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CATA 263 > lecture 12: conditions of the elbow and forearm > Flashcards

lecture 12: conditions of the elbow and forearm Flashcards

1
Q

what are the 2 joints assocatied with the elbow/forearm

A

humeroulnar joint

proximal/distal radioulnar joint

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2
Q

what is the function of the humeroulnar joint

A

flexion and extensionn

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3
Q

what is the function of the prox and distal radioulnar joint

A

supination and pronatior

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4
Q

what is the most commonly injuried ligament of the elbow

A

anterior bands of MCL

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5
Q

what are some ligaments of the elbow

A

MCL
LCL
annular ligament

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6
Q

what is the function of the annular ligament

A

keeps the radial head in place

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7
Q

what are the muscles that help with elvow and wrist movement

A

triceps, biceps wrist extensions and flexors

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8
Q

what are the 3 nerves of the arm

A

1) median nerve
2) ulnar nerve
3) radial nerve

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9
Q

where does the median nerve pass thru

A

goes thru pronator quadratus

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10
Q

where does the ulnar nerve pass thry

A

goes thru flexor carpi ulnaris

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11
Q

where does the radial nerve paSS THROUGH

A

through supinatory (dorsal side)

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12
Q

what nerve more commonly gets injured iwth valgus stretch

A

ulnar nerve

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13
Q

what is another name for MCL

A

ulnar collateral ligament

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14
Q

what is a MCL sprain caused by

A

valgus loading of the humeroulnar
joint
• FOOSH

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15
Q

what is the problem with a larger carrying angle

A

since there is more stress put on the medial side they are most likely to injure the MCL

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16
Q

MCL is typically injured in what types of athletes

A

overhead atheltes

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17
Q

what movements causes the most stress on MCL

A

cocking and acceleration pahses

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18
Q

what band of the MCL is most commonly injured

A

anterior band

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19
Q

what motion can injure the posterior band of the MCL

A

elbow flexion past 60 degrees (most strecthed in full flexion)

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20
Q

ehat are the SS of MCL sprain

A 
Pain with movement
• Feeling of potential instability
• Pronation and wrist flexors weak
• Swelling can be noted- medial and posterior aspects
• Ecchymosis
• Ulnar nerve involvement
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21
Q

what movement will be weak with MCL

A

pronation and wrist flexors

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22
Q

true or false: there is usually ulnar nerve involvement in MCL

A

true

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23
Q

what is valgus extension overload

A

Collection of tensile, shear and compressive forces caused by UCL laxity

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24
Q

where is there a lot of tension of valgus extension overlead

A

on MCL and ulnar nerve

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25
Q

and are the SS of valgus extension overlead

A

posteromedial and lateral elbow pain, nerve paresthesia

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26
Q

what strucutes will be compressed in valvus extrensionn overload

A

radial head and posterior medial olecrannon process

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27
Q

is LCL sprain rare and why

A

yes because most positions are shielded from varus stress

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28
Q

what are the SS of LCL sprain

A

pain, laxity

weakness during pronation and supination of wrist extensors

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29
Q

anterior capsular ligament sprain can be seen in what MOI

A

FOOSh (because of hyperextension of tehe elbow)

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30
Q

where will there be pain with an anterior capsular ligament sprain

A 
Pain in cubital fossa with
palpation
• Pain with passive elbow
extension at EROM
• Elbow flexors may also be
affected
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31
Q

true or false:
• Elbow flexors may also be
affected in anterior capsular ligament sprain

A

true

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32
Q

what is anothre name for medial epicondylitis

A

golfers eblow

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33
Q

what is medial epicondylitis caused by

A

Repeated, medial tension/lateral
compression (valgus forces)

• Swift, powerful snapping of the
wrist and pronation of the forearm

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34
Q

what are the SS of medial epicondylistis

A

Swelling, ecchymosis

  • Tenderness on origin of common flexor tendon (just distal to the medial epicondyle)
  • 1-2cm below along FCR and PT muscle
  • Pain with wrist flexion and pronation
  • Grip decreased
  • May have nerve involvement- ulnar nerve
  • Valgus stress test may cause pain at 20-30°
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35
Q

where will there be tendernesss for medial epicondylitis

A

Tenderness on origin of common flexor tendon (just distal to the medial epicondyle)

• 1-2cm below along FCR and PT muscle

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36
Q

can medial epicondylitis have any nerve involvement ?

A

yes ulnar

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37
Q

what is little league elbow

A

Little league elbow”- avulsion of the common flexor tendon from
medial epicondyle due to tension build up

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38
Q

what is vulnerable in litlte league elbow

A

growth plate

39
Q

how can you avoid little league elbow

A

restrict # of pitches/week

less than 200, 3-4 innings/game

40
Q

what is another name for lateral epicondylitis

A

tennis elbow

41
Q

what is lateral epicondylistis

A

Inflammation or repetitive

stresses at the lateral epicondyle which Irritates the common origin of the wrist extensor muscles

42
Q

what are the most common muscle affected by latetral epicondylitis

A

extensior carpi radialis brevis

43
Q

true or false: lateral epicondilytis can be caused by repetive concentric forces

A

false, eccentric

44
Q

what are the SS of lateral epicondylitis

A

Pain over the lateral epicondyle

  • Decreased grip strength, pain with gripping
  • May see swelling, point tenderness over lateral epicondyle with palpation

• Pain with resisted wrist extension, elbow extension, and forearm
supination

• Possible entrapment of the radial nerve

45
Q

where will there is point tenderness in lateral epicondylitis

A

main over lataral epicondylitis

46
Q

is there any nerve enrtapment involved with latteral epicondylitis

A

yes possible enttrapment of radial nerve

47
Q

what motions will be painful for lateral epicondylitis

A

pain w reistance wrist extension, elbow extension and foream supinationn

48
Q

what nevre is superficial

A

ulnar nevre

49
Q

what is the problem with ulnar nerve being superficial

A

it predisposes is to concussive forces

50
Q

what is the MOI of ulnar nerve pathology

A

May chronically sublux as forearm is flexed
(Sublux from behind medial epicondyle)

• Subject to traction forces when
throwing (valgus)

• Inflammed structures can decrease cubital tunnel leading to compression of the ulnar nerve

51
Q

inflammed structures can dexrease cubital tunnel which leads to what

A

compression of the ulnar nerve

52
Q

what are the SS assocatied with ulnar nerve pathology

A

• May complain of decreased sensory and motor function

  • Complain of increased symptoms with elbow flexed for extended periods of time
  • Night pain- if elbow flexed
  • Burning to medial forearm, pinky/ring finger
  • Decreased strength of finger flexors, thumb abductors and FCU

• Numbness on dorsal side- indicates ulnar neuropathy coming from the
elbow

• Numbness on the palmar side- indicates entrapment in the tunnel of guyon

53
Q

Ulnar nerve is stretched with what movements

A

elbow flexion and wrist extension

54
Q

where will there be burning for ulnar nerve pathology

A

burning to medial forearm, pink/ring finger

55
Q

where will there be decreased strengtth witth ulnar nervre pathology

A

decreased strength of finger flexiors, thumb abductors and FCU

56
Q

wha are the 2 cmomon places for ulnar nerve entrapment

A

1) between two heads of the FCU

2) behind medial epicondyle

57
Q

how is radial nerve pathology most comoonly injured

A

Most commonly injured with deep lacerations of the elbow or

secondary to fractures of the humerus or radius

58
Q

what is radial tunnel syndrome and where is it locatied

A

Entrapment of the radial nerve

• Located more distally then lateral epicondylitis

59
Q

what are the SS of radial nerve patholy

A

• S/S reproduced with resisted supination, extension of the middle finger

60
Q

where is median nerve pathology usually injured

A

at distal foream

61
Q

explain how the median nerve patholgy is injured

A

Pressure as the nerve crosses the
cubital fossa can put pressure on the
median nerve

62
Q

median nerve compresses by the BLANK muscle

A

pronator teres

63
Q

what is pronnator teres synndrome

A

Inability to pinch the tips of the

thumb and index finger together

64
Q

where does increase pressure happen in forearm compartment syndrome

A

incrased pressure in the palmar, dorsal components of the forearm

65
Q

what is forearm compartmennt syndrome caused by

A

hypertrophy muscles
• Hemorrhage
• Fractures to the mid forearm or distal radius, supracondylar area

66
Q

forearm comparement sybdrome icnrnases the risk of compromising what things

A

1) circulationn

2) neurological function

67
Q

ehat are the SS of forearm compartment syndrome

A

Complains of pressure in the
forearm

• sensory disruption in the
hand/fingers

• decreased muscular strength

• pain during stretching of the
muscles

• Prolonged/increased intensity,
absence of radial or ulnar pulses
can lead to Volkmann’s ischemic contracture

68
Q

Prolonged/increased intensity,

absence of radial or ulnar pulses can lead to what

A

Volkmann’s ischemic contracture

69
Q

biceps stran can occur where

A

occur midbelly of muscle of distal end of tendon

70
Q

biceps rubptures are most common in what age and gender and why

A

in males 40 and plus

=tendonn degrades with time

71
Q

what is the MOI of biceps strain/rupture

A

eccentric loading of the biceps brachii when elbow is flexed to 90 degrees

72
Q

where is there loss of strength in a biceps strain/rupture

A

elbow flexion and supination

73
Q

what are the chief complaints of biceps strain/rupture

A

immediate pain, “pop”, loss of elbow flexion

74
Q

is there any swelling with biceps

A

yes swelling and ecchymossi

75
Q

true or false: there is no palpable defect fo biceps straign

A

false there is palpable defect possible

76
Q

what is triceps strain usually cause by

A

eccentric loading of the tricpe s

77
Q

what are the chief complants of triceps strain

A

pain with elbow extension, loss of strength

78
Q

true or false: there is possible swelling with triceps straign

A

true, and ecchymosis and palpable defect

79
Q

elbow dislocations are usually caused by

A

large trauamatic force

=axial load through the forearm with elbow slightly flexed

80
Q

posterior dislocation of the elbow is approximately BLANK percent of the cases

A

90%

81
Q

what is the position of the elbow in posterior discolationns

A

forearm is displaced posterior or posterolateral to the humerus

82
Q

elbow dislocations dont swell alot?

A

FALSE THEY RAPIDLY SWELL AND HAVE DEFORRMITY

83
Q

what is the problem with elbow dislocations

A

it compromises blood vessels and nerves therefore reduction needs to be doneASAp

84
Q

how does osteochondritis dissicans of the capitellum develop from

A

Develops from increased valgus loading compressing the radial head and capitulum with overhead throwing

85
Q

what are the chief explain of osteochondritis dissicans of the capitellum (3)

A

Lateral elbow pain that increases with activity

  • A flexion contracture
  • Locking of the elbow (loose body)
86
Q

what can lead to osteochondritis dissifcacans of the capitellum

A

LCL sprain and valgus extension overload

87
Q

true or false: olecrannon bursitis can only be acute

A

false also chronic

88
Q

explain the MOI for olecranon bursitis

A

Fall on flexed elbow

• Constantly leaning on elbow- repetitive pressure

89
Q

where is the subcuteanous bursa located

A

betweent he olecranon process and the skin

90
Q

how is subcuteanous bursa typically injured

A

from a traumatic force to the elbow

91
Q

where is the subtendinous bursa located

A

located b/w triceps tendon and olecranonn process

92
Q

how does the subtendinous get inflammed

A

due to repetitive streeses applied to a joint

93
Q

what are the SS of olecreanon bursitis

A

Immediate, tender swollen area (golf ball)
• redness
• Pain with movement of the elbow
• Rebound pain

94
Q

what is assocaited with rebound pain

A

olecranon bursistis

CATA 263 (17 decks)

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