Elbow Flashcards
Elbow flexion = ? degrees
150
Elbow extension = ? degrees
0
What is the degree of forearm supination?
80 degrees
T or F
Forearm supination and pronation are not the same degrees
False
80 degrees for both
T or F
Medial Collateral Ligament test is an adduction stress test
False!
Abduction stress test
LCL = adduction stress test
Name the Elbow special tests
Medial Collateral Ligament Test Lateral Collateral Ligamet Test Tinel Elbow Sign Cozen Test Mills Test aka Evans Maneuver Golfers Elbow Test
What + tests indicate Lateral Epicondylitis?
Cozen Test
Mills Test
T or F
Golfer’s elbow test indicates if + Neuroma of the ulnar nerve
False!
Tinel Elbow indicates neuroma of ulnar nerve
Golfer’s elbow = medial epicondylitis
What is the common name given to Lateral Epicondylitis
Tennis Elbow
Instructions for Medial Collateral Ligament Test
Patient Seated
Examiner stabilizes the lateral aspect of the arm and places an abduction (valgus) pressure on the medial forearm
+ MCL test indicates?
medial collateral ligament instability
Instruction for the Lateral Collateral Ligament Test
Patient Seated
Examiner stabilizes the medial aspect of the arm and places an adduction (varus) pressure on the patients lateral forearm
Instruction for Tinel Elbow Sign
Patient Seated
With a Taylor reflex hammer, examiner taps over the groove between the medial epicondyles and the olecranon process.
+ Tinel Elbow = ?
Pain at the site being tapped and paresthesia in the ulnar nerve distraction area (fingers 4,5)
+ Tinel Elbow indicates?
Neuroma of the ulnar nerve
Instructions for Cozen Test
Patient Seated
Examiner instructs patient to make a fist and place wrist into extension.
Examiner instructs patient to resist as examiner tries to push extended wrist into flexion.
What is a positive Cozen Test
Pain over the lateral epicondyle
What is a confirmation test that can be done if you suspect a + Cozen test?
Mills Test
Instructions for Mills Test
Patient Seated
Forearm supinated
Ina smooth continuous motion the DC passively maximally flexes the patient’s fingers and wrist. While maintaining wrist and finger flexion, the DC passively extends the patient’s elbow (the forearm is now pronated)
+ Mills Test = ?
Pain over the lateral epicondyle
Instruction for Golfer Elbow Test
Patient Seated
Examiner instructs patient to extend the elbow and supinate hand. Examiner instructs patient to flex the wrist against resistance.
What is the median nerve distribution?
The radial portion of the palm and the palmar surfaces of the thumb, 2nd and 3rd and lateral 1/2 of the 4th digit.
+ for Tinel Wrist Sign
Reproduction of pain, tenderness, and/or parasthesia in the median nerve distribution (thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit)
Indicator for Tinel Wrist Sign
Median Neuritis, possibly Carpal Tunnel Syndrome
What are some confirmation tests for Tinel Wrist Sign
Phalen Test
Reverse Phalen Test
Nerve Conduction Test
+ for Phalen Sign & Reverse Phalen Sign
Reproduction of pain, tenderness, and/or parasthesia in the median nerve distribution (thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit)
What does a + Phalen or Reverse Phalen Indicate?
Median Neuritis, possibly Carpal Tunnel Syndrome
How long must your patient hold Phalen or Reverse Phalen Sign?
Until point of pain or 60 seconds
+ Finkelstein Test
Pain distal to the radial styloid process
+ Finkelstein indicates?
Stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis braves tendons (DeQuervain’s Disease)
T or F
you could do Phalen’s Sign to confirm a + Finkelstein Test
False!
Blood Testing
MRI
Why would you do Bunnel-Littler Test
Patient presents with difficulty flexing the PIP
+ Bunnel-Littler Test
- Flexion of the proximal interphalangeal joint cannot be achieved
- Flexion of the proximal interphalangeal joint is achieved
Indicators for a + Bunnel-Littler Test
- Joint capsule contracture
2. Tight intrinsic muscles
T or F
For the Reticular Test - patient presents with difficulty flexing the PIP
False
DIP
+ Retinacular Test
- Flexion of the distal interphalangeal joint cannot be achieved
- Flexion of the distal interphalangeal joint is achieved
+ Retinacular Test indicates?
- Joint Capsule Contracture
2. Tight Retinacular Ligament
+ Allen Test
A delay of more than 10 seconds (Evans 5 sec.) in returning a reddish colour to the hand.
What does a + Allen Test indicate?
Radial or Ulnar artery insufficiency.
T or F
The artery being occluded in Allen Test is NOT the artery being tested.
True
+ Tinel Wrist Sign
Reproduction of pain, tenderness and/or paresthesia in the MEDIAN nerve distribution (thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit.
What does a + Tinel Wrist Sign indicate?
Median neuritis, possibly carpal tunnel syndrome
Reproduction of pain and/or paresthesia in the median nerve distribution area is a positive for what wrist special tests?
Tinel Wrist
Phalen Sign
Reverse Phalen Sign
What does a + Phalen and Reverse Phalen indicate?
Median Neuritis, possibly Carpal Tunnel Syndrome
+ Finkelstein Test
Pain DISTAL to the radial styloid process.
What is the primary function of the elbow complex?
To work with the shoulder to position the hand in space.
Name the 3 distinct elbow complex articulations
The humeroulnar joint
The humeroradial joint
The proximal radioulnar joint
T or F
When the elbow is flexed the points at the olecranon and the medial & lateral epicondyles lie in a straight line
False
That is when the elbow is EXTENDED
What shape do the olecranon and medial and lateral condyles form in flexion?
Isoceles Triangle
What type of Monteggia Fracture occurs 60% of the time?
Type 1
T or F
The Humeroulnar Joint is biaxial
False
Uniaxial
What is the approximate degree of carrying angle in women and in men?
Women = 13-16 degrees Men = 11-14 degrees
The carrying angle is formed by?
The hand and the elbow
What is the resting, or open packed position for the humeroulnar joint?
70 degrees of flexion with 10 degrees of forearm supination
T or F
Fractures of the lateral condyle represent 15-17% of paediatric elbow fractures
True
MOI for most lateral epicondylar fractures is?
When a VARUS force is applied to the elbow, causing the extensor muscles and lateral collateral ligament to avulse the lateral condyle.
A decrease in the carrying angle is known as?
Cubital Varus
An aka for Cubital Varus?
Gunstock Deformity
What is the MOI for a gunstock deformity?
Trauma - supracondylar fracture
What is the least common elbow fracture in children according to Rogers?
I dunno who the fuck Rogers is but apparently he says medial epicondylar 10%
T or F
The majority of supracondylar fractures are extension injuries and are due to a fall on an outstretched arm
True
What is the primary cause of Cubitus Varus
Primarily to alignment of the fracture at the time that it is set rather than to epiphyseal injury.
T or F
The Humeroradial joint is between the trochlea of the humerus and the concave head of the radius
False moihahahaha
Between the capitellum of the humerus and the concave head of the radius.
What type of joint is the proximal (superior) radioulnar joint?
Uniaxial pivot joint
What is the resting, or open packed position for the proximal radioulnar joint?
70 degrees of flexion and 35 degrees of forearm supination
T or F
The closed packed position for the Proximal Radioulnar Joint is 10 degrees of forearm supination
False
5 degrees
What ligament forms 80% of the articular surface of the proximal radioulnar joint?
Annular Ligament
What is the function of the Annular Ligament
To maintain the relationship between the head of the radius and the humerus and ulna
Pulled elbow aka ________ __________
Nursemaids Elbow
MOI of a pulled elbow?
The result of a sudden pull on the hand of a child ages 2-5 by an impatient adult. The lesion is due to the radial head slipping out from under the annular ligament, trapping the ligament in the radiohumeral articulation.
