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(1) MS: Orthopedic and Rheumatic Conditions 🩺 > S1_L3: Elbow and Forearm Conditions > Flashcards

S1_L3: Elbow and Forearm Conditions Flashcards

1
Q

TRUE OR FALSE: Elbow complex is a strong and stable compound joint. Stability of elbow allows little compensatory adjustments making it prone to overuse injuries

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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2
Q

The following statements are true about the anatomy of the elbow joint, EXCEPT:

A. it positions the hand for functional activity
B. it is a modified hinge
C. it is a trochoginglymus joint
D. it functions to serve mobility and stability for the hand
E. None of the above

A

E. None of the above

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3
Q

Determine which bundles and ligaments comprises which collateral ligament.

  1. Ligament of Cooper
  2. Annular ligament
  3. Oblique cord
  4. Anterior bundle
  5. Transverse bundle

A. Ulnar collateral ligament
B. Radial collateral ligament

A
  1. A
  2. B
  3. B
  4. A
  5. A
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4
Q

TRUE OR FALSE: The anterior joint capsule of the elbow is usually thinner and more transparent.

A

True

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5
Q

Match the following muscle to its primary action.

  1. Brachioradialis
  2. Anconeus
  3. Pronator quadratus

A. Flexor
B. Extensor
C. Supinator
D. Pronator

A
  1. A
  2. B
  3. D
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6
Q

The biceps brachii is primarily an elbow (1)_______, but acts as a secondary (2)_______

A
  1. flexor
  2. supinator
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7
Q

CASE: A 2 year old girl fell, this is followed by swelling and severe pain on the elbow. Patient complained of pain with swelling on the elbow. What is the most plausible diagnosis?

A

Supracondylar fracture or elbow dislocation

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8
Q

CASE: A 60 year old female complained of pain on the elbow 3 months ago after a history of trauma on the medial aspect of the elbow. She later experienced sharp shooting pain and sensory deficits in the distribution of the hand. This was followed by weakness of hand grip. What is the most plausible diagnosis?

A

Cubital tunnel syndrome

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9
Q

CASE: A 45 year old tennis player complained of pain on the lateral aspect of the hand. The pain was more pronounced when doing a backhand stroke. PE: tenderness at the lateral aspect of the elbow and pain on extending the elbow and flexing the wrist. Give 3 plausible diagnosis?

A
  1. Lateral epicondylitis
  2. Ulnar collateral ligament sprain
  3. Radial collateral ligament sprain
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10
Q

What are the 3 joints of the elbow complex?

A
  1. Humero-radial joint
  2. Humero-radial joint
  3. Proximal radioulnar joint
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11
Q

The greatest capacity of the joint capsule is (1)_____ml at (2)_____° of flexion, when it is fully distended.

A
  1. 30-35
  2. 80
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12
Q

Which bundle of the ulnar collateral ligament is the primary stabilizer against valgus stress?

A

Anterior bundle

NOTE: It is also the strongest and stiffest.

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13
Q

This ligament prevents radial head to sublux (partial dislocation) during pronation and supination

A

Annular ligament

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14
Q

What is the main function of the elbow bursae?

A

To protect soft tissue from rubbing into the bone (Friction)

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15
Q

TRUE OR FALSE: The olecranon bursa is the main bursa of the elbow complex, but it does not communicate with the elbow joint. It is most prone for injury from direct trauma to the elbow.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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16
Q

What is the normal ROM of elbow extension?

A

0 or slight hyperextension

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17
Q

What is the normal ROM of elbow flexion?

A

150 degrees

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18
Q

What is the normal ROM of forearm supination?

A

85 degrees

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19
Q

What is the normal ROM of forearm pronation?

A

75 degrees

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20
Q

What is the function ROM needed to do activities of daily living?

Enumerate the amount of degrees for flexion and extension.

A

30 degrees of extension to 130 degrees of flexion

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21
Q

What is the function ROM needed to do activities of daily living?

Enumerate the amount of degrees for pronation and supination.

A

50 degrees of pronation up to 50 degrees of supination

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22
Q

TRUE OR FALSE: Loss of terminal flexion is more disabling than is the same degree of terminal extension

A

True

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23
Q

Where is the most common fracture site of humerus?

A

Surgical neck

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24
Q

This is the most common fracture in children with the cause being a fall on out-stretched hand.

A

Supracondylar fracture

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25
Q

This is the most common distal humeral fracture in adults

A

Intercondylar Fracture

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26
Q

This refers to a bone that is broken in at least two pieces.

A

Comminution

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27
Q

A fall on the point of the elbow or direct trauma to the olecranon typically results in what kind of fracture?

A

comminuted olecranon fracture

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28
Q

A fall onto the outstretched hand accompanied by a strong, sudden contraction of the triceps(extend) typically results in what kind of fracture?

A

transverse or oblique fracture

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29
Q

This condition refers to a proximal 1/3 ulnar fracture with associated radial head dislocation/instability.

A. Monteggia fracture
B. Galeazzi Fracture

A

A. Monteggia fracture

30
Q

This condition’s MOI is fall onto an outstretched hand with forearm in pronation

A. Monteggia fracture
B. Galeazzi Fracture

A

B. Galeazzi Fracture

31
Q

This condition refers to a distal 1/3 radius shaft fx & dislocation of associated distal radioulnar joint (DRUJ) injury

A. Monteggia fracture
B. Galeazzi Fracture

A

B. Galeazzi Fracture

32
Q

This condition is more common in children 4 and 10 years of age

A. Monteggia fracture
B. Galeazzi Fracture

A

A. Monteggia fracture

33
Q

The following is true about elbow dislocations, EXCEPT:

A. Second most commonly dislocated joint in adults
B. Most commonly dislocated in children
C. Most commonly occurs in anterolateral direction
D. Steroids must not be given
E. None of the above

A

C. Most commonly occurs in anterolateral direction

NOTE: It commonly occurs posterolaterally.

34
Q

Biceps tendon injury may be cause by ruptures in which 3 areas?

A
  1. radial tubercle
  2. supraglenoid tubercle
  3. coracoid process

NOTE: It can be ruptured in any of its attachments (origin, insertion)

35
Q

Distal biceps tendonitis is usually cause by (1)_____ overload of the distal biceps during (2)______ of follow-through phase of throwing

A
  1. Eccentric
  2. deceleration
36
Q

The following is true about
Distal biceps tendon rupture, EXCEPT:

A. Occurs in patients between 30 and 50 y/o
B. M > F
C. Injury usually occurs during a heavy lifting activity with the elbow at 90 deg flexion
D. S/sx include acute pain and a popping sensation in the antecubital fossa
E. None of the above

A

E. None of the above

37
Q

What sign signifies a distal bicep tendon rupture?

A

Popeye Sign

38
Q

TRUE OR FALSE: Distal biceps tendon rupture involves the dominant side more

A

True

39
Q

What is the best way to diagnose a distal biceps tendon rupture?

A

Magnetic resonance imaging (MRI)

40
Q

TRUE OR FALSE: In distal biceps tendon rupture, non-operative treatment is considered only for the elderly, sedentary patients who do not require strength and endurance in forearm flexion and supination. When operative treatment is opted, a plantaris and gracilis graft will be used.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

41
Q

The following is true about
Distal Triceps tendonitis and rupture, EXCEPT:

A. Overuse injury to the distal triceps brachii
B. Rupture occurs in individuals who fall onto an outstretched hand
C. Rupture is due to direct blow to the distal triceps tendon
D. A communited olecranon fracture might be present
E. None of the above

A

D. A communited olecranon fracture might be present

42
Q

The following is true about
Lateral epicondylitis, EXCEPT:

A. Common in tennis players who do backhand
B. Common in over 35 y/o
C. Common in over 35 y/o
D. Primarily affects the extensor carpi radialis brevis tendon
E. None of the above

A

E. None of the above

43
Q

What is the other name of lateral epicondylitis?

A

tennis elbow

44
Q

TRUE OR FALSE: Lateral epicondylitis is more common in male than female tennis players

A

True

45
Q

TRUE OR FALSE: Lateral epicondylitis is actually degenerative in nature. Therefore, the proper term for the condition is lateral epicondylalgia.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

NOTE: According to Brashear, Lateral epicondylosis also denotes a degenerative condition.

46
Q

In a suspected lateral epicondylalgia patient, which special test is expected to be positive?

A. Golfer’s elbow test
B. Cozen’s test
C. Hoffa’s test
D. Adson’s Test
E. Bear Hug Test

A

B. Cozen’s test

47
Q

A PT palpates for a patient’s lateral epicondyle with one hand, while pronating the patient’s forearm, fully flexing the wrist and extending the elbow.

What test is the physical therapist performing?

A

Mill’s test

48
Q

A PT stabilizes a patient’s elbow with one hand and asks the patient to pronate the forearm and extend and radially deviate the wrist against the manual resistance of the clinician.

What test is the physical therapist performing?

A

Cozen’s test

49
Q

The following is true about Medial epicondylitis, EXCEPT;

A. caused by forceful pronation or wrist flexion
B. primarily involved the pronator teres tendon
C. common in the 3rd to 5th decades
D. pain on making a fist, wrist extension, forearm pronation and supination
E. none of the above

A

D. pain on making a fist, wrist extension, forearm pronation and supination

NOTE: Pain is felt upon wrist flexion

50
Q

If a patient with medial epicondylitis presents with concomitant ulnar neuropathy with no objective deficits, what is this classified as?

A

Type II A

51
Q

If a patient with medial epicondylitis presents with affectation of medial ligaments but no nerve affectation, what is this classified as?

A

Type 1

52
Q

If a patient with medial epicondylitis presents with weakness, claw hand and sensory deficit, what is this classified as?

A

Type II B

53
Q

Most frequently tendons affected in medial epicondylosis are the (1)_____ and (2)_______ origins

A
  1. pronator teres (humeroulnar head)
    2.flexor carpi radialis
54
Q

Which muscle is the primary dynamic contributor to valgus stability?

A

Flexor carpi ulnaris

55
Q

What bundle of the Ulnar collateral ligament is often affected when sprained?

A

Anterior bundle

56
Q

The following is true about olecranon bursitis, EXCEPT:

A. Acute injury may be due to direct blow to the area
B. Frequently seen in athletes who play football and hockey
C. Aseptic bursitis may occur due to localized or systemic infection
D. Also called as miner’s elbow or student’s/thinker’s elbow
E. None of the above

A

C. Aseptic bursitis may occur due to localized or systemic infection

57
Q

This is also known as hyperextension valgus overload syndrome, olecranon fossitis, or Boxer’s elbow

A

Olecranon Impingement Syndrome

58
Q

TRUE OR FALSE: The Olecranon Impingement Syndrome is an overuse injury often seen in volleyball and hockey players.

A

False

NOTE: They are often seen in throwers.

59
Q

TRUE OR FALSE: Olecranon Impingement Syndrome is worsened by elbow flexion. Repetitive varus flexion overloading resulting in olecranon process being forced into the medial wall of the olecranon fossa.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

B. Both statements are false

60
Q

This refers to a condition wherein the radial head subluxes over the annular ligament

A

Nursemaid’s elbow (Pulled elbow)

61
Q

Pulled elbow most often occurs between what ages?

A

1-4 years old

62
Q

This is a late sequela of untreated or inadequately treated compartment syndrome in which necrotic muscle and nerve are replaced with fibrous tissue

A

Volkmann’s Ischemic Contracture

63
Q

TRUE OR FALSE: Anterior compartment is looser than the other compartments, where brachial artery will pass to bifurcate

A

False

64
Q

Beneath the lacertus fibrosus the (1)_____ and (2)____ pass to enter the flexor compartment.

A
  1. brachial artery
  2. median nerve
65
Q

This is the most common precipitating injury for Volkmann’s Ischemic Contracture

A

Supracondylar fractures of the humerus in children

66
Q

Enumerate the 5 signs or symptoms common for Volkmann’s Ischemic Contracture.

A

Pain
Paresthesia
Pulselessness
Pallor
Paresis

67
Q

Nerves become functionally impaired after (1)____ of ischemia, while muscles become functionally impaired after (2)____ of ischemia

A
  1. 30 minutes
  2. 2-4 hours
68
Q

Determine if the following symptoms of Volkmann’s Ischemic Contracture is mild, moderate, or severe.

  1. Pronation contracture involving either the pronator teres or pronator quadratus
  2. Involves most of the flexor digitorum profundus, flexor pollicis longus and part of flexor digitorum superficialis
  3. Deformity is intrinsic minus hand
  4. Wasting of forearm muscles
  5. Diminished sensations in median and ulnar nerve zones

A. MILD
B. MODERATE
C. SEVERE

A
  1. A
  2. B
  3. B
  4. C
  5. B
69
Q

This is the 2nd most common nerve entrapment in the UE

A

Cubital Tunnel Syndrome

70
Q

The following are anatomical sites of compression, leading to cubital tunnel syndrome, EXCEPT:

A. Middle head of triceps
B. Arcade of Struthers
C. Osborne’s fascia
D. Medial intermuscular septum
E. FCU aponeurosis

A

A. Middle head of triceps

NOTE: The medial head of triceps is the site of compression

71
Q

The following is a special test for Cubital Tunnel Syndrome, EXCEPT:

A. Froment sign
B. Wartenberg sign
C. Tinel sign
D. Elbow flexion test
E. None

A

E. None

(1) MS: Orthopedic and Rheumatic Conditions 🩺 (13 decks)

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