Exam 4 Other Flashcards
Elbow Dislocations
- MOI: axial force through the forearm with the elbow flexed
- Extremely painful
- Obvious deformity
- “Terrible triad of the elbow”
- Swelling can be rapid, masking deformity
Elbow Dislocation Types
Posterolateral:
- most common (90%)
- proximal ulna and radius are displaced posterolaterally
Posteromedial:
- proximal ulna and radius are displaced posteromedially
Medial:
- proximal ulna and radius are displaced medially
Lateral:
- proximal ulna and radius are displaced laterally
Anterior:
- Very rare
- proximal ulna and radius are displaced anteriorly
Nerve Innervations
Median Nerve
- Supplies all wrist extensor muscles as well as pronator teres and pronator quadratus (exception: flexor carpi ulnaris and medial portion of flexor digitorum profundus)
Nerve Innervations
Median Nerve (Anterior Interosseous Nerve)
Projects off Median Nerve
Nerve Innervations
Ulnar Nerve
- Funny Bone
- Innervates flexor carpi ulnaris and medial portion of the flexor digitorum profundus
Nerve Innervations
Ulnar Nerve (Arcade of Struthers)
- Where the ulnar nerve enters the elbow
- Located approximately 8cm proximal to the medial epicondyle
Nerve Innervations
Ulnar Nerve (Tunnel of Guyon)
- Area between the pisiform bone and hook of hamate bone
Nerve Innervations
Radial Nerve
- Crosses elbow between the brachioradialis and the brachialis then diverges into a superficial branch and deep branch
Nerve Innervations
Radial Nerve (Superficial Branch)
- Direct continuation of the radial nerve
- provides sensations to dorsum of wrist, hand, and thumb
Nerve Innervations
Radial Nerve (Deep Branch)
- Provides motor innervation exclusively to several muscles (extensor carpi radialis longus and brevis, the supinator, the extensor pollicus longus, the adductor pollicus, brachioradialis, extensor pollicus brevis and extensor digitorum muscles)
Pulses
- Brachial
- Radial
- Ulnar
Dermatomes
- Lateral Arm (C5)
- Lateral Forearm (C6)
- Middle Finger (C7)
- Middle Forearm (C8)
- Medial Arm (T1)
- Axilla (T2)
UCL Injuries
Sprain of Ulnar Collateral Ligament
- Valgus force (Lateral blow to elbow)
- Valgus extension overload (collection of tensil, shear, and compressive force)
- Elbow posterolateral rotatory instability
RCL Injuries
Radial Collateral Ligament Sprain
- Varus Force (medial aspect - RARE)
Forearm Compartment Syndrome
- can be acute due to trauma or exertional due to overuse
- Volar, dorsal and carpal tunnel
Early Stages: - pressure in forearm
- sensory disruption in hand and fingers
- decreased strength
pain with passive stetch
Forearm Compartment Syndrome Chronic or Increased Severity
- Decreased or absence of radial or ulnar pulses
- Volkmann’s ischemic contracture
Terrible Triad of Elbow
- Posterior dislocation, fracture of the radial head, and fracture of the coronoid process
Tennis Elbow (Lateral Epicondylalgia)
- Extensor carpi radialis brevis is most commonly affected - due to broad origin
- Inflammation or repetative stress at the lateral epicondyle
- Swelling
- POP
- Pain with active wrist extension
- Decreased grip strength and pain with gripping
Golfers Elbow (Medial Epicondylitis)
- Movement including swift, powerful, snapping o fthe wrist and pronation of the forearm
- POP on the medial epicondyle
- Avolsion of the common tendon from attechment site due to tension build up in medial epicondyle
- Neuropathy of the ulnar nerve
