S8) The Elbow Flashcards

1
Q

What is the elbow joint?

A
  • The elbow is the joint connecting the anatomical arm to the forearm
  • It is marked by the olecranon process and the medial and lateral epicondyles
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2
Q

Classify the elbow joint in terms of its structure and function

A
  • Structurally, it is classed as a synovial joint
  • Functionally, it is classed as a hinge joint
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3
Q

Describe the articulating surfaces of the elbow

A
  • Trochlear notch of ulna articulates with the trochlea of humerus
  • Head of the radius articulates with the capitulum of humerus
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4
Q

Which other joint is also found within the joint capsule of the elbow?

A

Proximal radioulnar joint

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5
Q

Describe the movement of the elbow joint and identify the muscles involved

A
  • Extension: triceps brachii and anconeus
  • Flexion: brachialis, biceps brachii, brachioradialis
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6
Q

Discuss the stability of elbow joint

A
  • Like all synovial joints, the elbow joint has a strong and fibrous capsule enclosing and strengthening the joint
  • The joint capsule is thickened medially and laterally to form collateral ligaments, which stabilise the flexing and extending motion of the arm
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7
Q

Describe the anatomical position of the collateral ligaments of the elbow joint

A
  • The radial collateral ligament lies on the laterally, extending from the lateral epicondyle and blending with the annular ligament of the radius
  • The ulnar collateral ligament originates from the medial epicondyle, and attaches to the coronoid process and olecranon of the ulna
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8
Q

What is a bursa and what does it do?

A
  • A bursa is a membranous sac filled with synovial fluid
  • It acts to cushion the moving parts of a joint, preventing degenerative damage and reducing friction
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9
Q

Identify the 3 elbow bursa of clinical importance

A
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10
Q

Describe the anatomical location of the 3 elbow bursa

A
  • Intratendinous bursa is located within the tendon of the triceps brachii
  • Subtendinous bursa is located between the olecranon and the tendon of the triceps brachii
  • Subcutaneous bursa is located between the olecranon and the overlying connective tissue
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11
Q

Identify the common injuries to the elbow and wrist joint

A
  • Acute/trauma: fractures, dislocations
  • Chronic/degenerative: arthritis, tendinopathies
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12
Q

Identify 4 acute / traumatic clinical conditions affecting the elbow

A
  • Elbow dislocation
  • Supracondylar fracture
  • Radial head/neck fractures
  • Radial head subluxation
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13
Q

Identify 6 chronic / degenerative clinical conditions affecting the elbow

A
  • Osteoarthritis
  • Rheumatoid arthritis
  • Lateral elbow tendinopathy
  • Medial elbow tendinopathy
  • Olecranon bursitis
  • Gout tophi
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14
Q

What is an elbow dislocation?

A
  • An elbow dislocation is a clinical condition in which the joint surfaces of the elbow are separated and presents with pain, deformity or loss of function
  • It is the 2nd most common dislocation and results from FOOSH
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15
Q

What is a supracondylar fracture of the distal humerus?

A
  • A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint which occurs from FOOSH
  • It is usually transverse/oblique above the medial and lateral condyles and epicondyles and involves neurovascular compromise – paraesthesia, radial pulse, capillary return
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16
Q

What are radial head/neck fractures?

A
  • Radial head/neck fractures are the commonest elbow fracture and involves a fracture to the proximal radius due to FOOSH
  • It presents with lateral pain, modest swelling or loss of range
17
Q

What is radial head subluxation?

A
  • Radial head subluxation (nursemaid’s elbow) is a clinical condition in which the radial head is dislocated from the annular ligament in the elbow joint
  • It commonly occurs in young children due to longitudinal traction along extended arm
18
Q

What is elbow osteoarthritis?

A
  • Elbow osteoarthritis is a degenerative disease of the articular cartilage in the elbow joint that can cause pain and stiffness
  • It can be primary (degeneration without a cause) or secondary (post-traumatic)
19
Q

What is Rheumatoid arthritis?

A
  • Rhematoid arthritis is a systemic autoimmune disease causing long-term stiffness, swelling and pain in the joints of the body
  • Symptoms are due to inflammation of the synovium of small and large joints
20
Q

In terms of swellings around the elbow, what are rheumatoid nodules?

A
  • Rheumatoid nodules are firm, noticeable lumps that form underneath the skin of some rheumatoid arthritis patients
  • These lumps generally form on/near the base of the arthritic joints and are the commonest extra-articular manifestation of RA
21
Q

In terms of swellings around the elbow, what is olecranon bursitis?

A
  • Olecranon bursitis (student’s elbow) is the inflammation of the bursa in the elbow joint due to trauma or friction
  • It presents with pain, redness and swelling around the elbow and can become infected
22
Q

In terms of swellings around the elbow, what is gout tophi?

A
  • Gout tophi is a disorder of nucleic acid metabolism leading to hyperuricaemia and urate crystal deposits in the joints
  • It leads to recurrent attacks of arthritis and mainly affects soft tissues e.g. ear, elbow, achilles tendon
23
Q

What is lateral elbow tendinopathy?

A
  • Lateral elbow tendinopathy (tennis elbow) is a degenerative condition that can cause significant functional impairment in working-age patients
  • It is the commonest cause of elbow pain and involves pathology in the common extensor tendon
24
Q

What is medial elbow tendinopathy?

A
  • Medial elbow tendinopathy (golfer’s elbow) is a degenerative condition / overuse injury predominantly seen in athletes
  • It is 10x less common than LET and involves pathology in the common flexor tendon