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Semester 4 PM Exam 3 > Elbow Pathology > Flashcards

Elbow Pathology Flashcards

1
Q

Etiology - elbow dislocation

A

Usually from forced elbow hyperextension

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2
Q

Elbow dislocation - which direction is most common

A

98% are posterior dislocations

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3
Q

What is typically associated with an elbow dislocation

A 
MCL injury (34% are torn)
25-50% have associated fractures
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4
Q

What are the associated fractures with an elbow dislocation

A

Usually radial head

Coranoid process can also be fractured (brachialis)

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5
Q

Type of elbow dislocation

A

Complete

Partial/Perched

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6
Q

Complete elbow dislocation

A

Anterior capsule is disrupted

Brachialis is torn or significantly stretched

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7
Q

Partial/perched elbow dislocation

A

Partial dislocation

Less capsular/ligamentous injury

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8
Q

Presentation with elbow dislocation

A

Pain/edema
Possible deformity
ROM limitations
Weakness

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9
Q

Elbow dislocation - stable dislocations are usually

A

splinted to prevent hyperextension of the elbow for the first few days

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10
Q

Elbow dislocation - unstable dislocation usually require

A

repair of the MCL

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11
Q

Elbow dislocation - recurrence

A

is rare but may be present if dislocation was unstable or occurred in childhood

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12
Q

What structures may be involved with an elbow dislocation

A 
Coronoid
Radial head
Brachialis
Ulnar or median n. 
MCL
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13
Q

Functional limitations someone with an elbow dislocation may complain of

A

Dec ROM
Inflammation
Maybe bruising if mm involved
Wont be able to lift things, carry objects, extension would be bad

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14
Q

Nursemaid’s elbow - describe what it is

A

Radial head subluxation - typically in children

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15
Q

Etiology of nursemaid’s elbow

A

traction force applied to forearm

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16
Q

Presentation of nursemaid’s elbow

A

Diffuse pain

Dec use of arm

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17
Q

MCL Sprain/Tear - etiology

A

Elbow dislocation
Forceful valgus stress
Repetitive trauma (throwing)

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18
Q

MCL Sprain/Tear - surgical repair

A

Graft from palmaris longus, extensor hallucis longus

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19
Q

Presentation of an MCL sprain/tear - Grade 1

A

A small number of fibers are torn

Some pain but full function

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20
Q

Presentation of an MCL sprain/tear - Grade 2

A

A significnat number of fibers are torn

Moderate loss of function

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21
Q

Presentation of an MCL sprain/tear - Grade 3

A

All fibers are ruptured resulting in elbow instability

Major loss of function

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22
Q

Can you live with an MCL tear/without an MCL?

A

Yes - Humeroulnar joitn has a lot of boney contact, plus there are not many times that we go into full extension with a calgus stress at the elbow
Might have reduced extension but as long as life/occupation allows, the person would be fine

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23
Q

What is the surgery called for MCL tear

A

Tommy Johns

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24
Q

Etiology - radial head fracture

A

Direct trauma

Usually a fall or dislocation

25
Q

Presentation for radial head fracture - Type 1

A

Non displaced

26
Q

What should be avoided with Type 1 Radial head fracture

A

Carrying
Pronation and supination in full range
Flexion and extension in extreme range

27
Q

Presentation of radial head fracture - Type 2

A

Minimal displacement and/or angulation

28
Q

Presentation of type 3 radial head fracture

A

Comminuted radial head

29
Q

Presentation of type 4 radial head fracture

A

Radial head fracture with elbow dislocation

30
Q

Radial head fracture secondary to elbow dislocation - what other structures may be involved

A

MCL
Coranoid process
Brachialis
Capsule

31
Q

Rehab for type 1 radial head fracture

A

Little to no immobilization

ROM ASAP

32
Q

Protocol and rehab for type 2 radial head fracture

A

ORIF
Immoblization for brief time
Pain and edema relief, ROM

33
Q

Protocol and rehab for type 3 radial head fracture

A

ORIF - usually requires stabilization of elbow and excision of fragments
Immobilize
Pain and edema relief

34
Q

Protocol and rehab for type 4 radial head fracture

A

Rehab depends on extent of injury

35
Q

Etiology of lateral epicondylitis/epicondylagia

A

Caused by repetitive microtrauma to teh extensor mass - specifically ECRB
Could also be caused by change in regular activity or overuse

36
Q

Presentation of lateral epicondylitis/epicondylagia

A

Pain with resisted wrist and finger ext
Tenderness with palpation of common extensor site
Wrist ext weakness, maybe decreased grip strength
Coffee cup sign

37
Q

Diffuse medial region elbow pain - what will you check

A

Tendon of wrist flexors
Ulnar nerve and mm innervated by it
MCL

38
Q

Etiology of medial epicondylitis/epicondylalgia

A

Tendonitis of the wrist flexors
Caused by microtrauma to wrist flexor insertion site
Faulty mechanics with gold swing
Repetitive and/or forceful throwing

39
Q

Presentation of medial epicondylitis/epicondylalgia

A

pain with resisted wrist flexion and/or pronation

Weakness due to pain, dec grip

40
Q

Etiology of olecranon bursitis

A

Trauma - direct blow to elbow

Prolonged sustained pressure on the elbows

41
Q

Presentation of olecranon bursitis

A

Swelling and erythema over olecranon process
Exquisite tenderness directly over olecranon process
Swollen bursa

42
Q

Functional limitation with medial epicondylitis/epicondylalgia

A

elbow and/or wrist flexion activities

43
Q

Olecranon bursitis patient - cause is trauma - what else do you need to do

A

Check for fracture - refer for xray

44
Q

Olecranon bursitis - not concerned about fracture - what do you do

A

Rest, avoid stress and pressure on bursa, make sure they keep motion but avoid repetitive motion

45
Q

Arthroplasty - post decompression of the elbow - etiology

A

Presence of a post compartment osteophyte

Severe arthritis

46
Q

Presentation of arthroplasty - post decompression of the elbow

A

ROM limitations

Pain

47
Q

Biceps brachii rupture - etiology

A

Degeneration - long head prox attachment (most common)

Heavy lifting - typically distal attachment

48
Q

Presentation of biceps brachii rupture -

A

Physical deformity
Initial pain and then progress to no pain
Strength limitations

49
Q

If long head of biceps ruptures proximally - does the patient need surgery

A

No because the the shoulder mm can produce shoulder flexion and we can flex shoulder without long head

50
Q

If long head of biceps ruptures distally - do they need surgery

A

No - but elbow flexion and supination will dec in power and force

51
Q

Neuropathies =

A

Compression of nerve located within the area of the elbow or forearm

52
Q

Symptoms of neuropathies

A

Parasthesias, weakness, pain

Can be acute or chronic

53
Q

Compression of the median nerve- site

A

Elbow
Pronator teres
Ant. interossei region
Wrist - carpal tunnel

54
Q

Median nerve compression - presentation

A

Paresthesia in thumb, 2nd and 3rd fingers

Weakness in forearm/hand mm innervated by median nerve

55
Q

Radial nerve compression - sites

A

Elbow

Post interosseous region

56
Q

Diff Dx - complain of lateral elbow pain

A

Radial head position
Nerve
Extensor mm for lat epi

57
Q

Radial nerve compression - presentation

A

Paresthesia in radial nerve distribution
Possibel weakness in radial nerve innervated mm
Similar sx of lateral epcondylitis

58
Q

Ulnar nerve compression - site

A

Cubital tunnel

Guyon’s tunnel

59
Q

Ulnar nerve compression - presentation

A

Paresthesia in ulnar nerve distribution

Possible weakness in ulnar nerve innervated mm

Semester 4 PM Exam 3 (8 decks)

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