Grey's Anatomy - Elbow Flashcards
1
Q
how many and what are the articulations of the elbow joint? what type of joint(membrane) is it?
A
- 2
- HUMEROULNAR JOINT
- HUMERORADIAL JOINT
- synovial
2
Q
humeroulnar joint
A
- between the trochlea of the humerus and the trochlear notch (sigmoid notch) of the ulna
3
Q
humeroradial joint
A
- between the capitulum of the humerus and the radial head
4
Q
what other articulation is there in the elbow joint? and whats it called?
A
- between the side of the head of the radius and the radial notch of the ulna
- PROXIMAL RADIOULNAR joint
5
Q
describe the distal humerus
A
- has 2 epicondyles (medial and lateral) and they support the articular elements ; trochlea and capitellum
6
Q
what do the epicondyles do
A
- support the articular elements
- attachments for muscles of the forearm
7
Q
what does each epicondyle attach to?
A
- medial = flexor-pronator muscles of anterior forearm
- lateral = extensor group of posterior forearm
8
Q
label this
A
labelled
9
Q
label this
A
label
10
Q
describe what happens to the fossa during extension and flexion
A
- flexion ; the coronoid fossa accommodates the radial head and the coronoid process
- extension ; the olecranon fossa receives the olecranon process tip on the posterior aspect
11
Q
what can you say about the way radius behaviours during ‘x’ action?
A
- when flexion occurs, the radial head articulates with the capitellum of the humerus and the inferior to the radial head is the radial neck and this is a weak spot because its thin and so it is vulnerable to fracture
12
Q
label THIS TBEROSITIES ,what happens here?
A
- radial tuberosity is insertion side of the biceps brachii tendon
13
Q
describe the ulnar image
A
- on posterior aspect has olecranon wc is the insertion point of the tricep brachii muscle
- sigmoid notch/ trochlear notch
- supinator crest where the supinator muscle attaches
14
Q
whats type of joint capsule is the elbow joint and what supports it?
A
- synovial
- ligaments on the medial and lateral aspects
15
Q
name and describe the ligament of the joint capsule
A
- radial (lateral) collateral ligament ; attaches between the lateral epicondyle of humerus and blends into the annular ligament of the radius (ligament of the proximal radioulnar joint), keeps the head of radius and capitellum of humerus in close Association during pronation and supination
- ulnar (medially) collateral ligament ; stretches over medial epicondyle of humerus and the coronoid process and olecranon of the ulna. has 3 bands, anterior, posterior and inferior band
16
Q
whats the proximal radioulnar joint and whats special about it?
A
- articulation between the head of the radius and the radial groove of the ulna
- has a ligament supporting it called the proximal radioulnar ligament
17
Q
what’s the function of the lateral collateral ligament
A
- keeps the radial head in close association with the capitellum of the humerus during supination and pronation of the forearm
18
Q
shape of the radial collateral ligament and the ulnar collateral ligament
A
- R= fan shaped
- U= triangular shaped
19
Q
describe the medial collateral ligament
A
- stretches over the medial epicondyle , coronoid process and the olecranon of the ulna
- has 3 bands ; anterior ; which is the strongest ; posterior wc is fan like and weak and the inferior wc is slender oldie and deepens the comet of the trochlea of the humerus
20
Q
label this
A
- anterior wc is the strongest
- posterior wc is fan like and weak
- inferior wc is the oblqiue and slender and depends the socket for the trochlea of humerus
21
Q
whats this
A
- supracondylar fracture of the distal humerus
- usually transvere or oblique fracture of the humerus more distally but still about he condyles where its most thin
- accounts for 75% of all elbow injuries, 90% patients kids below 10, peak age being 6-7 years of age and is due to hyperextension so like climbing bars ,
- (5% occur in elderly due to hyeprflexion)
- the child presents with loss of function, deformity and pain
- 3 main complications wc malunion c cuibtal varus / damage to most commonly the median nerve and so loose sensation of the anterior aspect of the forearm / ischaemic contracture
- treatment is surgery its an emergency
- make sure to do nerurovascular testing (motor and sensation )
22
Q
what are the complications of supracondylar fraction
A
- damage to the median (most commonly), radial or ulnar nerve
- malunion , = cubital varus ‘ aka the gunstock deformity , because looks like stock of old long barrel
- ischamic contacture ; the brachial artery can become occluded or damaged so the forearm isnt being supplied so this causes oedema resulting in COMPARTMENTsyndrome wc further exacerbate the ischaemia as it impedes arterial flow , and if this isn’t treated we get infarction , and we end the repair phase where dead tissue is replaced by fibrosis . this fibrotic tissue contracts (d my-fibroblast activity) and eventually c flexion contracture known as Volkmann’s ischaemic contracture (patient presents with wrist, fingers extend at the metacarpophalangeal joints , flexed at the interpharangeal joints,forarm pronated and the elbow flexed)
23
Q
where’s the pivot joint in the elbow
A
proximal radioulnar joint between the head of the radius and the radial groove of the ulnar and is held in place by the annular ligament
24
Q
movements of the elbow and radioulnar joint
A
- elbow joint ; full extension making valves and varus angles at long axis of the huemrus , this is known as the carrying angle and is 5-10 men, 10-15women, this angle prermists forearm to clear the hipsina. shining movement of the arm during walking, when the carrying angle deviates -5 towards the body = VARUS, cubital varus, +5 deviation = VALGUS (lateral deviation)
25
whats the major muscles flex the elbow?
- brachialis ; O= anterior surface of thehumeral shaft / I= ulnar tubersoiry
- biceps brachi (long head and short head ); long head (MORE LATERAL; O=supraglenoid intertubercule of the scapula , I= radial tuberosity / SHORT HEAD ; O= coracoid process of the scapula I= radial tuberosity with long head)
- brachioradialis ; O= lateral supraepiconduylr tuberosity /I= distal radius
26
whats the major extensors of elbow
- triceps brachii ; long medial and lateral head,
long ; O= infraglenoid tuberosity I= olecranon
medial ; medial tot he radial artery O=shfat
lateral; lat. to the radial artery O= shaft
27
what are the muscles that originate from the medial and lateral epicondyles like
- m= weak flexors
| - l= weak extensor
28
where does the supination occur and if weak where chain?
- 1) proximal radioulnar joint
2) supinators
3) bicep brachi
29
where does pronationoccur and if weak where?
1) proximal radioulnar joint
2) pronator quadratura
3) pronator teres
30
what are 2 main bursae of the elbow joint
- olecranon bursa; wc lies in the subcutanous connective tissue overlying the olecranon
- suntendinous bursa ; between the tricep tendon and the tip of the olecranon
31
function of the bursae
- decrease friction between the skin and bone(ole.) and bonesand tendon (subt) during elbow movement
32
whats the DRUJ
- distal radioulnar joint, wc is the proximal to the wrist and is a pivot joint , theres ulnar notch on the radius where it rotates anteriorly around the head of the ulna.
33
where does the axis of rotation exist?
- longitudinally through head of radius and proximally and through the styloid process of the ulna distally
34
what's an important disc at the wrist
TFCC triangular fibrocartilage complex
35
TFCC
- bind th radius and ulna together and separates the distal radioulnar joint from the wrist joint
36
what muscles c pronation and supination at the distal radioulnar joint
- SU= supinator , bicep brachi
| - P= pronator quadratus then pronator teres
37
what forms between the radius and ulna
interosseous membrane
| -runs diagonally more proximal to the radius and distally to the ulnar
38
whats the function of the interosseous membraen
- prevents displacement of the U and R during pro. and sup.
| - prvents proximal displacement of the radius if force applied to outstretched hand
39
what general classes of muscles act on the elbow join
- ARM
- posterior forearm
- supreficial anterior forarm
- intermediate muscle of anterior forearm
- deep muscle of anterior forearm
40
muscles of the arm (involves in elbow)
- bicep brachi
- brachialis
- tricep brachi
41
posterior forearm
- brachioradialis (flexor of the arm in mid prone position and is also the lateral boarder of cubital fossa)
- supinator ; forms distal floor of cubital fossa
- anconeus ; weak extensor of the elbow
42
superficial muscles of the Arm + their function
- from the ulnar to the radial side)
- flexor carpi ulnaris, palmaris longus, flexor carpi radialis, pronator teres
- they call come from the medial epicondyle but insert into different places
- common flexors
43
intermediate muscles of the anterior forarme
flexor digitorium superficials
44
deep muscles of the anterior forearm
- flexor digitorium profundus
- flexor pollicis longus
- pronator quadratus
45
flexor ulnaris
- 2 heads so 2 O=medial epicondyle of the humerus and ulnar head orgintes of the medial margin the olecranon of the ulna
- I = pisiform bone and hook of the hamate bone ad base of 5th metacarpal bone
- the ulnar nerve passes through the 2 heads of the flexor carpi ulnaris to enter the anterior compartment of the forearm
- IN= ulnar
- F= flex and adduct the wrist
46
palmaris longus
- absent in 15% of the population but when present
- O= medial epicondyle
- I =flexor retinaclum of the wrist and palmar aponeurosis
- F = weak flexor of wrist, so is used for graft harvesting in surgery and no effect left
- IN= median nerve
47
in dissecting hats underneath of the portion of the palmar longus proximal to the wrist?
-median nerve
48
flexor carpi radialis
- O= medial epicondyle
- I= base of the second and third metacarpals
- F= flexion and abducts the wrist (whilst flexor carpi ulnaris adducts it)
- IN=Mediannerve
49
pronator teres
- 2 origins ; 1 humeral head from the common flexor origin on the medial epicondyle of the humerus , and ulnar head from the coranoid process of the ulnar
- I= passes laterally (like diagonally ) an inserts on the mid shaft of the radius
- forms the latral boarder of the cubital fossa
- in between the two heads median nerve passes
50
label the
image
51
flexor digitorium superficialis
- 2 sites of orgin ; humeroulnar head wc orginates from the medial epicondyle and the radial head wc originates at the anterior surface of the radius, they form a continuous tendinous arch
- it then splits into 4 tendon of the wrist wc travel through the carpal tunnel an insert to the base the middle of the 4 phalanges
- F= flexes the metacarpophalangeal joint and proximal interphalageal joints of the 4 fingers, it also assists flexion the wrist
- IN = median nerve
52
with your knowledge why doe the Volkmann conn
- since the flexor digiotorim superficilais isn't getting b supply, it looses function and undergoes infarction, followed by fibrosis necrosis, wc involve myefibroblasts wc c contraction of the muscles , so the flexor digiotium superficialis muscles are engaged and theres extension of the metacarpophalangeal joints but flexion at the interphlangeal joints along side other signs (unopposed extension )
53
why is flexor digitorium superficilais important
- because median nerve and ulnar nerve pass between its 2heads
54
image label
image
55
deep muscles of the forearm
- flexor digitorium profundus
- flexor pollicis longus
- pronator quadratus
56
flexor digitorium profundus
-O= proximal two thrids of the shaft the ulna
and associates with the interosseous membrane
- at the wrist splits into 4 an dtrvales under the carpal tunnel ( flexor retinaculum) and ins
- I= base of the distal phalanges of the 4 fingers
-F= flexes the distal interphalangeal joints and metacarcophalangeal joints an dassits wrist flexion
-IN= little finger and ring is ulnar, but the 2 is IN by anterior branch of the interosseous branch of the median nerve
57
flexor pollicis longus
- o = anterior surface of the radial shaft and adjacent interosseous membrane
- I= base of the distal phalanx of the thumb
- F= flexed the interphaangeal joint and metacarpophalngeal joint of the humbug's
- IN= anterior osseous branch of median nerve
58
pronator quadratus
- rectangular shaped, deep to the flexor digitorium profundus and digitorium pollicis longus
- O= anterior surface of the distal ulna
- I= anterior surface of the distal ulnar
- F= pronates forearm at the radioulnar joints (proximal and distal)
- IN= anterior interesses branch of median nerve
59
posterior forearm muscles and their function and common origin
- brachioradialis
- supinator
- anconeus
- extensors and they come for lateral epicondyle
60
brachioradialis
- pradixoial muscles b original nd innervation of an extensor muscle but it is a flexor
- O= lateral supercondyular ridge of the humerus
- I= distal end of the raid just proximal to the radial styloid process
- F= flexor in midpoint postion
- IN= radial nerve
61
image
imag
62
supinator
- 2 heads
- O= lateral epicondyle 'humeral head', the other is u;anrhead from supinator crest c is on lateral(radial) boarder of ulna,
- it wraparound the ulnar together
- I= radial (lateral) boarder of the radius , extending as far distally as the insertion of the pronator teres
- F= supinates the arm, when resistance to supination at this muscles the bicep brachi supinate the forearm
- IN= radial nerve (deep branch, wc passes through 2 heads of the supinator
63
how does the supinator work
- it only exerts fiction when in pronated starting position, it contracts and fibres c lateral rotation of the radial head within the annual ligament m and lateral (external ) rotation of the radius over the ulnar in the distal raioulnar joint
64
anconeus
-o=lateral epicondyle
I= radial (lateral) side of the olecranon and proximalulnar
-F= extensor weak, assits tricpes But during pronation it abduct the ulnar and prevents the joint capsule from impingement within the olecranon Fossa
-IN= radial nerve
65
whats the median nerve and where is its passage way from the brachial plexus
- contains spinal roots 5 6 7 8 T1 ,
- runs through the cubital fossa, leaves it and then passes between the 2 heads of the pronator teresand then passes through the hummer-ulnar head and radial head of the flexor digitorium superficial
- then down the forearm linearly then runs deep to the f d suprfciialis and just proximal at theorist becomes mores superficial in position towards the lateral side
- then enters the forearm as it passes beneath (deep) to the flexor retiniculum ie. through carpal tunnel
66
describe how the anterior interosseous branch of the median nerve forms
originates at the 2 heads of pronator teres
67
what does the median nerve innervate
- deep muscles ( f d p , f.p.l., pq)
- superficial muscles of the forearm (pt, fcr, pl, NOT FCU)
- intermediate ; (fds)
68
what does damage to the median nerve c loss of
- unopposed extension due to the superficial, deep and intermediate flexors not working)
- including fdp and fpl and pq
69
what does the anterior interosseous muscle innervate
- starts at the 2 heads of the pronator teres muscles and innervates the flexor p . l . and f d profundus , then travels below the p.q and innervates it
- where it terminates at the lunate bone of the wrist
70
what other branch does the median nerve give off? whats its root, what does it innervate and what 's its significance?
- palmar branch wc forms at the distal forearm proximal to the flexor reticulum and doesnt pass through the carpal tunnel and so in carpal tunnel syndrome doesnt get compressed
- innervates the skin over the base and central balm
71
once the median nerve leaves the flexor retinaculum what does it become
- terminates as 2 branches, the digital palmar branch wc innervates the thumb and the recurrent branch wc innervates the thenar muscles of the 2 first fingers
72
interns of the hand and forearm what does the ulnar nerve innervate
-flexor carpi ulnaris and the 2 medial thenar muscles
73
whats the sensory and muscle innervations of the ulnar in the hand
- sensory = little finger and half of ring
| - motor = two lateral fingers
74
whats the coarse of the ulnar nerve
- medial to the epicondyle of the humerus ; travels in the ulnar canal
- enters the forearm as it passes in between the humeral and ulnar head of the flexor carpi ulnaris
- passes then along the medial aspect of the fdp
- enters the hand by passing superficial to the flexor retinaculum and immediately lateral to the pisiform bone
there are 2 branches to the ulnar nerve; the muscular branch which is ^ and 2 small subcutaneous branches which supply the skin
* palmar branch forms in the middle of the forarm 1/2 through the fdp and runs more medially to the muscular ulnar nerve branch F is to supply the medial side of the palm skin
* the other ulnar nerve branch is the dorsal branch wc arises more distally in the forarm and externs posteriorly to innervate the posteriomedial side of the back of the hand's skin
75
what are the branches of ulnar nerve
- muscular branch wc innervates the fCU and medial aspect of the fdp hence why the last 2 fingers are innervated by ulnar
- at the middle fo the forearm PALMAR BRANCH and supplies the medial skin of the hand hence the ring finger half and little finger
- doral branch of the ulnar nerve wc originates at the distal forearm and passes posteriorly deep to the tendon of the flexor carpi ulnaris and innervates the posptomedial aspect of the forearm and back of the half of the ring and little finger skin
76
how do you test for the ulnar nerve
-FROMENT'S SIGN
77
froment's sign
- tets for ulnar nerve palsy, specially in paralysis of adductor pollicis ,
- ask patient to grasp piece of finger between the thumb and index finger and then pull the paper
- they should be able to hold paper without flexing thumb
78
musculocutanoues nerve innervation the forearm
-MUSCLES; lateral aspect i.e brachialis (wc is on medial aspect because it inserts on the ulnar tuberosity
79
what does musculocutanoues give branch to
- lateral ante brachial cutaneous nerve providing sensory innervation to the lateral position of the forearm
80
what are the arteries of the forearm
- ulnar and radial wc are formed from the bifurcation of the brachial artery within the cubital fossa
81
what does the ulnar artery supply
- anteromedial aspect of the forearm and anatomic network surrounding the elbow joint
82
what does the radial artery supply
-posterolateral aspect of the forearm and anatomic network surrounding the elbow joint
83
what does the ulnar artery give rise to?
- anterior and posterior interosseous arteries wc supply deeper structures
84
what can you palpate on the anterior aspect of the arm and what is inside thissoace
- cubital fossa , can palpate the brachial artery, when wearing stethoscope is the location where you hear Korotkoff sounds
85
where can you palpate to listen to the ulnar radial and brachial artery
- R= lateral to the flexor carpi radials
- U= radial to the tendon of fcu and proximal to the pisiform bone
- B= cubital fossa medial to the tendon of biceps
86
veins of the forearm
-in cubital fossa ; lateral aspect = cephalic , medial = basilic , then join forming the median vein of the forearm , before they branch and follow the ulnar artery and radial artery in respect
87
whats special about the relationship between the brachial artery and its veins
- the brachial artery's pulsations help with its venous retun
88
what runs between superficial and deep veins
-perforating veins connect them
89
whats the boarders fo the cubital fossa
- lateral = brachioradiuals
- medial = pronator teres
- superior = hypothetic line of the epicondyle
- roof is the cubital aponeuosris
90
image
-
91
image
-
92
posterior forearm muscles compartments
- superficial ;
| - deep
93
superficial posterior forearm muscles whats their common function and what orgin to they share
- brachioradialis
- extensor carpi radialis longus
- extensor carpi radialis brevis
- extensor digitorium
- extensor digiti minimi
- extensor digiti ulnari
- anconeus
- extensor and lateral epicondyle
94
brachioradialis
- supracindylar lateral
- I= dital wrsit
- IN= radial
- F= flex elbow in mid-tone position (neutral) and in supinated position it assists flexion
95
extensor carpi radialis
- O=;lateral supraepicondylar rigde
- I= posterior surface of base of second metacarpal bone
- F abduct the wrist and extendit
- IN= radial nerve
96
extensor carpi radialis brevis
- O lateral epicondyle
- I= dorsal (posteriors) surface of the 3rd metacarpal bone
- F= extend and abduct the wrist
- IN= deep branch of radial nerve
97
whats the difference in inervation of brevis and longs
- longus is radial nerve whilst brevis is more deeper branch of radial nerve this is due to the difference in origin and the fact that after the EXCL orginin the radial nerve branches into superficial and deep branches
98
extensor digitorium
- O= lateral ep.
- I=splits into 4 and inserts on the extensor hood of the 4 fingers, 4 tendons of extensor digitorium are linked by fibrous band on dorsum of hand = JUNCTURAE TENDINUM, this prevents full extension of the middle and ting finger when other fingers are flexed
- F= extend fingers
- IN= posterior branch of the interosseous branch of radial nerve
99
extensor digiti minimi
- O lat. ep
- I= ulnar side of the extensor digitorium tendon, into the extensor hood of the little finger
- F= extend little finger and assist the wrist
- IN= posterior interosseus branch of radial nerve
100
extensor carpi ulnaris
- 2 heads ; 1 O=humeral head 'lat ep) the other 'ulnar head' from the olecranon, posterior surface of proximal ulna and the deep fascia
- I= base of the 5th metacarpals
- F= abduct and extend the wrist
- IN= posterior interosseous branch of radial nerve
101
why can the ECU abduct
- because 1 head comes from the posterior aspect of proximal ulnar
102
anconeus
cp
103
deep muscles of the posterior forearm
- supinator
- abductor pollicis longus
- extensor pollicis brevis
- extensor indicis
104
abductor pollicis longus
- O= interosseous membrane and adjacent posterior surface of the radius and ulna
- I = radial side of the first metacarpal
- F= abducts the thumb, assist extension of carpometacarpal joint
- IN= posterior interossoues branch of the radial nerve
105
extensor pollicis longus
- O= middle third of the posterior surface of the ulnar and the interosseous membrane
- I= on the distal phalanx of the thumb
- F = extends all the joints of the thumb; carpometacarpal , metacarpophalngeal and interphalangeal
- IN= posterior interosseous branch of radial nerve
106
extensor pollicis brevis
- O =posterior surface of the radius and interosseous membrane
- I= base of the phalanx of the thumb
- its tendon lies in the medial side of boarder of anatomical snuffbox
- IN= posterior interossues branch of radial nerve
- extends the metacarpophalangeal and carpometacarpal joints of the thumb
107
extensor indicis
- o= from the posterior surface of the ulnar
- I=extesnor hood of the index finger on medal side of tendon of extensor digitorum
- f ; extends the index finger
108
radial nerve passage
- travels anterior to the lateral epicondyle of humerus through cubital fossa where it terminates into deep branch 9'motor) = muscles of the posterior compartment
- and superficial branch (sensory) = dorsal surface of three and half fingers and portion dorsal of thumb
- after passing through cbitlfossa it passes poster to extensor carpi radialis brevis and behin the 2 heads of the supinator wc it also innervates
- after passing supinator it becomes the posterior interossues nerve
109
what does the posterior interosseous nerve supply
- extensor polices longus
- extensor p b
- apl
- ed
- edm
- ecu
- eindicis
110
dislocated ebow
- occurs when fall onto outstretched hand often child
- in mid-flexion you use the ligaments wc make you more likely to dislocate, since the elbow joint is most strongest at flexion or extension
- most common dislocation in kids and second most common inducts
- usually 90% posteriorly of the distal fragment (ulnar and radius, not the humerus
- ulnar collateral ligaments gets torn and they can be ulnar nerve damage
- anterior is 10% d direct blow from posterior aspect
- associated w fractures to the olecranon
111
pulled elbow nursemaids Elbow
- d subluxation of the radial head (partial disruption of the joint w some remaining but abnormal apposition of the articular surface i.e incomplete dislocation)
- 2-5 year olds most common
- presents w v movement and paver the lateral aspect of proximal forearm parents say 'not using arm'
- usually d tugging kids hands when doing arm play
- injury mostly in pronation b annular ligament is taut in supination and more relaxed in pronation do easier to sublaxtion to occur
- d longitudinal traction radial head tears from distal attachment of annular ligament
- radial head is the displaced distally through the torn ligament
- less common asked grows up because the annular ligament strengths
112
radial head and neck fracture
-most common elbow fracture in adults
- fall on outstretched elbow so radius head impacts the capitellum of the humerus
-patient presents with pain in lateral since radius and loss of range of movement
-on x ray difficult to see but can see a 'sail sign'
cis c by the displacement of the anterior /posterior fat pad (pos. within olecranon fossa
113
osteoarthiris of the elbow
- tear and wear d age
- 4:1 in men to women esp athletics and sports
- patients say 'grating sensation' =crepitusor locking d loose fragments of ligaments
- osteophyts can impinge the ulnar nerve
114
RA
- autoimmune disease where antibodies known as rheumatoid factor attack the synovial membrane , inflamed synovial membrane form panes wc penetrates the cartilage and adjacent bone c joint erosion and deformity
- affects mainly the metacarpophalane and ineterphalangeal of hands feels and cervial spine
- autoimmune process causes organ damage egg skin, eyes kidney bv lungs etc,
- more women 2:1 or 3:1
- 1% population peak 40-50
115
what do you see in x ray of RA
- joint space narrowing
- periarticular osteopenia (hollowing of bone)
- junta-articular bone erosions in non cartilage protected bone
- subluxationand gross deformity
116
lateral elbow tendinopathy (tennis elbow)
- 3% of 40-60 yrs
- presents with pain in common extensor regions lateral epicondyle
- extensor carpi radialis brevis works to stabilise the wrist when elbow straight
- it weakens fromoversuse and microscopic tears form in tendon where it attaches to lateral epicondyle c inflammation and pain
- typically experience pain over lateral epicondyle during extension of the wrist especially if against resistance
- 90% recover in a year just let it rest and modify actives
117
medial elbow tendipathy golferes elbow
- common flexors medial epicondlt
- 10xless common that lateral elbow tendipathy
- valgus stress
- mostly between pt and fcr origin
- pain is produced on resisted flexion or pronation of the wrist
- ulnar nerve symptoms in 20% of patients
118
common swellignaroudn the elbo
- olecranon bursitis
- rhemautoid nodules
- gouty tophi = gout d defective purine metabolism leasing to increased uric acid and so increased in blood and forms crystals of crate at synovial joints wc trigger innate immune system and c inflammation. treats with NSAIDs. and xanthine oxidase inhibitor like allopurinol to reduce the production of it...tophi are nodule masses of monosodium rate crystals deposited in soft tissues , later become complication of hyperuricaemia, most sites are fingers, ears, toes alnows
119
olecranon bursitis aka?
(students elbow) ( d repeated trauma when students kneel on table, it is cystic fluid filled and transilluminates (light can be shone through it, treat it with bandaging (compression and if infected aspiration and ab rewired)
120
RA
extra-articular manifestations of RA affects 20% of patients , most tend to smokers and tend to have more aggressive joint disease, they can be prone to other extra-art.. where RA manifesting in bv and inflames c vasculitis and lung disease)
121
gout trophi
gout d defective purine metabolism leasing to increased uric acid and so increased in blood and forms crystals of crate at synovial joints wc trigger innate immune system and c inflammation. treats with NSAIDs. and xanthine oxidase inhibitor like allopurinol to reduce the production of it...
-tophi are nodule masses of monosodium rate crystals deposited in soft tissues , later become complication of hyperuricaemia, most sites are fingers, ears, toes alnows
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cubital tunnel syndrome
- cubital tunnel is when the ulnar travels behind the medial epicondyle fo humerus
- it is formed by 2 heads of fcu
- funny bone hit it
- compressioncan c qarasethia silting in compression of nerve and paresthsa
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What number and types of joints does the biciptal bicep pass through
- 3
| - Glenohumeral , proximal radioulnar , elbow
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Which the the uni... muscle
Flexor pollicis longus
