Lecture 12 Flashcards

1
Q

What type of joint is the elbow joint

A

-hinge joint

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2
Q

What is the 3 joints of the elbow joint

A

-ulnohumeral joint
-radiohumeral joint
-proximal radioulnar joint

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3
Q

What are the elbow ligaments

A

-ulnar (medial collateral ligament
-radial (lateral) collateral ligament

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4
Q

Joints of the wrist and hand

A

-radioulnar joint
-midcarpal joints
-carpometacapal joint
-metacarpalphalangeal joint
-proximal interphalangeal joint
-distal interphalangeal joint

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5
Q

Ligaments of the wrist and hand

A

-collateral ligaments of wrist and fingers
-collateral ligaments of fingers
-intercarpal ligament
-triangular fibrocartilage complex (TFCC)

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6
Q

What are the intercarpal ligaments

A

-dorsal
-palmar

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7
Q

What is the triangular fibrocartilage complex (TFCC)

A

-complex made up of load beaing triangular fibrocartilage artciular disc and ligaments on medial aspect of wrist

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8
Q

What does the TFCC do

A

-disperses axial load from carpals to ulna

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9
Q

What is TFCC thickened by

A

-ulnar collateral ligament medially

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10
Q

What is the TFCC a major stabilizer of

A

-ulnocarpal joint
-distal radioulnar joint

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11
Q

Nerves of the elbow and wrist to note

A

-ulnar nerve
-median nerve

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12
Q

What are the elbow flexors

A

-biceps brachii
-brachialis
-brachioradialis

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13
Q

What are the heads of the biceps

A

-long head
-short head

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14
Q

What is another movement of the long head of biceps other than elbow flexion

A

-shoulder flexion

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15
Q

What are the elbow extensors

A

-triceps brachii
-anconeus

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16
Q

Where does the common flexor tendon originate

A

-medial epicondyle

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17
Q

Where does the common extensor tendon originate

A

-lateral epicondyle

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18
Q

What are the major structures that run through the carpal tunnel

A

-flexor tendons
-median nerve

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19
Q

What are the ROM of elbow

A

-flexion
-extension
-pronation
-supination

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20
Q

What are the ROM of the wrist

A

-flexion
-extension
-radial deviation
-ulnar deviation

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21
Q

What are the ROM of the digits

A

-flexion
-extension
-adduction
-abduction
-1-5th opposition/reposition

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22
Q

What is lateral epicondylitis known as

A

-tennis elbow

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23
Q

MOI tennis elbow

A

-overuse of forearm extensors

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24
Q

What sports are tennis elbow common in

A

-tennis
-squash
-badminton

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25
Q

What muscles are tennis elbow common in

A

-extensor carpi radialis longus
-extensor carpi radialis brevis

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26
Q

What are the signs and symptoms of tennis elbow

A

-TOP common extensor origin
-pain and weakness with wrist extension

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27
Q

Acute management of tennis elbow

A

-stretch wrist extensors in elbow extension and flexion
-PIER
-tennis elbow brace
-eccentric strengthened program for forearm extensors

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28
Q

What is medial epicondylitis known as

A

-golfers elbow

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29
Q

MOI golfers elbow

A

-overuse of wrist flexors

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30
Q

What sports are golfers elbow common in

A

-golfers
-pitchers

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31
Q

What muscles are most commonly affected by golfers elbow

A

-flexor carpi radialis
-pronator teres

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32
Q

Signs and symptoms of golfers elbow

A

-TOP common flexor origin
-pain and weakness with wrist flexion

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33
Q

Acute care of golfers elbow

A

-stretch forearm flexors
-PIER

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34
Q

MOI ruptured biceps

A

-sudden lengthening of contracting muscle (eccentric)
-sudden load when lifting or catching a heavy load

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35
Q

Where is ruptured biceps most common

A

-distal tendon

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36
Q

Signs and symptoms of ruptured biceps

A

-popeyes muscle balled up
-bruising
-pain near insertion of biceps into radial tuberosity
-pain and weakness with elbow flexion and supination

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37
Q

Acute management of ruptured biceps

A

-PIER
-pressure pad to approximate ends
-shorten biceps in sling to remove tension
-surgical repair

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38
Q

MOI dequervains syndrome tenosynovitis

A

-overuse of thumb due to gripping/wringing

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39
Q

What is dequervains syndrome tenosynovitis

A

-inflammation of the tendons and sheath around the thumb tendons

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40
Q

Signs and symptoms of dequervains syndrome tenosynovitis

A

-pain over tendons of thumb
-weakness in thumb
-abduction or extension
-pain with gripping

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41
Q

What sport is dequarvains syndrome tenosynovitis common in

42
Q

Special test for dequarvains syndrome tenosynovitis

A

-finkelstein test

43
Q

Acute management of dequarvains tenosynovitis

A

-PIER
-thumb spica brace

44
Q

What can happen to dequarvains tenosynovitis if left untreated

A

-can progress to thickening/scarring
-reduced ROM

45
Q

MOI elbow hyperextension injuries

A

-FOOSH
-sometimes with an added external force

46
Q

Signs and symptoms of elbow hyperextension injuries

A

-anterior elbow pain
-swelling from ligament/capsule sprain and/or muscle sprain
-posterior elbow pain from osteochondral lesion

47
Q

What do you need to rule out in an elbow hyperextension injury

A

-olecranon fracture

48
Q

Acute management of elbow hyperextension injury

A

-PIER
-shorten injured tissues
-sling
-tape job

49
Q

MOI ulnar collateral ligament sprains of elbow

A

-FOOSH
-overuse by repeat valgus force on the elbow

50
Q

Signs and symptoms of ulnar collateral ligament sprains of elbow

A

-pain and laxity in medial elbow joint
-can include ulnar nerve symptoms

51
Q

Special test for ulnar collateral ligament sprains of elbow

A

-valgus stress test

52
Q

Who is ulnar collateral ligament sprains of elbow common in

A

-pitchers due to repeat high velocity force

53
Q

What surgery is used for ulnar collateral ligament sprains of elbow

A

-tommy john surgery

54
Q

What does tommy john surgery do

A

-reconstructs UCL using a graft tendon from palmaris longus, semitendonosus or gracilis

55
Q

MOI collateral ligament sprains of the wrist

A

-FOOSh
-forced forearm rotation

56
Q

What ligament is affected with valgus force

A

-ulnar collateral ligament

57
Q

What ligament is affected with varus force

A

-radial collateral ligament

58
Q

Signs and symptoms of collateral ligament sprains of the wrist

A

-pain
-swelling and instability of medial (UCL) or lateral (RCL) aspect of wrist

59
Q

Special test for UCL

A

-valgus stress test

60
Q

Special test for RCL

A

-varus stress test

61
Q

Acute management of collateral ligament sprains of the wrist

A

-PIER
-wrist wrap

62
Q

What is UCL sprain of the thumb known as

A

-skiers thumb
-gamekeepers thumb

63
Q

MOI UCL sprain thumb

A

-traumatic or overuse hyperabduction of the thumb

64
Q

Traumatic MOI UCL sprain thumb

A

-skiers thumb
-thumb gets caught
-FOOSH
-catching ball

65
Q

Overuse MOI UCL sprain thumb

A

-gamekeepers thumb
-repeat gripping/twisting

66
Q

What can UCL sprain thumb also result in

A

-avulsion fracture

67
Q

Signs and symptoms of UCL sprain thumb

A

-pain
-swelling and instability at 1st MCP joint

68
Q

When is surgery recommended for UCL sprain thumb

A

-for instability to stabilize joint
-prevents osteoarthritis longer term

69
Q

Acute management for UCL sprain thumb

A

-PIER
-possible x ray to rule out avulsion
-brace for healing
-tape for RTP

70
Q

What ROM do you want to limit with a thumb tape job

A

-hyperextension
-abduction

71
Q

Acute MOI TFCC tear

A

-FOOSH
-forced forearm rotation

72
Q

Overuse MOI TFCC tear

A

-repetitive wrist motions

73
Q

Signs and symptoms of TFCC tear

A

-medial wrist pain
-pain with ulnar deviation and loading through wrist
-popping/clicking
-wrist weakness

74
Q

Special test for TFCC tear

A

-TFCC compression test

75
Q

Acute management of TFCC tear

A

-PIER
-brace as heals
-anti-inflam injections if needed
-surgery for persistent instability

76
Q

MOI elbow dislocations

77
Q

Signs and symptoms of elbow dislocations

A

-deformity
-pain
-holding elbow
-tingling/numbness
-shock

78
Q

Acute care for elbow dislocations

A

-stabilize
-splint
-monitor/treat for shock
-ER/EMS
-reduction under sedation

79
Q

MOI elbow fractures

A

-direct trauma
-fall

80
Q

Signs and symptoms of elbow fractures

A

-pain
-unable or unwilling to move elbow

81
Q

Acute care for elbow fractures

A

-splint
-monitor for shock
-ER for xrays/surgery

82
Q

MOI colles fracture

83
Q

What happens with a colles fracture

A

-distal radius gets displaced posteriorly

84
Q

Signs and symptoms of colles fracture

A

-dinner fork deformity
-pain
-numbness

85
Q

Acute management of colles fracture

A

-splint
-monitor for shock
-emerge for xrays
-surgery if unable to align

86
Q

MOI scaphoid fracture

87
Q

Signs and symptoms of scaphoid fracture

A

-TOP of anatomical snuffbox

88
Q

Why does scaphoid have a reduced ability to heal

A

-scaphoid has poor blood supply

89
Q

MOI metacarpal and finger fractures

A

-axial compression (jammed)
-direct trauma
-being stepped on

90
Q

Signs and symptoms of metacarpal and finger fractures

A

-localized pain
-swelling
-unable to grip

91
Q

Acute care of metacarpal and finger fractures

A

-buddy tape to stabilize
-SAM splint

92
Q

What may happen with metacarpal and finger fractures

A

-avulsion fractures (tendon pulls off piece of bone)

93
Q

MOI cyclist palsy

A

-compression from handlebars

94
Q

Signs and symptoms of cyclist palsy

A

-tingling/numbness/nerve pain
-decreased muscle strength of 5th digit
-hand cramping

95
Q

Who is cyclist palsy common in

A

-new cyclists
-distance cyclists

96
Q

Prevention of cyclist palsy

A

-avoid hyperextension of wrist on handlebars
-proper bike fit

97
Q

Acute care of cyclist palsy

A

-PIER
-splint
-may require NSAIDS

98
Q

MOI carpal tunnel syndrome

A

-overuse of wrist flexor tendons causing pressure on median nerve within carpal tunnel

99
Q

Signs and symptoms of carpal tunnel syndrome

A

-burning/tingling/numbness in anterior wrist and hand (along median nerve distribution- digits 1-3 and 1/2 of 4)
-decreased grip strength

100
Q

Acute care for carpal tunnel syndrome

A

-bracing
-PIER
-anti-inflam treatment
-proper ergonomic set up
-steroid injection sometimes
-surgery

101
Q

What does surgery for carpal tunnel syndrome do

A

-open up tunnel if conservative treatment unsuccessful