Elbow + Nerve Entrapments

Question 1

What are the 3 joints of the Elbow

Answer 1

1. Ulno humeral jt
2. Radio humeral jt
3. Sup radio-ulnar jt.

Question 2

What ligs are the ulno humeral and radio humeral jt supported by

Answer 2

Medially by ulnar collateral lig

Laterally by radial collateral lig

Question 3

What forms the cubital tunnel and what nerve passes thru it t

Answer 3

Medial collateral lig and flexor carpi lunaris (ulnar n passes thru)

Question 4

The 3 elbow articulations are innervated by branches of what n (4)

Answer 4

musculocut
median
ulnar
radial

Question 5

If there is limited flex/ ext prom what jts are likely affected (2)

Answer 5

Either:
Ulno humeral jt
Radio humeral jt

Question 6

If pronation/supination is limited what jts. are likely affected (3)

Answer 6

Either:
Radio humeral
Ulno humeral (sup, mid, inf)
Ulno meniscocarpal

Question 7

What is an elbow sprain typically due to

Answer 7

Partial tearing/stretching of lig/capsul that holds elbow together

-often occurs when arm is forcefully straightened

Question 8

Diagnosis of elbow sprain and tx

Answer 8

-Approx 30 mins post injury elbow will swell

• apply ice off/om
• after swelling regain full ROM and start strengthening
• can also take in flexion to prevent extension (only for short periods of time)

Question 9

What is elbow bursitis due to and how to tx

Answer 9

Due to repeated falls or forcefull extension of elbow which irritates the bursa sac

tx- ice twice a day for 20 mins, let drain on own

Question 10

Where is 75% of cases of lateral humeral epicondylitis found

Answer 10

75% at tenoperiosteal junction (where common extensor tendon originates)

-Tenderness at the extensor carpi radials tendon at attachment

Question 11

where are 2 other locations for lat humeral epicondylitis pain

Answer 11

Body of the tendon- lesion in extensor carpi radials mm but tenderness is in tendon

Body of extensor mm- no pain at epicondyle

Question 12

tx of lat epicondylitis (should u work towards or away from pain)

Answer 12

rest/ice 2x day for 2/3 days + modalities

Strengthen forearm

• *Work away from pain (wrist eccentric extension)
• stretch into flex/ulnar dev

Question 13

What is loose bodies at the elbow due to + symptoms

Answer 13

jamming elbow into full extension + loose body will be created(ex. throwing)

• Usually pt is unable to fully extend elbow/ will lock
• Rom decreased

Question 14

How is medial epicondytis diagnosed

Answer 14

• Pain reproduced by passive wrist extension + resisted wrist flexion
• tenderness found 1/2 inch away from med epicondyle

Question 15

tx for medial epicondyle

Answer 15

10 days rest
gradual return to play
-antiinflammatories/cortisone if pain persists

Question 16

what are the 4 biomechanics of throwing (+ what is affected during each)

Answer 16

1. Medial slide (stretch ulnar n, avulsion etc)
2. Lat compression (bone issues)
3. Post impingement (olecranon bursae, triceps path)
4. Ant traction (ant capsule stretch)

Question 17

What can throwing cause in the med, lat, and post elbow in youngsters

Answer 17

med- avulsion fx

Lat- Capitular/radial head osteochondritis

Post- Traction apopystisis on olecranon

Question 18

How does a radial head fx occur and where is pain located

Answer 18

When a fall is stopped by sticking the arm out

-pain/swelling on outer aspect of jt., extremely sensitive to touch/decreased ROM

Question 19

how does a colles fx occur and what occurs to fracture fragments

Answer 19

FOOSH

Dorsal and radial displacement of distal frags

Question 20

What occurs in a motteggia fx

Answer 20

Fx of ulna w/ dislocation of radial head

Question 21

What occurs in a galezzi fx

Answer 21

fx of radial shaft w dislocation of distal radio ulnar jt