Elbow Eval and Exam Flashcards
When screening for an elbow problem, looking at posture of the cspine, scapulothoracic, thoracic, GH and pelvis in particular (regional interdepence). What other examination elements can be discovered in posture inspection?
- Abnormal position of the elbow: carrying angle
- normal is 15* valgus in front plane) - Triangular alignment of med/lat epicondyle and tip of the olecranon (prominent olecranon = posterior subluxation due to FOOSH).
- Edema/joint effusion: easiest to see laterally between the radial head, olecranon and lateral epicondyle.
- Olecranon bursitis (extra capsular): seen at tip
Describe a gunstock deformity (cubitus varus).
Occurs with a reversal of the valgus carrying angle as a result of a medial humeral condyle fracture or bony overgrowth in the lateral condyle.
When assessing PROM for the elbow, there are 4 movements tested, 2 are firm end feels, 1 is soft and 1 is hard. True?
Yes. Name each.
Resisted isometrics for the elbow are assessed in what position?
Anatomical for flexion / extension. At 90* for supination / pronation.
When testing MMT, what important distal consideration needs to be made?
Motion at the wrist, as well as mass grip strength.
What four joints is the elbow composed of?
- Distal Radio-ulnar joint
- Proximal Radio-ulnar joint
- Radiohumeral joint
- Ulnohumeral joint
When assessing joint play of the distal radio-ulnar joint, it is best done in seated with the forearm in 10* of supination. Applying the concave/convex rule, what glide directions for pronation and supination?
Concave: distal radius
Convex: distal ulna
Pronation: anterior/ventral
Supination: posterior/dorsal
When assessing PROM for the elbow, there are 4 movements tested, 2 are firm end feels, 1 is soft and 1 is hard. True?
Yes. Name each.
Resisted isometrics for the elbow are assessed in what position?
Anatomical for flexion / extension. At 90* for supination / pronation.
When testing MMT, what important distal consideration needs to be made?
Motion at the wrist, as well as mass grip strength.
What four joints is the elbow composed of?
- Distal Radio-ulnar joint
- Proximal Radio-ulnar joint
- Radiohumeral joint
- Ulnohumeral joint
When assessing joint play of the distal radio-ulnar joint, it is best done in seated with the forearm in 10* of supination. Applying the concave/convex rule, what glide directions for pronation and supination?
Concave: distal radius
Convex: distal ulna
Pronation: anterior/ventral
Supination: posterior/dorsal
What is the most common type of elbow fracture in children, and what are its causes and implications?
Intra-articular fracture of distal humerus due to FOOSH. Can be associated with nerve damage and impaired circulation.
At the radiohumeral joint is assessed in full supination and extension. What are the rules and glide directions?
concave – radius
convex – capitulum of humerus
Dorsal or posterior glide of radius: indication: extension
Ventral or anterior glide of radius indication: flexion
The ulnohumeral joint is the main joint of the elbow. Assessed in 10* of supination and 70* of flexion, it is typically scooped during distraction. What re its rules and glide directions?
Concave – olecranon fossa of ulna
Convex – trochlea of humerus
Indication: overall joint play
-scouping of forearm away form humerus.
What is the primary purpose of the RCL?
Elbow stabilizer over the joint capsule and common extensor origin. Limits supination.
The UCL has an anterior, posterior and transverse band. What is its primary role?
Limiting valgus stress. Varus stresses are mostly limited by bony articulations.
What is the most common type of elbow fracture in children, and what are its causes and implications?
Intra-articular fracture of distal humerus due to FOOSH. Can be associated with nerve damage and impaired circulation.
What are 3 common risk factors for UE MS disorders?
- Obesity
- High physical demand
- Repetitiveness of the task
___ is key in determining the source of elbow stress.
Proximal stability (shoulder and truck).
With a deficit in proximal stability, with overhead work, what part of the elbow is most commonly affected by excess joint stress?
The medial joint.
What 3 types of structures are being assessed with an elbow screen?
- Musculotendinous integrity
- Ligamentous tissue
- Articular cartilage
For patients with pain in the elbow region, what non-muscle parameter needs to be assessed?
Pain from nerve entrapment.
