Lecture 15

Question 1

Three joints of the elbow?

What movement do they do?

Answer 1

humero-radial = flexion and extension

humero-ulnar = flexion and extension

radio-ulnar = pronation and supination

Question 2

What are the ligaments of the elbow?

Answer 2

anular ligament of radius

radial collateral ligament

ulnar collateral ligament

Question 3

Radio-ulnar joint?

Answer 3

proximal = radial head with radial notch of ulna, it is held in place by the anular ligament

middle = interosseous membrane (connective tissue)

distal = articular head of ulna with ulnar notch of radius

movement = supination and pronation

Question 4

Radiocapitellar and anterior humeral lines?

Answer 4

Radiocapitellar line: A line drawn down the neck of the
radius should intersect the capitulum

Anterior humeral line: A line drawn down the anterior
surface of the humerus should intersect the middle third of the capitulum

Question 5

Nursemaid’s elbow or pulled elbow?

Answer 5

subluxation of the radial head
radial head slips out of the annular ligament
common in children (1-4)
the radiocapitellar line will not intersect the capitulum

easily reduced - pop the radial head back under the ligament

Question 6

supracondylar fracture of the humerus?

Answer 6

median nerve and brachial artery are at risk

the anterial humeral line will not line up with the capitulum

if not recognized and repaired, Volkmann’s ischemic contracture can occur

Injury to brachial artery lead to ischemic flexor contracture of the muscles of the anterior compartment

Question 7

What structures are at risk during a posterior dislocation of the elbow joint?

Answer 7

ulnar and median nerves

brachial artery

Question 8

Fracture of the radial head?

Answer 8

common, but can be very subtle and easy to miss

look for signs of elbow effusion (sail sign)

Question 9

pronator teres?

Answer 9

function:
pronation

nerve:
median nerve

Question 10

flexor carpi radialis?

Answer 10

function:
flexes and abducts the wrist

nerve:
median nerve

Question 11

palmaris longus?

Answer 11

function:
flex the wrist
resist shearing forces when gripping

nerve:
median nerve

Question 12

flexor carpi ulnaris?

Answer 12

function:
flexes and adducts the wrist

nerve:
ulnar nerve

Question 13

Flexor digitorum superficialis?

Answer 13

function:
flexes the wrist, flexes the MCP and PIP (2-5)

nerve:
median nerve

Question 14

Flexor pollicis longus?

Answer 14

function:
flexes MCP and IP joint of the thumb

nerve:
anterior interosseous nerve

Question 15

flexor digitorum profundus?

Answer 15

function:
flexes the wrist and flexes MCP, PIP, DIP (2-5)

nerve:
anterior interosseous nerve (lateral 2)

ulnar nerve (medial 2)

Question 16

pronator quadratus?

Answer 16

function:
pronation of the forearm

nerve:
anterior interosseous nerve

Question 17

Cubital fossa?

Answer 17

Borders:

medial: pronator teres
lateral: brachioradialis
superior: epicondyles
floor: brachialis muscle
roof: skin, fascia, bicipital aponeurosis, and medain cubital vein

contents:
median nerve, brachial artery, and bicep tendon

Question 18

Brachioradialis?

Answer 18

function: accessory flexor when the hand is midprone position
nerve: radial nerve

Question 19

Extensor carpi radialis longus?

Answer 19

function: extends and abducts the wrist
nerve: radial

Question 20

Extensor carpi radialis brevis?

Answer 20

function: extends and abducts the wrist
nerve: deep branch of the radial nerve

Question 21

Extensor digitorum?

Answer 21

function: extends wrist, extends MCP, PIP, DIP (2-5)
nerve: posterior interosseous nerve

Question 22

Extensor carpi ulnaris?

Answer 22

function: extends and adducts the wrist
nerve: posterior interosseous nerve

Question 23

Extensor digiti minimi?

Answer 23

function: extends the MCP, PIP, and DIP of the little finger
nerve: posterior interosseous nerve

Question 24

supinator?

Answer 24

function: supination of forearm
nerve: posterior interosseous

Question 25

abductor policis longus?

Answer 25

function: abducts CMC of thumb
nerve: posterior interosseous

Question 26

Extensor policis brevis?

Answer 26

function: extends the CMC and MCP of the thumb
nerve: posterior interosseous

Question 27

Extensor indicis?

Answer 27

function: extends the index finger
nerve: posterior interosseous

Question 28

Extensor policis longus?

Answer 28

function: extends the CMC, MCP, IPJ of the thumb
nerve: posterior interosseous

Question 29

Tennis elbow?

Answer 29

Lateral epicondylitis

Common extensor origin

Question 30

golfers elbow?

Answer 30

Medial epicondylitis

Common flexor origin

Question 31

Colle’s fracture?

Answer 31

fracture of the distal radius

“Dinner fork” deformity of the distal forearm because the distal fracture fragment of fracture is displaced posteriorly

May have injury to median and/ulnar nerves or acute carpal tunnel syndrome

Can compromise the radial or ulnar arteries and impair vascular supply to the hand

Question 32

Smiths fracture?

Answer 32

fracture of the distal radius (also called reverse Colle’s)

“Garden spade” deformity of distal forearm because of anterior displacement of the distal fragment

May have injury to median and/ulnar nerves or acute
carpal tunnel syndrome