Session 3 Lecture Notes Flashcards
What are the 3 joints that make up the elbow joint?
- Ulnohumeral
- Radiohumeral
- Radioulnar
Of the three joints that make up the shoulder - which is the only one that provides extension and flexion? (rather than supination and pronation)
The ulnohumeral joint
What is the carrying angle?
The angle that your elbow flexes and extends at - it is slightly angled away from the body to ensure that your clear your hips when walking/swinging arms
What is the difference in carrying angle between cubitus varus and cubitus valgus?
Cubitus varus = decreased carrying angle (only a cosmetic problem)
Cubitus valgus = increased carrying angle (this can lead to damage to the ulnar nerve)
What are the 3 ligament complexes of the elbow?
- Medial collateral (3 parts)
- Lateral collateral (2 parts)
- Annular
What is the fad pad sign?
It is a sign that there is fluid within the elbow joint cavity - clue that there may be a fracture as a fracture causes bleed (which collects in elbow joint cavity and raises the fat pad away from the elbow)
At the elbow joint what degrees can flexion and extension allow?
-5 (slight hyperextension) to 140 degrees
Which nerve innervates biceps brachii?
Musculocutaneous
Which nerve innervates brachialis?
Musculocutaneous
Which nerve innervates brachioradialis?
Radial nerve
Which 3 muscles are involved with flexion at the elbow joint?
- Biceps brachii
- Brachialis
- Brachioradialis
Which 2 muscles are involved with extension at the elbow?
- Triceps brachii
2. Aconeus
Which 2 muscles are involved in supination at the elbow?
Which is most dominant
- Biceps brachii (most dominant)
2. Supinator
What happens to movement at the elbow if biceps brachii is damaged?
Will not lose much function of extension/flexion as brachialis is the main muscle involved in this
You will however lose ability to supinate as supinator can only do this a little (mostly biceps brachii)
What nerve innervates supinator muscle?
Radial nerve
What 2 muscles are involved in pronation of the elbow?
- Pronator quadratus
2. Pronator teres
What two movements of the elbow involve muscles innervated by the median nerve?
Flexion and pronation
The radial nerve innervates muscles that provide what movement at the elbow joint?
Extension (as well as supinator which provides a little supination)
Name 5 muscles (involved in either pronation or flexion at the elbow joint) that originate from medial epicondyle
- Flexor carpi ulnaris
- Palmaris longus
- Flexor carpi radialis
- Pronator teres
- Flexor digitorum superficialis
Which 3 deep flexor and pronator muscles are innervated by the anterior interosseous nerve?
Which nerve does this branch from?
- Pronator quadratus
- Flexor digitorum profundus
- Flexor pollicis longus
What form the contents of the cubital fossa? (lateral to medial)
REALLY NEED BEER TO BE AT MY NICEST: Radial nerve Biceps tendon Brachial artery Median nerve
Name the 8 carpal bones
SOME LOVERS TRY POSITIONS THAT THEY CAN'T HANDLE Proximal row (lateral to medial): Scaphoid Lunate Triquetral Pisiform Distal row (lateral to medial): Trapezium Trapezoid Capitate Hamate
What are the top 2 most common dislocations?
- Shoulder joint
2. Elbow joint
What direction is a dislocation in the elbow most common?
Posteriorly (bone pushed out towards the back)
If you have dislocated your elbow what else must have been damaged?
Your soft tissue - ligaments and joint capsule (as these hold the joint in position)
Give 4 types of initial management for elbow dislocation
- Pain relief
- Sling or splint
- NVT assessment (nerve vessel tendon)
- X-ray
Name 3 types of definite management of elbow joint
- Re-x-ray to check for concentric reduction - making sure the trochlea is sitting within the trochlea notch
- Closed reduction (force to put the joint back in place
- Re-NVT assessment
What neurovascular checks can you do following a suoracondylar fracture?
- OK sign
- Radial pulse
- Capillary return (warmth and colour to hand)
- Paraesthesaie (tingling sensation)
What is the difference between a displaced and a non displaced fracture?
Displaced = bones are not aligned with one another (fragments have moved) Non-displaced = break in bone but it has not fragmented/ separated
What is most common elbow fracture?
On X-ray what could you look for to confirm a fracture?
Radial head/neck fracture
Look for fat pad sign = displacement of fat pad to due effusion of blood from broken bone
What is a pulled elbow?
When is this most common?
The radial head is pulled out of position and the annular ligament becomes trapped underneath
In young children it is most common (2-5 years)
What is the most common inflammatory arthropathy?
Elbow joint
What is the difference between lateral and medial elbow tendinopathy and the group of muscles it affects?
Medial elbow tendinopathy = affects the flexors
Lateral elbow tendinopathy = affects the extensors
With what disease is a rheumatoid module most likely to occur?
Rheumatoid arthritis
What is olecranon bursitis?
Inflammation of the bursa of the elbow joint
What is gouty tophi?
What can it lead to?
A disorder of nucleic acid metabolism leading to hyperuricaemia (a build up of sodium urate crystals)
This can lead to urate crystal deposition
What is a fracture of the distal radius often confused with?
A fracture of the wrist
What is an intraarticular fracture?
A fracture which crosses into a joint
It is associated with cartilage damage
What is a colles’ fracture?
A DORSALLY displaced fracture of the distal radius
What is a Smith’s fracture?
A PALMAR displacement of the distal radius
What is the most common carpal bone to be fractured?
Where would the pain present?
The scaphoid
Pain/tenderness in the anatomical snuff box
Why is there a risk of necrosis following a scaphoid fracture?
Because only 25% of the blood supply is not articular - after a break this is the only blood supply received
What causes cubital tunnel syndrome?
Compression of the ulnar nerve at the cubital tunnel (inside of the elbow) near the “funny bone”
