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OMS Peripheral > Elbow > Flashcards

Elbow Flashcards

1
Q

What kind of joint is the elbow?

A

Synovial hinge joint

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2
Q

What are the four stabilising ligaments of the elbow?

A

1- Medial collateral ligament
2- Lateral collateral ligament
3- Radial collateral ligament
4- Annular ligament

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3
Q

What does the capitulum articulate with?

A

The radial head

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4
Q

What does the trochlea articulate with?

A

The trochlear notch of the ulna

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5
Q

What do the radial and coronoid fossae articulate with?

A

Radial fossa - radial head in full flexion

Coronoid fossa - coronoid process of the ulna in full flexion

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6
Q

What are the three fossae of the elbow?

A

1- Olecranon fossa
2- Coronoid fossa
3- Radial fossa

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7
Q

What inserts onto the radial tuberosity?

A

The biceps tendon

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8
Q

What are the ranges of the elbow?

A

Flexion - 160 degrees

Extension - 180 degrees

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9
Q

What are the end feels of the elbow?

A

Flexion - soft

Extension - hard

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10
Q

What is the nerve supply for the elbow?

A

Anteriorly - musculocutaneous, median and radial nerves
Posteriorly - ulnar and radial nerves

C5-C8

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11
Q

What kind of joint is the superior (proximal) radioulnar joint?

A

Pivot joint - pronation and supination

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12
Q

What covers the annular ligament?

A

It is covered internally by a thin layer of articular cartilage

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13
Q

What are the ranges and end feels for the radioulnar joint?

A

Pronation - 85 degrees
Supination - 90 degrees

End feel - elastic

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14
Q

What is the normal carrying angle for men and women?

A

Women - 20-25 degrees

Men - 10-15 degrees

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15
Q

What makes up the cubital fossa?

A 
Proximal border - line between both epicondyles
Medial border - Pronator terres
Lateral border - Brachioradialis
Floor - Supinator and Biceps
Roof - skin and fascia
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16
Q

What runs through the cubital fossa medially to laterally? “My Brother Throws Rad Parties”

A 
Median nerve
Brachial artery
Tendon of biceps
Radial nerve
Posterior interosseous branch of the radial nerve
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17
Q

When can the biceps supinate the elbow?

A

Only with the elbow flexed at 90 degrees, it cannot supinate with the elbow extended.

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18
Q

What arises from the supracondylar ridge?

A

1- Brachioradialis

2- Extensor carpi radialis longus (ECRL)

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19
Q

How do you make it easier to palpate the lateral epicondyle?

A

With the elbow in flexion

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20
Q

How large is the common extensor tendon?

A

The size of a patient’s pinky nail

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21
Q

What is the best way to palpate the radial head?

A

Elbow extended and slightly distal to the lateral epicondyle

22
Q

How do you identify brachioradialis?

A

With the arm in mid-pronation/supination, flex the elbow against resistance and it is on the lateral side of the forearm

23
Q

When is it easiest to palpate the medial epicondyle?

A

With the elbow in extension

24
Q

What are the common flexor muscles of the wrist?

Hand down forearm trick

A 
Thumb: Pronator teres
Index: Flexor carpi radialis
Middle: Palmaris longus
Ring: Flexor digitorum superficialis (deeper than the others and not so obvious)
Pinky: Flexor carpi ulnaris
25
Q

Where is the anterior joint line of the elbow?

A

1 cm below the elbow crease (e.g. one finger width)

26
Q

What inserts onto the olecranon process?

A

1- Triceps

2- Subcutaneous bursa

27
Q

Common conditions of the elbow based on age?

A

Young (1-4 yrs) - “pulled elbow”
Adolescents - loose bodies associated with osteochondritis dissecans
Middle aged - degenerative changes due to overuse
Elderly - degenerative OA

28
Q

What are the dermatomes that affect the elbow?

A

C5-C8 and T1

29
Q

What are the usual sites of pain in the elbow?

A

It is usually well localised unless deeper and irritable lesion, then it will spread distally. Or it is being referred from a deeper more proximal structure

30
Q

What are the common causative factors for overuse injury to the common elbow tendons?

A

1- Intrinsic overload: from the force of muscle contraction
2- Extrinsic overload: through excessive joint torque forces stressing the connective tissue, stretching and eventually disrupting it
3- A combination of both

31
Q

Which two nerves in the elbow are susceptible to muscular compression?

A

1- Posterior interosseous nerve

2- Median nerve

32
Q

What kind of swelling would be seen with an olecranon bursitis?

A

A localised, soft, boggy, fluctuating swelling over the point of the elbow

33
Q

What pathology could cause widespread symptoms along the elbow’s dermatomes?

A

Cardiac pathology

34
Q

What are the symptoms for a loose body in the elbow?

A

Hx:

  • Twinges of pain
  • Catching and/or giving way of the elbow (usually just short of elbow extension)

Objective:

  • Non-capsular pattern
  • One movement is more limited than the other
  • Springy end feel
35
Q

What is the treatment for a loose body in the elbow?

A

Grade A mobilisation under traction

36
Q

What is the treatment for olecranon bursitis?

A
  • Aspiration
  • Ice
  • NSAIDs
  • Steroid injection (in the absence of infection/sepsis)
37
Q

What is the most commonly involved tendon in tennis elbow?

A

Extensor carpi radialis brevis tendon (ECRB)

38
Q

How much more common is tennis elbow compared to golfer’s elbow?

A

5-8 times

39
Q

What is the incidence of tennis elbow? And duration?

A
  • The incidence of the condition peaks around 35-54 yrs

- Duration of an average 6 months to 2 years

40
Q

What are the objective findings for tennis elbow?

A
  • Full pain free passive range of elbow
  • Pain on resisted wrist extension
  • Tenderness over palpation of the lateral epicondyle
41
Q

What are the four possible sites of tennis elbow?

A

1- Teno-osseous junction
2- Supracondylar ridge
3- Body of the common extensor tendon
4- Muscle bellies

42
Q

What is the mechanism of tennis elbow?

A

Repeated gripping action may initially produce traction of the common extensor origin causing microtrauma and inflammation.

Micro and macroscopic tears occur at the common extensor origin, with the development of fibrous scar tissue and contracture.

Eventually calcification can occur.

43
Q

Where is the most common site for tennis elbow to occur?

A

The teno-osseous junction (90%)

44
Q

What is the treatment for tennis elbow?

A
  • Mills Manipulation
  • Friction
  • Steroid injection
  • Stretch and strengthen
45
Q

What would be a possible differential diagnosis for golfer’s elbow?

A

Ulnar neuritis - causes paraethesia, medial elbow pain, tenderness in the ulnar distribution

46
Q

What are the findings for golfer’s elbow/medial epicondylitis?

A

Hx:

  • gradual onset of pain
  • may radiate distally
  • aggravated by use of elbow and stiffens at rest
  • aggravated by throwing

Objective:
- Pain on resisted wrist flexion

47
Q

What is the treatment for golfer’s elbow?

A
  • Friction (teno-osseous or musculotendinous site)
  • Steroid injection
  • Stretch and strengthen
48
Q

What are the findings for biceps tendinopathy?

A

Objective:

  • Pain on resisted elbow flexion and supination
  • Pain on passive stretching the elbow into extension
49
Q

What are the findings for subtendinous biceps bursa?

A

Objective:

  • Pain on resisted flexion
  • Pain on passive elbow extension and pronation as it squeezes the bursa
50
Q

What is the treatment for subtendinous biceps bursitis?

A

Steroid injection

51
Q

What is the treatment for biceps tendinopathy?

A

Friction

OMS Peripheral (8 decks)

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