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DPT 616 : MSK > MSK Management of the Elbow and Forearm > Flashcards

MSK Management of the Elbow and Forearm Flashcards

1
Q

t/f: fx in the elbow are often difficult to regain full ROM in

A

true

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2
Q

the ulnar nerve goes through the ___ ____

A

ulnar groove

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3
Q

irritation of the ____ compounds medial epicondylalgia

A

UCL

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4
Q

t/f: there is a synovial lining in the radial collateral lig

A

true

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5
Q

what is a quicker and easier way to gather pt info than a regular DASH?

A

quickDASH

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6
Q

is the trochlea on the side of the ulna or radius?

A

ulna

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7
Q

is the capitulum on the side of the ulna or radius?

A

radius

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8
Q

what ligament wraps around the radial head?

A

the annular ligament

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9
Q

what information should we gather in the pt history?

A

demographics

PMH

MOI

HPI

limitations/impairments

pain profile

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10
Q

if a pt has medial elbow pain, what should we be thinking about?

A

wrist flexors, ulnar nerve, medial epicondylalgia

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11
Q

if a pt’s occupation requires for them to lifting objects with pronation, what may be stressed?

A

wrist extensors

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12
Q

what info should we gather from observation?

A

posture

symmetry

carrying angle

epicondyle and olecranon alignment (triangle)

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13
Q

what is the normal carrying angle?

A

15 deg

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14
Q

do men or women tend to have a larger carrying angle? why?

A

women bc they tend to have wider hips

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15
Q

t/f: the elbow moves mostly in the sagital plane, but there is some add/abd to get the hand to the face

A

true

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16
Q

if we have the time, should we use girth or volumetric measurements for better measurements of the wrist and elbow?

A

volumetric measurements

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17
Q

why should we check the LE with cervical signs?

A

bc it would sniff out cervical myelopathy (cord and nerve root compression >65 y/o)

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18
Q

what is the spinal level of the biceps?

A

C5

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19
Q

what is the spinal level of the brachioradialis?

A

C6

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20
Q

what is the spinal level of the triceps?

A

C7

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21
Q

what DTRs should we check?

A

biceps, brachioradialis, and triceps

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22
Q

what is normal elbow flexion?

A

150-160 deg

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23
Q

what is normal elbow extension?

A

5-10 deg (hyperextension)

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24
Q

what is normal elbow pro/sup?

A

80-90 deg

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25
what is the concave surface of the humeroulnar jt?
trochlear notch of the ulna
26
what is the convex surface of the humeroulnar jt?
trochlea of the humerus
27
what is the roll and glide of the humeroulnar jt in flexion?
ulna rolls and glides ant on the humerus
28
what is the roll and glide of the humeroulnar jt in extension?
ulna rolls and glides post on the humerus
29
what is the concave surface of the humeroradial jt?
fovea of the radial head
30
what is the convex surface of the humeroradial jt?
capitulum of the humerus
31
what is the roll and glide of the humeroradial jt in flexion?
radius rolls and glides ant on the humerus
32
what is the roll and glide of the humeroradial jt in extension?
radius rolls and glides post on the humerus
33
what is the concave surface of the proximal radioulnar jt?
radial notch of the ulna
34
what is the convex surface of the proximal radioulnar jt?
radial head
35
what is the roll/spin/glide of the proximal radioulnar jt in pronation?
radius spins med on the ulna radius glides ant ulna glides post
36
what is the roll/spin/glide of the proximal radioulnar jt in supination?
radius spins lat on the ulna radius glides post ulna glides ant
37
what are the key points of consideration in the examination of muscle function?
active insufficiency muscle's angle of pull each muscle's fxn across primary and secondary jts
38
there is better elbow flexion with shoulder _____
extension
39
muscles have the most power _____
mid-range
40
what are the flexors at the elbow?
biceps brachialis brachioradialis
41
the elbow extensors are ___% strength of the flexors
60
42
most elbow flexors force is generated bw _______ deg of flexion w/supination (biceps and brachialis)
90-110
43
where are the biceps the strongest?
in supination
44
where is the brachialis the strongest?
in pronation
45
where is the brachioradialis the strongest?
in neutral
46
what are the extensors at the elbow?
triceps anconeus
47
the triceps produce what motions?
shoulder ext elbow ext adduction
48
where is the peak torque of the triceps?
bw 70-90 deg of flexion
49
the long head of the triceps accounts for ___% of total torque of elbow extension
25
50
the anconeus contributes _____% of total torque of elbow extension
10-15
51
the pronators are _____% strength of supinators
85
52
the biceps contributes to supination primarily at ___ deg flexion
90
53
what is the first muscles to supinate and mostly active in extension?
the supinator
54
what muscle is an elbow flexor and pronator primarily w/resistance?
pronator teres
55
what should we be feeling with palpation?
the jt line just proximal to the wrist ulnar and radial styloid processes med/lat epicondyles head of the radius muscles
56
what are the wrist flexors?
pronator teres flexor carpi radialis palmaris longus flexor carpi ulnaris
57
what are the wrist extensors?
extensor carpi radialis brevis and longus extensor digitorum extensor carpi ulnaris
58
how is the varus/valgus stress test performed?
elbow flexed to 20 deg avoid full supination valgus: stabilize the forearm medially and push the elbow in varus: stabilize the forearm laterally and push the elbow out
59
what nerve may get irritated by the pronator teres if gripping the forearm too hard with the varus/valgus stress test?
median nerve
60
what is the varus/valgus stress test a test for?
ligaments in the elbow
61
how do we perform the moving valgus stress test?
apply a valgus force as you extend the elbow in 90 deg shoulder abduction
62
what is the sensitivity/specificity and (+)LR and (-)LR of the moving valgus stress test?
sn=100% sp=75% (+) LR=4.0 (-) LR=0
63
what is the moving valgus stress test for?
ligaments test
64
how do we perform the tinel/compression test?
flex the elbow and tap/compress the cubital tunnel for 60 sec
65
what is the tinel/compression test for at the elbow?
ulnar nerve test
66
what is a (+) tinel/compression test?
tingling into the ulnar nerve distribution along the lateral hand
67
is volar tingling a (+) tinel test?
nope
68
what is the sensitivity and specificity of the tinel/compression test?
sn=68-70% sp=76-98%
69
what is the difference bw the pronator teres and carpel tunnel?
the pronator teres doesn't produce nocturnal symptoms, while carpal tunnel does
70
what is the Cozen and Mill test for?
lateral epicondylalgia
71
how do we perform the Cozen sign?
flex the elbow at the side and resist wrist extension (may do various deg of wrist ext)
72
what other resistance may also be painful with tennis elbow (lateral epicondylalgia)?
supination
73
how do we perform the Mill test?
extend the elbow and flex the wrist to stretch the wrist extensors that attach to the lateral epicondyle

DPT 616 : MSK (23 decks)

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