Elbow n' Such Flashcards
What is flick’s sign?
Paresthesias in the hand after sleeping that resolve with flicking of the wrist
What are the ssx of carpal tunnel syndrome?
Pain and numbness of the thumb, index, middle, and radial side of the ring finger
What are the late ssx of carpal tunnel?
Thenar eminence atrophy
What are the spinal levels that contribute to the brachial plexus?
C5-T1
What are the viscerosomatics to the UE?
T2-T8
What are the four main vascular parts of the axial skeleton?
Thoracic inlet
Clavicle
Ribs
Pectoral and axillary folds
What are the muscle attachments of the trapezius?
Occiput
C-spine
T1-T12
What are the areas that should be treated to “drain” the UE? (6)
- Thoracic inlet
- Thoracics and ribs
- Cervicals
- Head (OA)
- Shoulder and elbow
- Distal SDs
Treating the thoracics and ribs does what for the UE?
decreases sympathetic tone and improves V?L return
Treating the AA does what for the UE?
Addresses segmental and myofascial dysfunctions
Treating the shoulder and elbows does what for the UE?
Relieves bony and articular restrictions
What is the wrist important for?
Position of the hand to provide mechanical advantage, and acts as a stabilizer for effective functioning of the hand
What type of joint is the elbow joint?
Uniaxial hinge joint
What are the two joints in the elbow?
Humeroulnar
Humeroradial
What are the components of the humeroulnar joint?
Trochlea to the trochlear notch
What are the components of the humeroradial joint?
Capitulum to the radial head
What is the joint that comprises the pivot joint of the elbow?
Proximal radioulnar
What are the two ligaments of the elbow? What is their function?
Radial (RCL)
Ulnar (UCL)
Limit varus/valgus stress on the elbow joint
What is the purpose of the annular ligament of the elbow joint?
Prevents distal displacement of the radius
What is the function of the interosseous membrane between the radius and the ulna? Which way do the fibers run within this?
Increases surface area for muscular attachment
Slant upward from the ulna to the radius
Where does the force in the radius travel on an outstretched hand?
Loads on the radius will tense the interosseous membrane and be transferred to the ulna
What are the bones of the hand? (8)
- Scaphoid
- Lunate
- Triquetrum
- Pisiform
- Trapezium
- Trapezoid
- Capitate
- Hamate
What is the most commonly fractured carpal bone?
Scaphoid
What makes up the floor of the anatomical snuff box?
Scaphoid
What is the most frequently dislocated carpal bones?
Lunate
What is the largest carpal bone?
Capitate
Pain from where can radiate to the hand?
neck, shoulder or elbow region
What shoulder muscles in particular can cause hand pain?
- Infraspinatus
- Serratus posterior superior
- Lat dorsi
- Scalenes
What is Cozen’s test of the elbow?
It is a physical examination performed to evaluate for lateral epicondylitis or, tennis elbow. The test is said to be positive if a resisted wrist extension triggers pain to the lateral aspect of the elbow owing to stress placed upon the tendon of the extensor carpi radialis brevis muscle. The test is performed with extended elbow
What are the specific areas that may be tender at the elbow?
Lateral epicondyle
Medial epicondyle
Olecranon
What is the major flexor of the thumb?
Abductor pollicis brevis
Bringing the thumb anteriorly=?
Abduction
Bringing the thumb into the plane of the palm = ?
Adduction
Bringing the thumb away from the palm, but staying within the same plane = ?
Extension
Bringing the thumb toward the palm, but staying within the same plane = ?
Flexion
What is opposition of the thumb? What is the opposite motion of this?
Opposing the thumb with the other digits.
Reposition is the opposite motion
What is the piano key sign?
Tests for instability at the distal radioulnar joint
What are the two major causes of instability of the radioulnar joint?
RA
Trauma
What is nursemaid’s elbow?
Radial head subluxation away from the annular ligament
What are the PE findings with radial head subluxation?
- TTP near the radial head
- Pain with F/E
- Supination/pronation intact without pain
What does the Cozen’s test assess for?
Lateral epicondylitis
What does the finkelsteins test assess for?
De quervains
What is Maudsley’s test, and what does it assess for?
The examiner resists extension of the 3rd digit of the hand, stressing the extensor digitorum muscle and tendon, while palpating the patient’s lateral epicondyle. A positive test is indicated by pain over the lateral epicondyle of the humerus.
Lateral epicondylitis
What does the Phalens test assess for?
Carpal tunnel
What does the piano key test assess for?
DRUJ instability
What does the Snuff box test assess for?
Scaphoid fracture
What does the tinel sign at the elbow test assess for?
Cubital tunnel syndrome
What does the tinel sign at the wrist test assess for?
carpal tunnel syndrome
What does the varus and valgus stress test assess for?
UCL/RCL instability
What does pain with elbow flexion/extension or supination/pronation test assess for?
Elbow subluxation
Supination of the arm does what to the radial head?
Moves anteriorly
Pronation of the arm causes what motion of the radial head?
Radial head moves posteriorly
What are the three major hand/wrist problems that may be treated with s/cs?
Radial head
Coronoid process
Anterior interosseous
What are the two major posterior s/cs tender points at the elbow?
Medial and lateral olecranon
What happens to the anterior radial head with FOOSH?
Proximal radial head moves anteriorly, distal moves posteriorly
In supination, the radial head is where?
Anterior
What are the six steps of the DMU UE OMT protocol?
- Thoracic inlet
- Thoracics/ribs
- Cervs
- OA
- Shoulder/elbow
- Distal SD