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Sports Medicine > Elbow and Arm > Flashcards

Elbow and Arm Flashcards

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1
Q

what is the treatment for a low grade distal biceps tendon tear/ partial tear?

A

rest and activity modification

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2
Q

what is pronator syndrome?

A

median nerve entrapment at the elbow

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3
Q

how is pronator syndrome differentiated from carpal tunnel syndrome?

A

decreased sensation over the thenar eminence in the palmar cutaneous branch of the median nerve

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4
Q

a pronator compression test reproduces pain/tingling in the radial fingers. what is the lesion?

A

pronator syndrome - median nerve entrapment at the elbow

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5
Q

a patient experiences volar arm pain and radial digit pain with resisted flexion of the PIP joint of the middle finger. what does this cause compression of? what is the condition?

A

compression of the FDS heads ; pronator syndrome

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6
Q

a patient with history of FOOSH has a flake sign on XR of the elbow. what is this and what does it signify?

A

small bony avulsion fragment from the olecranon - pathognomonic for triceps rupture

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7
Q

for non surgical management of low grade partial tear of the distal triceps tendon, how should the elbow be immobilized?

A

30 degrees flexion

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8
Q

what is the pathophysiology of valgus extension overload?

A

repetitive forceful shearing of the olecranon within its fossa causing chrondromalacia and olecranon osteophyte formation

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9
Q

physical therapy for valgus extension overload will focus on what?

A

eccentric strengthening of the wrist flexors

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10
Q

what is the management for the majority of olecranon stress fractures?

A

non surgical

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11
Q

corticosteroids may increase the risk of what when used to treat olecranon bursitis?

A

septic bursitis or skin/fat atrophy

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12
Q

t/f MRI necessarily correlates with symptoms in medial epicondylitis

A

false

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13
Q

physical therapy for how long is successful in treating 90% of cases of medial epicondylitis?

A

6-12 weeks

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14
Q

what is the roof of the cubital tunnel?

A

arcuate ligament

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15
Q

describe 4 areas of impingement of the median nerve at the elbow? (pronator syndrome)

A

ligament of struthers, lacertus fibrosus, pronator teres ulnar and humeral heads, flexor digitorum muscle

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16
Q

what nerve runs in the arcade of froshe in the posterior elbow?

A

radial nerve

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17
Q

which nerve passes beneath the arcade of struthers at the medial posterior elbow?

A

ulnar nerve

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18
Q

resisted pronation of the elbow tests function of what nerve?

A

median nerve

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19
Q

what nerve innervates the brachialis and biceps brachii?

A

musculocutaneous nerve

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20
Q

which nerve gives rise to the lateral cutaneous nerve of the forearm?

A

musculocutaneous nerve

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21
Q

the brachialis muscle inserts on what bone?

A

ulna

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22
Q

the coracobrachialis is innervated by what nerve?

A

musculocutaneous nerve

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23
Q

the brachialis is innervated by what two nerves?

A

radial nerve and musculocutaneous nerve

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24
Q

what two tendons form the conjoined tendon at the coracoid process?

A

coracobrachialis and short head of the biceps brachii

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25
Q

what are the four borders of the quadralateral / quadrangular space?

A

teres minor, teres major, long head and lateral head of the triceps

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26
Q

the posterior cutaneous nerve of the forearm arises from what nerve?

A

radial nerve

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27
Q

the posterior cutaneous nerve of the arm arises from what nerve?

A

radial nerve

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28
Q

which nerve lies between the biceps and brachialis muscles?

A

musculocutaneous nerve

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29
Q

which artery runs with the median nerve through the anteromedial arm?

A

brachial artery

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30
Q

a humerus fracture increases risk of injury to what nerve?

A

radial nerve

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31
Q

the radial nerve exits the deep space of the arm between what two muscles?

A

brachialis and brachioradialis

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32
Q

name the three muscles innervated by the musculocutaneous nerve?

A

coracobrachialis, brachialis, and biceps brachii

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33
Q

the ulnar nerve runs under the arcade of struthers onto which head of the triceps?

A

medial head

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34
Q

what branch of the radial artery can compress the radial nerve?

A

leash of Henry

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35
Q

which artery runs with the radial nerve in the spiral groove?

A

deep artery

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36
Q

the ulnar nerve can be compressed by the fascia of which muscle as a variant of cubital tunnel syndrome?

A

flexor carpi ulnaris fascia

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37
Q

what is panner’s disease?

A

osteochondrosis of capitellum

38
Q

describe the difference in how a partial or proximal tear of the elbow UCL is managed compared to a distal tear

A

partial / proximal = better non operative outcomes, can treat non operatively
distal - more likely will need surgical repair

39
Q

what is Little Leaguer’s elbow?

A

medial epicondyle stress lesions including edema, fragmentation, separation, or avulsion of the medial epicondyle apophysis

40
Q

radiograph of the elbow in a 13 yo M throwing athlete shows medial epicondyle apophyseal widening, fragmentation, avulsion. what is the condition?

A

Little Leaguer’s elbow

41
Q

for a patient with Little Leaguer’s elbow, how long should throwing be avoided for non operative treatment?

A

3 months

42
Q

for non operative treatment of Little Leaguer’s elbow, how long should immobilization last at the start of treatment?

A

1-3 weeks

43
Q

where (anatomic location) is the ulnar nerve most often compresses, resulting in cubital tunnel syndrome?

A

flexor carpi ulnaris aponeurosis

44
Q

a patient with cubital tunnel syndrome should avoid which type of muscle strengthening exercise?

A

triceps

45
Q

how effective is non operative treatment for cubital tunnel syndrome including activity modification, nighttime extension splinting, elbow pads?

A

50% effective

46
Q

what nerve entrapment can mimic lateral epicondylopathy?

A

PIN

47
Q

after 6-12 weeks of non operative treatment for lateral epicondylitis, what is the treatment success rate?

A

90%

48
Q

describe the radiocapitallear joint compression test

A

elbow in extension, axial load applied, pronation and supination will resproduce lateral elbow pain

49
Q

how is a stable (intact articular cartilage) osteochondritis dessicans lesion of the capitellum lesion treated?

A

non operative : physical therapy, activity restriction, gradual return to activities in 3-6 months

50
Q

what is another term for “radial tunnel syndrome?”

A

PIN nerve compression

51
Q

what is the most common anatomic site for radial tunnel / PIN nerve compression syndrome?

A

arcade of Frohse

52
Q

a patient has lateral elbow pain, aggravated by supination and TTP 4cm distal to the lateral epicondyle. what is the most likely condition?

A

PIN nerve compression

53
Q

what motions of the elbow and wrist should be avoided for treatment of PIN nerve compression syndrome?

A

elbow extension, pronation, and wrist flexion

54
Q

what is the success rate of non surgical management of PIN nerve compression?

A

80% over 4-8 week recovery

55
Q

what is a Monteggia fracture?

A

proximal ulnar fracture with radial head dislocation

56
Q

a patient has lateral elbow pain and feelings of instability when axial loading the elbow and supinating, such as getting out of a chair. what is the most likely diagnosis?

A

posterolateral rotary instability (PLRI)

57
Q

what condition is characterized by FOOSH injury with axial loading / forearm supination resulting in posterolateral dislocation or subluxation and injury to the lateral ligament complex of the elbow?

A

PLRI

58
Q

a patient experiences lateral elbow joint pain, recurrent effusion, locking, catching, and loss of extension of the elbow. there is lucency seen in the capitellum. what is the cause?

A

OCD

59
Q

what is the typical time for return to sport after a complete distal biceps tendon rupture?

A

4-6 months

60
Q

how would you differentiate pronator syndrome from carpal tunnel syndrome from a sensation exam?

A

in pronator syndrome, there is decreased sensation over the thenar eminence in the distribution of the palmar cutaneous branch of the median nerve

61
Q

a patient has paresthesias in the lateral three digits with resisted flexion of the middle finger PIP joint. what is the most likely diagnosis?

A

pronator syndrome

62
Q

for a partial tear of the distal triceps tendon, in what degrees of elbow flexion should a patient be immobilized for 3-4 weeks?

A

30 degrees

63
Q

which condition is characterized by pain in the medial aspect of the olecranon, exacerbated by UCL laxity, occurring in throwing athletes, resulting in chondromalacia and osteophyte formation?

A

valgus extension overload

64
Q

how long does it typically take to return to sport in an adolescent with olecranon stress fracture?

A

3-6 months

65
Q

what is the most common pathogen responsible for septic bursitis?

A

staph aureus

66
Q

what two repetitive motions of the wrist lead to medial epicondylitis?

A

pronation and wrist flexion

67
Q

what two associated conditions should be evaluated for in a patient with medial epicondylitis?

A

ulnar neuropathy and valgus instability

68
Q

t/f MRI and ultrasound do not necessarily correlate with symptoms of medial epicondylitis

A

true

69
Q

what band of the elbow UCL is the strongest and most important stabilizer of the of the medial elbow?

A

anterior band

70
Q

the moving valgus stress test and milking maneuver are provacative tests for which condition?

A

medial elbow UCL injury

71
Q

t/f proximal tears have better prognosis than distal UCL tears when treated non operatively

A

true

72
Q

for how long should medial epicondyle stress fractures be immobilized for initial management?

A

1-3 weeks

73
Q

what is the most common site of cubital tunnel syndrome?

A

FCU aponeurosis

74
Q

what nerve innervates the adductor pollicis and is assessed with the Froment test (pinch)?

A

deep branch of the ulnar nerve

75
Q

what is the Wartenberg sign regarding ulnar neuropathy?

A

involuntary abduction of the fifth finger an inability to adduct the fifth finger

76
Q

what is the number one differential diagnosis to consider for lateral epicondylopathy?

A

PIN entrapment

77
Q

t/f MRI and ultrasound do not necessarily correlate with symptoms of lateral epicondylitis

A

true

78
Q

XR of an adolescent gymnastics athlete elbow reveals radiolucency of the capitellum, flattening of the articular cartilage, and sclerotic rim. what is the diagnosis?

A

OCD of the capitellum

79
Q

a patient has TTP over the supinator arch, approximately 4cm distal to the lateral epicondyle. what is the most likely diagnosis?

A

radial tunnel syndrome/ PIN compression

80
Q

for which nerve compressive neuropathy of the elbow should prolonged elbow extension, forearm pronation and wrist flexion be avoided?

A

PIN entrapment

81
Q

what is the success rate of non operative management for PIN entrapment/ radial tunnel syndrome?

A

80% effective

82
Q

what is the typical return to sports for time for non operative treatment of proximal PIN nerve entrapment?

A

4-8 weeks

83
Q

what type of wrist splint should be used temporarily for non operative treatment of PIN nerve entrapment?

A

dorsiflexion wrist splint

84
Q

what is the name for proximal ulnar fracture with radial head dislocation?

A

Monteggia fracture

85
Q

intraarticular swelling of the elbow joint from fracture or dislocation will most like result in what radiographic sign?

A

sail sign

86
Q

t/f non displaced radial head/neck fractures are considered stable

A

true

87
Q

what condition of the elbow is a disruption of the lateral ligamentous complex leading to instability of the radiocapitellar and ulnohumeral joint

A

posterolateral rotatory instability

88
Q

a patient has a feeling of instability with axial loading of the elbow and forearm supintation, such as a catch or pop with elbow extension. what is the condition?

A

PLRI

89
Q

explain how to conduct the apprehension / pivot shift test for diagnosis of PLRI

A

valgus stress on the elbow during flexion to extension of the elbow - will notice visible shifting of the elbow

90
Q

how should you immobilize the elbow for a stable PLRI injury?

A

2 weeks in pronation at 90 degrees

91
Q
A

Sports Medicine (12 decks)

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