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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
Q

what is the concave surface of the humeroulnar jt?

A

trochlear notch of the ulna

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26
Q

what is the convex surface of the humeroulnar jt?

A

trochlea of the humerus

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27
Q

what is the roll and glide of the humeroulnar jt in flexion?

A

ulna rolls and glides ant on the humerus

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28
Q

what is the roll and glide of the humeroulnar jt in extension?

A

ulna rolls and glides post on the humerus

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29
Q

what is the concave surface of the humeroradial jt?

A

fovea of the radial head

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30
Q

what is the convex surface of the humeroradial jt?

A

capitulum of the humerus

31
Q

what is the roll and glide of the humeroradial jt in flexion?

A

radius rolls and glides ant on the humerus

32
Q

what is the roll and glide of the humeroradial jt in extension?

A

radius rolls and glides post on the humerus

33
Q

what is the concave surface of the proximal radioulnar jt?

A

radial notch of the ulna

34
Q

what is the convex surface of the proximal radioulnar jt?

A

radial head

35
Q

what is the roll/spin/glide of the proximal radioulnar jt in pronation?

A

radius spins med on the ulna

radius glides ant

ulna glides post

36
Q

what is the roll/spin/glide of the proximal radioulnar jt in supination?

A

radius spins lat on the ulna

radius glides post

ulna glides ant

37
Q

what are the key points of consideration in the examination of muscle function?

A

active insufficiency

muscle’s angle of pull

each muscle’s fxn across primary and secondary jts

38
Q

there is better elbow flexion with shoulder _____

A

extension

39
Q

muscles have the most power _____

A

mid-range

40
Q

what are the flexors at the elbow?

A

biceps

brachialis

brachioradialis

41
Q

the elbow extensors are ___% strength of the flexors

A

60

42
Q

most elbow flexors force is generated bw _______ deg of flexion w/supination (biceps and brachialis)

A

90-110

43
Q

where are the biceps the strongest?

A

in supination

44
Q

where is the brachialis the strongest?

A

in pronation

45
Q

where is the brachioradialis the strongest?

A

in neutral

46
Q

what are the extensors at the elbow?

A

triceps

anconeus

47
Q

the triceps produce what motions?

A

shoulder ext

elbow ext

adduction

48
Q

where is the peak torque of the triceps?

A

bw 70-90 deg of flexion

49
Q

the long head of the triceps accounts for ___% of total torque of elbow extension

A

25

50
Q

the anconeus contributes _____% of total torque of elbow extension

A

10-15

51
Q

the pronators are _____% strength of supinators

A

85

52
Q

the biceps contributes to supination primarily at ___ deg flexion

A

90

53
Q

what is the first muscles to supinate and mostly active in extension?

A

the supinator

54
Q

what muscle is an elbow flexor and pronator primarily w/resistance?

A

pronator teres

55
Q

what should we be feeling with palpation?

A

the jt line just proximal to the wrist

ulnar and radial styloid processes

med/lat epicondyles

head of the radius

muscles

56
Q

what are the wrist flexors?

A

pronator teres

flexor carpi radialis

palmaris longus

flexor carpi ulnaris

57
Q

what are the wrist extensors?

A

extensor carpi radialis brevis and longus

extensor digitorum

extensor carpi ulnaris

58
Q

how is the varus/valgus stress test performed?

A

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
Q

what nerve may get irritated by the pronator teres if gripping the forearm too hard with the varus/valgus stress test?

A

median nerve

60
Q

what is the varus/valgus stress test a test for?

A

ligaments in the elbow

61
Q

how do we perform the moving valgus stress test?

A

apply a valgus force as you extend the elbow in 90 deg shoulder abduction

62
Q

what is the sensitivity/specificity and (+)LR and (-)LR of the moving valgus stress test?

A

sn=100%
sp=75%
(+) LR=4.0
(-) LR=0

63
Q

what is the moving valgus stress test for?

A

ligaments test

64
Q

how do we perform the tinel/compression test?

A

flex the elbow and tap/compress the cubital tunnel for 60 sec

65
Q

what is the tinel/compression test for at the elbow?

A

ulnar nerve test

66
Q

what is a (+) tinel/compression test?

A

tingling into the ulnar nerve distribution along the lateral palm

67
Q

is volar tingling a (+) tinel test?

A

nope

68
Q

what is the sensitivity and specificity of the tinel/compression test?

A

sn=68-70%
sp=76-98%

69
Q

what is the difference bw the pronator teres and carpel tunnel?

A

the pronator teres doesn’t produce nocturnal symptoms, while carpal tunnel does

70
Q

what is the Cozen and Mill test for?

A

lateral epicondylalgia

71
Q

how do we perform the Cozen sign?

A

flex the elbow at the side and resist wrist extension (may do various deg of wrist ext)

72
Q

what other resistance may also be painful with tennis elbow (lateral epicondylalgia)?

A

supination

73
Q

how do we perform the Mill test?

A

extend the elbow and flex the wrist to stretch the wrist extensors that attach to the lateral epicondyle

DPT 616 : MSK (15 decks)

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