Elbow, Wrist, Hand Flashcards
3 bones of the elbow
- humerus
- radius
- ulna
What side is the ulna on?
Pinky side
What side is the radius on?
Thumb side
Bony landmarks of the elbow
- medial and lateral epicondyles (humerus)
- olecranon process (ulna)
- head of the radius
Elbow ligaments
- ulnar collateral ligament (similar to MCL)
- radial collateral ligament (similar to LCL)
- annular ligament
UCL
Connects medial side of humerus to ulna
RCL
Connects lateral side of humerus to radius
Annular ligament
Wraps around the head of the radius and holds it in place during forearm pronation
Biceps and triceps function
Primary elbow flexor and extensors
Where do wrist and finger flexor originate?
Medial epicondyle of humerus
Where do wrist and finger extensors originate?
Lateral epicondyle of humerus
Where is the ulnar nerve?
Medially thru ulnar groove
Other elbow structures
Olecranon bursa
Where do elbow flexion and extension occur?
Hinge joint between humerus and ulna
Forearm pronation and supination function
Rotational component of radius and humerus
What meets to form the wrist joint
Distal radius and ulna meet the proximal carpal bones
How many carpal bones are there?
8
What are the carpal bones?
- scaphoid (navicular)
- lunate
- triquetral
- pisiform
- trapezium
- trapezoid
- capitate
- hamate
How many metacarpals?
5
How many phalanges?
14
Carpal tunnel
A small space on the anterior surface of the wrist that has tendons, nerves, and blood supplies running through it
What can cause carpal tunnel symptoms in hands?
If tendons or sheaths get inflamed, pressure on medial nerve or blood vessel
6 wrist motions
- flexion
- extension
- radial deviation (thumb lower)
- ulnar deviation (thumb higher)
- pronation
- supination
Finger anatomy
- flexor and extensor tendons running to each digit (extensor on top)
- collateral ligaments around each IP joint
Injuries to wrist elbow and finger
- fractures
- dislocation
- sprain
- strains
- Tendinitis
- bursitis
What causes strain?
Excessive force on muscle or tendon
Lateral epicondylitis
- tennis elbow
- inflammation of wrist/ hand extensors at lateral epicondyle
Medial epicondylitis
- “pitchers elbow” or “little league elbow”
- inflammation of wrist/ finger flexor muscles at medial epicondyle
Symptoms of strains, tennis elbow, and pitchers elbow
- Point tenderness
- pain with muscle activation and with muscle stretch
What causes a UCL sprain?
Overstretch of ligament fibers by traumatic valgus force
Where are UCL injuries common?
Pitching
What is the recovery for UCL sprain?
Tommy john surgery
Olecranon bursitis
Usually caused by direct blow to area and the bursa becomes irritates and swells
What is the most commonly injured carpal?
Scaphoid
What causes a carpal fracture?
FOOSH
Why are carpal fractures susceptible to avascular necrosis?
Poor blood supply
Where is pain in carpal fracture?
Anatomical snuffbox
What causes strain or tendinitis?
Chronic/ overuse or traumatic force
What causes ligament sprains?
FOOSH
Symptoms of ligament sprains?
- pain
- swelling
- loss of strength
- loss of ROM
- instability
Carpal tunnel syndrome
Inflammation of one or more of the structures in the carpal tunnel, usually leading to neurological irritation and symptoms due to compression of the median nerve
Symptoms of carpal tunnel syndrome
- numbness and tingling in the hand
- loss of strength in hand musculature
How to treat carpal tunnel syndrome
Treat conservatively with RICE, NSAIDs, splinting
-injection and surgery if necessary
Mallet finger
-extensor tendon avulsion causing inability to extend tip of finger
Jersey finger
Avulsion of flexor tendon causing inability to flex distal tip of finger
Boutinneire deformity
Disruption of extensor tendons causing PIP flexion and DIP in extension
Finger sprains or dislocations
Damage to the collateral ligaments of IP joints
“Jammed finger”
Symptoms of finger sprains
- pain
- swelling
- possibly deformity
- possible pain with ROM and strength testing
Treatment of finger injuries
- Surgery is not usually necessary unless fracture will not heal well conservatively
- reduce dislocations and splint fractures
What is important in treating finger injuries?
Identify early
How should finger be splinted?
Position to promote healing of involved structure
Why is it important to catch finger injuries early?
After acute phase, some injuries will not heal correctly if not identified and splinted correctly
other treatment of finger injuries
- buddy taping
- splinting
- RICE
- NSAIDs
