SCS Study Guide- Elbow Flashcards
brachialis innervation
MSk and radial
brachoradialis triceps, supinator, aconeous innervation
radial
Pronator teres
median
when should a fastball pitch start?
age 8-10
when should a change up pitch start?
10
when should a curveball/knuckleball pitch start?
14
when should a slider, forkball, splitter pitch start?
16-18 years
when should a screwball pitch start?
17-18
what does varus/valgus look at
LCL/MCL
what does pinch grip test look at
anterior interosseous nerve
tinel’s sign
ulnar nerve compression
cozen/mill test
lateral epicondylalgia
milking and moving valgus
MCL involvement
chair sign test
LCL
what is the appropriate rest days between for 21-35 pitches in 7-18 year olds
1day
what is the appropriate rest days between for 36-50 pitches in 7-18 year olds
2 days
what is the appropriate rest days between for 51-65 pitches in 7-18 year olds
3 days
what is the appropriate rest days between for 66+ pitches in 7-18 year olds
4 days off
what can cause LLE (little league elbow)
medial epicondyle fragmentation/avulsion, delayed or accelerated apophyseal growth of ME, forms of OCD
what is panners, ages, s+s
AVN of capitellum, 7-12,
stiffness and pain at lateral elbow
what is the treatment for panners
rest!
what is an OCD
articular cartilage which is separated from subchondral bone
what casuses OCD
repetitive trauma
what are signs and sxs of OCD
lateral elbow pain, popping, swelling and locking
Lateral epicondylalgia, exam, cause and treatment
tennis elbow, excessive gripping, ECRB
exam: cozen’s mills, decreased grip strength
conservative care
Medial epicondyle ages, cause, exam and treatment. muscles involved??
golfers elbow, too much flexion with trail arm and follow through, FCR, PT and FCU usually involved
pain medially, swelling, passive wrist ext pain
conservative treatment.
medial epicondyle apophysitis cause, exam and treatment
repetitive stress with throwing, ages 9-12
pain at medial elbow and decreased strength with rest and conservative care
Volkman’s contracture cause, exam and treatment
cause: ischemic contracture of brachial artery, usually a complication from an elbow injury
exam: pain in forearm with passive finger extension, and ceasation of brachial and radial pulse
treat: MD
pronator teres syndrome cause, exam and treatment
cause: entraped median nerve due to edema or hypertrophy
exam: neuropathy sensory and motor changes
treatment: anti-inflam and rest and surgery at times
the anterior bundle of the MCL is tight in ___ and loose in ___
tight in extension, loose in flexion
MCL posterior bundle is tightest and loosest where
tightest in flexion, loosest in extension
MCL injury cause, exam and treatment
cause: repetitive Valgus stress, valgus load during throwing
exam: pain medially, decreased strength, milking and moving valgus
treatment: docking procedure of anterior bundle
post op UCL-R weeks 1-4 ROM and splinting protocol
ROM 30-105
splint at 50-60 for 1 week
then 45-90 weeks 1-3
20-105 week 4
post op UCL-R weeks 4-6 ROM and protocol
ROM 15-115
pain free ISO
scap stab
post op UCL-R weeks 12-16 ROM and protocol
plyometrics and light forearm and wrist strengthening
post op UCL-R months 4-9 ROM and protocol
interval throwing at 4 months
interval batting 5 months
throwing from mound 9 months
pitching competitively at 1 year
flexor contracture cause, exam and treatment
cause: result valgus overload syndrome, osteophytes (prevention of extension)
exam: restricted ROM, pain at end ranges
treatment: LLLD, stretching, mobs, dynamic splinting at night
heterotrophic ossification cause, exam and treatment
cause: direct trauma or surgery, exam is swelling, hyperemia and loss of motion and treatment is surgery
elbow dislocation cause, exam and treatment and imaging
cause: FOOSH, severe twist in flexed position POSTERIOR 90%
exam: hemorrhage, swelling and pain
treatment: elbow splinted 5-7 days in hinged elbow 30-90 (inc 10-15 per week)
NO PROM, full flexion by 6-12 weeks and full extension by 3-5 months
imaging: a/p, lat and oblique
ROM restritions following elbow dislocation
5-7 days, hinged elbow brace 30-90 (inc 10-15 per week)
no PROM
full flexion 6-12 weeks,
full extension 3-5 months
OCD capitellum cause, exam and treatment
cause: OCD and loose bodies
exam: MRI
treatment: non-op or arthroscopic
olecranon bursitis cause, exam and treatment
cause: chronic injury or direct blow
exam: pain, swelling, TTP
treatment: protect with padding
monetggia fracture:
dislocation or proximal radioulnar joint at forearm fracture
night stick fracture
mid point ulnar fracture (Galenzzi fx) dislocation of ulnar head and fracture of distal radius
nursemaid elbow
dislocation of radius common from when pulled by hand.
ossification appearance sequence
CRITOE
capitellum, radial head, internal epicondyle, trochelar, olecranon, external epicondyle
