpation of the resilient wrist flex.u, passive wrist ext.u and flexor muscle origin related to?
medial epicondylitis
what are the phases of nonoperative treatment?
acute
chronic
protection
what is the acute phase for medial epicondylitis?
1- ice: for 15-20 min with 2-3 hours for 3 days
2- immobilizer splint: for 3 weeks
3- transverse friction massage
4- restriction of pic and grip movements
5-electrical stimulation
6- iontophoresis or NSAIDS
7- AROM wrist pron and flex
exercises with hard palpation will help in ?
reducing pain
Hot before the activity, ice application after the activity
is achieved in ?
chronic period
in chronic period what can we use for analgesia?
high voltage galvanic stimulation for 20 min
Increasing and maintaining flexor force and flexibility for?
medial epicondylitis in protective period
Increasing and maintaining extensor strength and flexibility for?
lateral epicondylitis in protective period
posture and positioning training is related to?
protection period
which position and degree we splint the wrist with ulnar nerve compression?
extension between 40-60 degree
Between the deep and superficial heads of the supinator muscle
we have?
radial nerve
sign and symptoms of lateral epicondylitis is same as?
radial nerve compression
It is seen after load bearing and forced supination - pronation movements when the elbow is at full extension
it is related to?
radial nerve compression
if median nerve compressed over carpal tunnel we will focus on?
and if the median nerve is compressed in the carpal tunnel we will focus on?
over= focusing as motor and sensory treatment
in carpal tunnel= only sensory and pain
Hypoesthesia and paresthesia, diffuse pain in forearm, weakness in forearm pronation
are seen with?
median nerve compression
resistant pronated and flexed wrist increases the?
pain with median nerve compression
what are the structures of carpal tunnel syndrome?
Median nerve
flexor digitorum profondes (4 tendons)
Flexor digitorum suparfesialis (4 tendons)
Flexor pollicis longus
Pain
Paresthesia (increased by night and repetitive hand movements)
Thenar atrophy
Weakness in hand
Symptoms are reduced by shaking hands.
are symptoms of?
carpal tunnel syndrome
list the test applied for CTS
Tinel’s test
commpression tent
phalen
2-point discrimination
vibrometer
Semmes- Weinstein Monofilament
are testing?
sensory innervation
Semmes- Weinstein Monofilament test we start from green till orange.
true or false?
false, from orange till green
what is the conservative treatment of CTS?
Wrist Rest Splint
3 weeks night and day
3 weeks night
NSAIDs
Vitamin B6
Electrotherapy (Iontophoresis, US, Laser)
Exercise
Tendon gliding exercises.
Nerve gliding exercises
Patient education
Wrist extension splint
Edema control
Elevation
Compression clothes
Intermittent overhead punch
Contrast Bathroom
Scar Treatment (if)
Exercise (3-5 times a day, 10 repetitions)
Tendon gliding exercises
Nerve gliding exercises
Thumb ROM
isometric strengthening thenar and hypothenar
treatment for?
postoperative CTS
Abductor polices longus and extensor polices brevis tendons are compressed in?
De Quervain Syndrome
Swelling in the anatomical snuffbox
Decreased (CMC) abduction (ROM) of the first digit.
thickening of the extensor sheaths of the first dorsal compartment and crepitus
Weakness and paranesthesia in the hand
A provocative Finkelstein test.
in?
De Quervain Syndrome
