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DPT 616 : MSK > Elbow Pathology > Flashcards

Elbow Pathology Flashcards

1
Q

in what plane does most elbow motion occur?

A

sagittal

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2
Q

there is some degree of frontal plane motion at the elbow with _____ accompanying elbow flexion and _____ accompanying elbow extension

A

adduction, abduction

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3
Q

how does limited elbow fxn limit fxn?

A

limited ability to bring arm up for eating/drinking or self care

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4
Q

what is lateral epicondylalgia?

A

irritation of the lateral epicondyle and the extensors, radial deviators, and sometimes supinators

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5
Q

what muscles are primarily effected in lateral epicondylalgia?

A

extensor carpi radialis brevis

1/3 extensor digitorum communis

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6
Q

what is tennis elbow?

A

lateral epicondylalgia

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7
Q

what age group is most effected by lateral epicondylalgia?

A

those 35-50 y/o

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8
Q

what extremity is usually effected by lateral epicondylalgia?

A

the dominant arm

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9
Q

what is the usual MOI of lateral epicondylalgia?

A

overuse, but can be traumatic too

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10
Q

what is the difference in treatment of inflammatory vs degenerative/fibrotic disease?

A

inflammatory disease is treated with US and is very protective

degenerative/fibrotic disease is not likely to focus on US treatment, but rather uses IASTM, TFM, stretching, and eccentrics

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11
Q

describe stage 1 lateral epicondylalgia

A

inflammatory

often resolves

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12
Q

describe stage 2 lateral epicondylalgia

A

fibroblastic and vascular response within tendon

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13
Q

describe stage 3 lateral epicondylalgia

A

pathologic changes (tendinosis) or rupture

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14
Q

describe stage 4 lateral epicondylalgia

A

fibrosis, calcification

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15
Q

when do symptoms occur in lateral epicondylalgia?

A

with active wrist extension or grasping

morning/night

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16
Q

does pro/sup tend to be more painful in elbow flexion or extension with lateral epicondylalgia?

A

elbow extension

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17
Q

t/f: pts with lateral epicondylalgia may frequently drop things

A

true

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18
Q

where is a pt with lateral epicondylalgia TTT?

A

over the lateral epicondyle

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19
Q

what tests would we expect to be positive in lateral epicondylalgia?

A

Cozen

Mills

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20
Q

what are some treatment options for lateral epicondylalgia?

A

US

iontophoresis

TFM

modify techniques

injections

mobilizations (wrist, elbow, cervical)

stretching

PREs (conc and ecc)

counterforce bracing

dry needling

Tenex

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21
Q

are PREs for concentric or eccentric contractions more important?

A

eccentric

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22
Q

what does counterforce bracing do?

A

applies pressure to the epicondyle just distal to the muscles insertion dispersing force and making the muscle think it inserts more distally than it does

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23
Q

is lateral or medial epicondylalgia more common?

A

lateral epicondylalgia

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24
Q

what is Golfer’s elbow?

A

medial epicondylalgia

25
what is medial epicondylalgia?
tendonopathy of the common flexor tendons, primarily the FCR and pronator teres with increased valgus stress and failure of the UCL
26
where is there pain and TTT in medial epicondylalgia?
over the medial epicondyle
27
what is the common MOI of medial epicondylalgia?
overuse due to repeated stress to the flexor-pronator tendons, increased valgus stress, and failure of the UCL
28
what motions cause pain with medial epicondylalgia?
resisted wrist flexion, pronation passive wrist extension, supination
29
what are some treatment options for medial epicondylalgia?
RICE modalities avoid immobilization stretching PREs (conc and ecc) bracing
30
what are the 5 criteria for classification of instability?
1) acute, chronic, recurrent 2) articulations involved 3) direction of displacement (valgus, varus, ant/post rotatory) 4) degree of displacement (sublux or disloc) 5) presence of fx
31
what causes an ulnar collateral sprain?
chronic valgus and ER forces (ie tennis and throwing)
32
what are some other common MOIs, other than throwing for ulnar collateral sprain?
FOOSH chronic medial epicondylalgia
33
what tests would we expect to be positive with ulnar collateral sprain?
valgus stress test moving valgus stress test
34
what are some treatment options for ulnar collateral sprain?
RICE 2-4 weeks modalities PREs for FCU, pronator teres, FDS, and shoulder
35
what types of forces are responsible for contributing to UCL sprain/instability?
valgus stress occuring with throwing cooking phase of throwing puts a lot of medial stress of the elbow
36
what causes radial collateral sprain?
a combo of compression, ER, and varus forces, or secondary to chronic LE can be caused by dislocation too
37
what can radial collateral sprain result in?
posterolateral rotatory instability
38
what are the interventions for radial collateral sprain?
RICE 2-4 weeks modalities PREs
39
what functional losses are associated with median nerve injury?
loss of pronation loss of wrist flexion, RD loss of thumb flexion, abduction, opposition loss of gripping ape hand deformity (loss of pinch) closing hand of benediction
40
what functional losses are associated with ulnar nerve injury?
loss of wrist flexion, UD loss of 5th digit PIP flexion loss of finger adb/add opening hand of benediction (loss of ext of PIP and DIP of digits 4-5)
41
what functional losses are associated with radial nerve injury?
loss of supination loss of wrist extension loss of gripping loss of wrist stabilization loss of finger extension loss of thumb abduction
42
why is there a weaker grip in wrist flexion?
bc of active insufficiency do the finger and wrist flexors
43
what is cubital tunnel syndrome?
entrapment of the ulnar nerve at the medial intermuscular septum which slopes from a thick wide base at the medial epicondyle to a thin edge on the humeral shaft
44
t/f: cubital tunnel syndrome is caused by traction in flexion
true
45
t/f: the anconeus can cause entrapment of the ulnar nerve causing cubital tunnel syndrome
true
46
what are the s/s of cubital tunnel syndrome?
pain/paresthesia in digits 4-5 worse at night reduced sensation in ulnar nerve distribution inability to abd/add fingers loss of grip atrophy of intrinsics contracture of digits 4-5 (+) Tinel over the medial elbow
47
what are some interventions for cubital tunnel syndrome?
ADL modification night splinting 40-60 deg padding ulnar nerve transposition in severe cases
48
what should be avoided with cubital tunnel syndrome?
leaning on the elbow elbow flexion while sleeping
49
what is pronator teres syndrome?
median nerve most commonly entrapped at the ligament of Struthers
50
what condition can look similar to carpal tunnel syndrome?
pronator teres syndrome
51
where is there pain in pronator teres syndrome?
wrist and medial forearm
52
pain in pronator teres syndrome is increased with what motions?
extension and pronation
53
where do we expect to see paresthesias in pronator teres syndrome?
digits 2-3
54
what are the 3 sites of entrapment for pronator teres syndrome?
Lacertus fibrosis pronator teres FDS
55
there can be reproduction of symptoms of pronators teres syndrome with palpation over what muscles?
pronators 4cm distal to the cubital crease
56
what is a unique spot we may perform a Tinel test at for pronator teres syndrome?
4cm distal to the cubital crease
57
what motions may cause reproduction of symptoms in pronator teres syndrome?
resisted pronation supination long finger flexion elbow and Wrist flexion
58
t/f: pronator teres syndrome responds well to conservative measures
true

DPT 616 : MSK (23 decks)

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