Elbow Flashcards
Pronator Teres Syndrome
Weakness of muscles supplied by median nerve, parasthesia to second and third digits of hand, pain w/ resisted forearm pronation and elbow flexion
Anterior Interosseous Syndrome
Weakness of pronator quadratus, unable to make “ok” sign, no sensory changes
Posterior Interosseous Syndrome
Pain increased w/ extension of middle finger against resistance, weakness of extensors of the thumb, no sensory loss, functional wrist drop, Arcade of Frohse entrapment sight
Cheralgia Parasthetica (handcuff palsy)
Parasthesia and burning pain on dorsum of hand and wrist, fingertips are spared
What motion has the greatest loss following elbow dislocation and is most difficulty to regain?
Extension
What is the most sensitive test for assessing UCL?
Moving valgus stress test
Red flags following closure by primary intention
severe pain and neurologic symptoms
Anamolous structure that can be a sight of entrapment for median nerve proximal to elbow
Ligament of Struthers
Fat Pad sign at elbow indicates:
Radiographic finding of intra-articular fracture
Most common occult elbow fractures in children:
Supracondylar fractures (ex: kid fell on outstretched arm who was in 7th grade and fractured trochlea)
Structures in cubital fossa from lateral to medial:
biceps tendon, brachial artery, median nerve
Radial Tunnel Syndrome
Entrapment sight can be Arcade of Frohse, pain over lateral humeral epicondyle, can have MILD reduced grip strength but mostly just pain, radial distribution numbness
Cubital Tunnel Syndrome
Pain in 4th/5th digits, reduced grip strength, atrophy/weakness of ulnar intrinsic in late stage, ulnar claw in late stage, Wartenburg’s and Froment’s sign
Froment’s sign
Flexion of IP of the thumb when trying to grip a piece of paper due to adductor pollicis weakness
Wartenburg’s sign
abduction of the 5th finger due to weakness of adducting palmar interosseous muscles (ulnar nerve)
a patient presents to the ED and is able to achieve full elbow extension, are radiographs necessary?
No - Elbow extension test can be used to rule out fractures – if they have full extension, you don’t need a radiograph
Where is the site that most pediatric elbow fractures occur?
Most pediatric fractures are extra-articular involving the thin bone between the coronoid fossa and olecranon fossa of the distal humerus
Difference between AIN and median nerve entrapment?
Median nerve will have sensory issues, AIN will not
Patient is sitting with elbow supported and in flexion. Wrist is passively positioned into wrist extension, radial deviation and finger flexion. The tester produces a force into wrist flexion and ulnar deviation.
Cozen’s test - lateral epicondylitis
Maudley’s test
3 rd finger resistance test for lateral epicondylitis
Handshake Test
Patient perfoms a handshake with the elbow extended and then generates force into supination. Pain is reported at lateral epicondyle. Test is repeated with the elbow flexed to 90. Pain is lessended in flexed position this indicates surgery is not needed. If its the same, surgery is indicated.
What are the 3 MOI for a radial head fracture?
Axial load to a pronated forearm
direct blow
hyperflexion
Type 1 - 4 radial fracture’s:
- Undisplaced
- Large displaces
- Comminuted
- Fx with dislocation
Patho phys of Heterotopic ossifications
osteogenic precursor cells, inducing agents and permissive enviornment
Transient physiological block caused by ichemia without Wallerian degeneration. Nerve architecture is preserved
Neuropraxia
Internal architecture of the nerve is preserved but axons are badly damaged and wallerian degeneration occurs
Axonotmesis
