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Musculoskeletal > Elbow and wrist > Flashcards

Elbow and wrist Flashcards

1
Q

It is estimated that approximately __-__% of tennis players experience tennis elbow in their life.

A

40-50%

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2
Q

What muscle tendon is most affected when lateral elbow tendinopathy is present?

A

ECRB

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3
Q

Along with dysfunction of the ECRB, lateral elbow tendinopathy can result in pain/dysfunction of the ___ and ___ structures.

A

Annular ligament
LCL

*because they are all connected

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4
Q

(true/false) There is inflammation in the acute and chronic phase.

A

False (only in the acute phase)

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5
Q

What age range is most likely to experience elbow tendinopathy?

A

35-55 y/o

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6
Q

Contractile testing for elbow tendinopathy is ___ and ___ when testing elbow PROM/AROM.

A

pain-free and full

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7
Q

Contractile testing for lateral elbow tendinopathy is ___ and ___ when testing wrist FLX AROM while the elbow is EXTENDED.

A

painful and weak

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8
Q

Contractile testing for lateral elbow tendinopathy is ___ and ___ when testing Wrist FLX PROM with the elbow EXT and forearm PRON.

A

painful and weak

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9
Q

Contractile testing for lateral elbow tendinopathy is ___ and ___ when testing resisted wrist EXT and RD.

A

painful and weak

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10
Q

Contractile testing for elbow tendinopathy is ___ and ___ when testing grip strength.

A

painful and weak

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11
Q

What tests are used when lateral elbow tendinopathy is suspected?

A
  • Cozen’s Test
  • Maudsley’s test
  • Mill’s test
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12
Q

What muscle tendon is most affected with medial elbow tendinopathy?

A

FCR

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13
Q

(true/false) Those with an elbow tendinopathy have paresthesia.

A

false

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14
Q

Contractile testing for medial elbow tendinopathy is ___ and ___ when testing wrist EXT AROM while the elbow is EXTENDED.

A

painful and weak

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15
Q

Contractile testing for lateral elbow tendinopathy is ___ and ___ when testing wrist EXT PROM while the elbow is EXTENDED and SUP.

A

painful and weak

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16
Q

Contractile testing for lateral elbow tendinopathy is ___ and ___ when testing resisted wrist FLX.

A

painful and weak

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17
Q

Cervical spine referral from ___ can affect the elbow with medial elbow tendinopathy

A

C8

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18
Q

Cervical spine referral from ___ can affect the elbow with lateral elbow tendinopathy

A

C6

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19
Q

What age range are olecranon bursitis, bicipital tendinosis, and/or triceps tendinosis most commonly seen in?

A

20-50 y/o

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20
Q

Treat olecranon bursitis with ___.

A

NSAIDS

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21
Q

Where are the points of irritation when bicipital tendinosis is present?

A
  • muscle belly
  • insertion at radial tuberosity
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22
Q

What causes bicipital tendinosis?

A
  • repetitive elbow hyperEXT w/ PRON
  • repetitive elbow FLX w/ SUP
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23
Q

What causes pain when bicipital tendinosis is present?

A
  • resisted elbow FLX and SUP
  • PROM shoulder and elbow EXT
  • TTP at muscle belly or insertion
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24
Q

What causes pain when triceps tendinosis is present?

A
  • TTP at insertion on olecranon
  • PROM full elbow EXT
  • Resisted elbow EXT
25
Q

What are the causes of triceps tendinosis?

A
  • repetitive elbow EXT against resistance
  • weightlifting, gymnastics, boxing, etc
26
Q

Weakness and pain are common with resisted _____ when triceps tendinopathy is present.

A

Elbow EXT

27
Q

What causes an MCL injury?

A
  • repetitive valgus and ER forces placed on medial elbow
  • trauma and/or inflammation
28
Q

What age range is most likely to be seen with a MCL injury?

A

20-40 y/o

29
Q

Is the MCL or LCL more commonly injured?

A

MCL

30
Q

What is the cause of LCL injury?

A
  • varus force to the elbow with trauma
31
Q

What are the signs of an abducted ulna lesion?

A
  1. mechanism of injury is FOOSH
  2. increased carrying angle w/ hand positioned in slight UD
  3. decreased elbow FLX, forearm SUP, and Wrist EXT PROM w/ abnormal hard end-feel
32
Q

Why can an abducted ulna lesion cause lateral epicondylitis?

A

It results in a decrease of wrist EXT ROM

33
Q

Why can an abducted ulna lesion cause ulnar nerve injury, medial epicondylitis, and/or MCL injury?

A

The carrying angle is increased

34
Q

Why can an abducted ulna lesion cause wrist pain and dysfunction?

A

It can result in a carpal bone shift

35
Q

Cubital Tunnel syndrome is the entrapment of the ___ nerve.

A

ulnar nerve

36
Q

What is the most affected nerve around the elbow?

A

ulnar nerve

37
Q

What are the causes of cubital tunnel syndrome?

A
  • repetitive/prolonged elbow FLX
  • medial elbow instability
38
Q

Night splinting at __-__ degrees of elbow FLX is used to treat cubital tunnel syndrome.

A

40-60 degrees

39
Q

What are the s/s of ulnar nerve entrapment?

A
  • paresthesis of 4th and 5th digits
  • pain or paresthesia worse at night
  • decreased sensation
  • decreased grip strength and finger AD
  • (+) tinel test
  • clawing contracture of 4th and 5th digits
  • atrophy of ulnar intrinsic mm.
40
Q

What is another name for Median nerve entrapment?

A

pronator syndrome

41
Q

What are the 3 sites of possible compression with median nerve entrapment?

A
  1. under bicipital aponeurosis
  2. pronator teres
  3. under FDS
42
Q

What are the s/s of median nerve entrapment?

A
  • insidious onset of pain in anterior elbow, and palmar side of digits 1-3 and half of the 4th digit
  • heavy sensation in forearm
  • pain reproduced with pressure to PT
43
Q

What movements does a patient have pain with then they have a general median nerve entrapment?

A

resisted elbow FLX, PRON, and wrist FLX

44
Q

What movements does a patient have pain with then they have a median nerve entrapment caused by the bicipital aponeurosis?

A

resisted SUP

45
Q

What movements does a patient have pain with then they have a median nerve entrapment caused by the FDS?

A

Resisted Finger FLX

46
Q

What is the most injured peripheral nerve in the UE?

A

radial nerve

47
Q

What are the 4 types/areas of radial nerve entrapment?

A
  1. High radial nerve palsy
  2. posterior interosseous nerve syndrome
  3. radial tunnel syndrome
  4. superficial radial nerve palsy
48
Q

definition:
- Compression of radial nerve at lateral head of triceps muscle due to strenuous triceps exercise.
- Can also occur from fracture of mid-shaft of humerus

A

high radial nerve palsy

49
Q

What are the s/s of high radial nerve palsy?

A
  • loss of wrist/thumb/finger EXT
  • decreased sensation over 1st digit web space on the dorsal aspect
50
Q

definition: Compression of radial nerve as it traverses through the Radial Tunnel.

A

posterior interosseous nerve syndrome

51
Q

What are the 4 main compression sites along the radial tunnel?

A
  1. between the fibrous bands connecting the brachialis and BR
  2. vascular leash of henry (fan of blood vessels at neck of radius)
  3. proximal ECRB tendon
  4. between fibrous bands at the proximal and distal end of supinator muscle
52
Q

What are the s/s of posterior interosseous nerve syndrome?

A
  • Lateral Elbow pain that radiates into distal forearm
  • Pain with resisted SUP and repetitive SUP/PRON
  • TTP 3-4 cm distal to lateral epicondyle where nerve penetrates the supinator
  • Weakness of wrist/finger EXT
  • decreased grip strength
  • inability to ABD thumb
53
Q

definition: Compression of the deep branch of the radial nerve as it is dynamically compressed through the Radial Tunnel.

A

radial tunnel syndrome

54
Q

With radial tunnel syndrome, what muscles compress the nerve during elbow EXT, PRON, and wrist FLX?

A

ECRB and supinator

55
Q

What are the s/s of radial tunnel syndrome?

A
  • Poorly localized Lateral Elbow pain (Can mimic lateral epicondylitis)
  • Pain with resisted SUP of forearm with elbow fully EXT
  • pain with resisted middle finger EXT
  • Pain with passive wrist FLX with elbow EXT and forearm PRON
  • TTP 5 cm distal to lateral epicondyle anterior to the radial neck
56
Q

Radial sensory nerve entrapment is also referred to as ____.

A

Wartenberg Syndrome

57
Q

definition: Radial Nerve becomes compressed as it pierces the fascia between the Brachioradialis and Extensor Carpi Radialis Longus Tendons (ECRL)

A

radial sensory nerve entrapment

58
Q

What are the s/s of radial sensory nerve entrapment?

A
  • Shooting or burning pain along dorsa-lateral forearm, wrist, and thumb
  • Pain with wrist FLX and UD

(Can mimic de Quervain’s Tenosynivitis and 1st CMC Joint arthritis)

Musculoskeletal (23 decks)

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