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Diff Dx > Elbow/Forearm 1 > Flashcards

Elbow/Forearm 1 Flashcards

1
Q

What kind of stress of the elbow predominates with athletes?

A

valgus stress

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2
Q

overuse of the elbow (pronation/supination)

A

muscle strain, trigger points, or peripheral nerve entrapment

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3
Q

overuse of the elbow (cocking or medial stretch)

A

consider medial collateral ligament sprain, flexor muscle strain, ulnar nerve stretch irritation

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4
Q

when do you refer out for an elbow problem?

A

fracture/dislocation
infection, unresolving butsitis, gout
inflammatory joint disease
soft tissue and articular disorders if unresponsive

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5
Q

if there is a history of hyperextension due to FOOSH injury or a direct blow to antecubital fossa, what should you always consider?

A

supracondylar fracture in child

radial head fracture in adult

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6
Q

if there is a sudden valgus force of the elbow, what do you consider?

A

potential avulsion of the medial epicondyle
medial collateral ligament sprain
capitulum fracture

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7
Q

direct fall onto the tip of the elbow with elbow flexed may result in?

A

olecranon fracture or olecranon bursitis

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8
Q

nursemaid’s elbow

A

sudden traction on the forearm of a young child that can result in radial head entrapment

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9
Q

medial epicondylitis

A

repetitve flexion and medial elbow pain

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10
Q

lateral epicondylitis

A

repetitive extension associated with lateral elbow pain

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11
Q

weakenss at the elbow without associated pain is a possibility of?

A

biceps tendon rupture

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12
Q

instability is a consequency of?

A

past fracture, dislocation or sudden valgus force

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13
Q

restricted passive flexion or extension coupled with trauma is suggestive of?

A

joint effusion or fracture

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14
Q

nontraumatic restriction to passive extension suggest what?

A

tight biceps or anterior capsule, history of overuse is usual

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15
Q

nontraumatic restriction to passive flexion suggests?

A

tight triceps or posterior capsule adhesion

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16
Q

locking/creptius in young patients

A

suggestive of osteochrondritis desiccans

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17
Q

locking/crepitus in older patients

A

degenerative changes

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18
Q

swelling at the elbow is suggestive of?

A

gouty tophi
rheumatoid nodules/arthritis
olecranon bursitis

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19
Q

Mill’s test

A

passive wrist flexion with elbow extended

for lateral epicondylitis

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20
Q

reverse Mill’s

A

passive wrist extension with elbow extended

medial epicondylitis

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21
Q

Cozen’s test

A

resisted wrist extension (with elbow flexed and extended)

increases lateral epicondylitis pain

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22
Q

tinel’s test

A

ulnar nerve irritation

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23
Q

lateral epicondylitis

A

lateral pain on resisted wrist extension &/or passive flexion of wrist with elbow extended/forearm pronated &/or resisted finger extension

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24
Q

medial epicondylitis

A

medial pain on resisted wrist flexion with elbow extended &/or passive wrist extension with the elbow extended/fore arm supinated &/or reissted finger flexion

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25
lateral elbow pain worsened by? What is the name for this?
resisted wrist extension and gripping | tennis elbow
26
motions that cause tennis elbow
``` repetitive motion (computer keyboardists, carpenters, golfers, meat cutters, etc) cause forceful wrist extension, radial deviation and supination ```
27
what muscles are mainly involved in tennis elbow?
extenor carpi radialis brevis* extensor digitorum communis extensor carpi radialis longus
28
how will someone with lateral elbow pain present?
cozen's, mill's will be positive pain on resisted wrist extension or 3rd finger extension with extended elbow causes pain lifting a chair with pronated hand pain, often sharp, in the lateral elbow occurs upon extension of the wrist or supination of the forearm may cause inability to lift or hold objects
29
medial epicondylitis has pain following what?
repetitive activity
30
inciting activity for medial epicondylitis?
wrist flexion and pronation
31
what are the other names for medial epicondylitis?
golfer's elbow | little leaguer's elbow
32
what muscle tendons are involved in meidal epicondylitis?
wrist flexors | pronators
33
what motion reproduces pain for medial epicondylitis?
resisted wrist flexion | pronation and grasping
34
what test exacerbates medial epicondylitis?
mill's
35
monteggia fracture
ulnar shaft fracture with associated proxial dislocated radius
36
galeazzi fx
fracture distal radius and dislocated distal radial ulnar articulation
37
greenstick/torus
incomplete fracture
38
colles fx
distal radial fracture with dorsal and radial angulation
39
smith's fx
distal radial fracture with volar/palmar angulation
40
how do wrist complaints usually occur?
direct trauma, falls, over use, arthritic conditions
41
when do we send someone out for a wrist complaint?
``` fracture dislocation disassociation AVN soft tissue/articular disorders that don't resolve in 2-3 months ```
42
most common carpal fracutred
scaphoid fracture at the waist
43
how is the scaphoid usually fractured?
FOOSH injury
44
what is teh most common site for an occult fracture?
scaphoid
45
where is the pain in a scaphoid fracutre?
in the anatomic snuffbox after a FOOSH injury
46
AVN of the lunate
Kienbock's disease
47
history and clinical presentation of kienbock's
stiff and painful wrist often no history of trauma repetitive minor truama is supected as a commin initiator
48
how might someone acquire a scapholunate disassociation?
radial or dorsal wrist pain following FOOSH
49
what is the sign associated with scapholunate disassociation?
terry thomas sign | or david etterman's sign
50
signet ring sign
rotatory subluxation of the scaphoid with scapholunate instability
51
dequervain's tenosynovitis
presents as radial wrist pain forceful gripping with ulnar deviation or repetitive use of the thum stenosis tenosynovitits of abductor ppollicis longus and extensor pollicis brevis resulting from chronic microtrauma
52
what test is positie with dequervain's tenosynovitis
resisted thumb extension with wrist in radial deiation | finkelstein's
53
patient presents with forearm pain with hand and wrist numbness/tingling and weakness. what should you look for?
dequarvain tenosynovitis
54
if median nerve is involved, what should you look for?
CTS, pronator syndrome
55
if ulnar nerve is inolved, what should you look for?
cubital tunnel syndrome, tunnel of guyon
56
if radial nerve is involved, what should you look for?
radial tunnel syndrome
57
what is the most common nerve entrapment syndrome?
carpal tunnel
58
what will patient complain of if they have carpal tunnel?
numbness/tingling in palmar surface of thumb and radial 2 1/2 fingers
59
when would someone have median nerve involvement?
direct external pressure on the tunnel or history of prolonged full flexion or extension
60
most common cause of "nonspecific flexor tenosynovitis"
repetitive motion* | swelling in carpal tunnel
61
compression of the median nerve can be compressed by?
wrist flexor retinaculum
62
what test should you do for wrist complaints?
``` tinel sign phalan's test reversed phalan's pressure provocative test electrodiagnostic studies flick sign**** ```
63
what might someone with pronator syndrome complain of?
volar forearm pain, usually no history of trauma
64
what history might someone with pronator syndrome have?
repetitive pronation and wrist flexion such as incurred by carpenters, assembly-line workers and weightlifters
65
how do you provoke the pain of someone with pronator syndrome
resisted pronoation with elbow extended and wrist flexed (from hypertrophy) resisted middle finger flexion (compression at flrxor digitorum superficialis
66
where can the median nerve be compromised?
at the wrist, or at the level of the pronator teres
67
most common entrapment sites for median nerve
between two heads of pronator teres and arch of flexor digitorum superficialis
68
ulnar nerve/cubital tunnel syndrome
complaint of medial forearm pain and paresthesia into the ring and little finger throwing history
69
where does the ulnar nerve usually get compressed/stretched?
elbow(cubital tunnel or ulnar groove)
70
how are symptoms reproduced with cubital tunnel syndrome
passive or reissted elbow flexion with the elbow in a maximally flexed pposition
71
tunnel of guyon
complaint of numbness/tingling or pain in the 4th or 5th digits
72
what is the tunnel of guyon?
osseofibrous tunnel formed by a groove between the pisiform and hook of the hamate
73
handlebar palsy
chronic compression at the tunnel of guyon
74
provocative tests for tunnel of guyon?
tinel's or presser at the pisiform hamate area
75
radial tunnel syndrome
complaint of dull aching pain over the lateral forearm compression of the radial nerve tenderness is distal to the lateral epicondyle provocative measures are based on the site of entrapment
76
finger and thumb complaints are usually due to?
trauma
77
what are non traumatic conditions that cause finger and thumb complaints?
arthridities, CT disease, vascular problems (raynaud's, relfex sympathetic dystrophy)
78
hand fracture examples
``` mallet finger metacarpal fracutre volar plate fracture gamekeeper's thumb bennett's fracture rolanto's ```
79
baseball/mallet finger
avulsion of the extensor tendon at its insertion on the dorsal surface of the base of the distal phalynx results from a blow to the end of the finger causing a hyperflexion to a forcibly extended finger may have partial or complete tendon tear or bony avulsion
80
bennett's fracutre
oblique intra-articular fx at the base of the thumb with radial deviation fo the distal fragment
81
rolando's fracutre
intraarticular comminuted fracture at the base of the 1st metacarpal with radial displacement

Diff Dx (17 decks)

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