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Musculoskeletal Pathophysiology > Elbow > Flashcards

Elbow Flashcards

1
Q

When are the Radius and ulna farthest from each other?

A

During supination

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2
Q

Which bone of the forearm extends more distally?

A

The Radius. Creates ulnar variance or the tendency for the hand to deviate towards the ulnar side

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3
Q

RA causes a diffuse thickening of what structures?

A

Synovium

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4
Q

What two things can develop with RA?

A

Flexion contracture

Ligamentous laxity causing instability

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5
Q

When is a total elbow replacement most commonly performed?

A

For severe RA

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6
Q

How is OA usually treated?

A

Arthroscopically

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7
Q

Why are total elbow replacements not typically done?

A

Hard to mimic the multidirectional movement at the the elbow

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8
Q

What is OA seen with?

A

an end result of trauma, sports injuries or in heavy laborers

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9
Q

What are osteophytes?

A

Bone spurs/growths

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10
Q

What happens to the joint space with OA?

A

Narrows

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11
Q

What can happen to elbow extension with OA and why?

A

You will loose terminal extension due to flexion contractures

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12
Q

What are two treatments of severe OA?

A

Arthroscopic capsular release

Arthroscopic removal of osteophytes and/or loose bodies

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13
Q

Which muscle is usually the biggest culprit in Lateral Epicondylitis?

A

ECRB

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14
Q

In what patients is Lateral Epicondylitis most common in?

A

THose >35 yrs who participate in racquet sports or occupations such as carpentry, painting etc.

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15
Q

What are some common signs/symptoms of Lateral Epicondylitis?

A

pain with grip especially elbow extended, no loss of ROM

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16
Q

What is done surgically if there is no success with a conservative program for lateral epicondylitis?

A

Surgical release of the common extensor tendon

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17
Q

What is another name for lateral epicondylitis?

A

Tennis elbow

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18
Q

What is the prescription for Medial Epicondylitis?

A

same as that for lateral epicondylitis

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19
Q

What is triceps tendonitis usually secondary to?

A

Sudden stress with elbow extended fully

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20
Q

When will someone experience pain with triceps tendonitis?

A

pain at insertion to olecranon with resisted elbow extension and passive elbow flexion

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21
Q

How would you describe an olecranon Bursitis?

A

Very boggy, hot, swollen, posterior elbow

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22
Q

How can you get an olecranon bursitis?

A

Trauma, gout, or often from prolonged pressure on the olecranon.

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23
Q

What is the Rx for Olecranon bursitis?

A

rest, NSAIDS, may require cortisone injection

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24
Q

What ligament is compromised with a valgus stress?

A

MCL

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25
Q

What ligament is stressed with a Varus stress?

A

LCL

26
Q

Where does the biceps tendon usually rupture?

A

At the musculotendinous or tendoperiosteal juncture

27
Q

What is a conservative treatment for a Biceps tendon rupture?

A

Treated with a Velpeau bandage in 90 degree flexion for 3-6 weeks

28
Q

What is a surgical treatment for a biceps tendon?

A

Repaired with sutures

29
Q

In adolescent sport injuries, what is the cause of medial joint injuries?

A

Traction or tensile force injuries of/at flexor forearm group

30
Q

In adolescent sport injuries, what is the cause of Lateral joint injuries?

A

compression forces on the lateral joint

31
Q

What is traction apophysitis also known as?

A

Little leaguers elbow, due to excessive throwing

32
Q

What happens with traction apophysitis?

A

inflammation with/without micro tears of the wrist flexors at their insertion

33
Q

What are some signs of traction apophysitis?

A

tenderness at medial elbow, 15 degree loss of extension ROM

34
Q

What are some treatments from traction apophysitis?

A

REST!!!!! strengthening as symptoms subside

35
Q

What is an avulsion fracture of the medial epicondyle usually secondary to?

A

more forceful valgus stress from a fall or violent muscle contraction

36
Q

When do you use conservative treatment vs. surgery with an avulsion fx of the medial epicondyle?

A

1 cm ORIF with K wire

37
Q

What is osteochondritis Dessicans?

A

Piece of the Capitillum comes off the ulna

38
Q

What is osteochondritis Dessicans often secondary to?

A

trauma or avascularity

39
Q

What is the treatment for osteochondritis Dessicans?

A

Arthroscopy if there is a loose body

40
Q

What on an X-ray can be a sign of trauma?

A

Whiteness - sign of effusion

41
Q

What is a distal humerus fx usually 2ndary to?

A

FOOSH, especially in younger pts

42
Q

Whats the difference between an intra-articular and extra-articular distal humerus fx?

A

extra-articular fx’s heal better due to blood supply

43
Q

How can extra-articular distal humerus fx’s be treated?

A

Closed reduction

44
Q

What is an extension supracondylar fx?

A

distal fragment of the humerus travels posteriorly

45
Q

What is a flexion supracondylar fracture?

A

distal fragment of the humerus travels anterior

46
Q

How do they repair an intercondylar Fx?

A

with tension band wiring

47
Q

what type of fx accounts for about 50% of fxs at the elbow?

A

radial head fxs

48
Q

Wht will a radial head fx do to the radio-ulnar length?

A

can shorten radius (normally longer)

can cause sxs at wrist

49
Q

What direction are 80% of the Adult elbow dislocations?

A

posterior

50
Q

How do radial head fxs usually occur?

A

FOOSH

51
Q

What is a Monteggia Fracture?

A

Fx of proximal 1/2-1/3 of ulna with radial head dislocation

52
Q

What is a Galleazi Fracture?

A

Fx of mid to distal RADIAL shaft with subluxation of distal RU joint

53
Q

What is cubital Tunnel syndrome?

A

Ulnar nerve compression within ulnar nerve tunnel at bedial elbow

54
Q

What is anterior interosseous syndrome?

A

Median Nerve compression under the pronator teres

55
Q

What is posterior interroseous syndrome?

A

RADIAL nerve compression under the supinator and arcade of Frohse

56
Q

What is myositis ossificans?

A

Ossified inflammatory tissue within muscles, commonly occurs after a brachialis injury where bleeding occurs

57
Q

What should you avoid with Myositis ossificans?

A

No vigorous stretching, no US, no massage

58
Q

What is Volkmann’s Ischemic contracture?

A

following injury to brachial artery leading to ischemia of muscle and nerves in forearm

59
Q

What is Volkmann’s Ischemic contracture associated with?

A

Supracondylar fracture, which are more common in younger patients

60
Q

What happens if treatment is not gotten w/in 4-6 hours?

A

irreversible damage

61
Q

What are signs and symptoms of Volkmann’s ischemic contracture?

A 
severe pain in forearm muscle groups
 limited and very painful finger motion 
purple hand color with prominent hand veins 
initial paresthesiae, 
eventual sensory loss
loss of radial pulse
pallor
eventual paralysis if not treated

Musculoskeletal Pathophysiology (14 decks)

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