The Elbow Flashcards
bones of the elbow (3)
humerus
ulna
radius
joints of the elbow (3) + the movements
humeroulnar (flexion/extension
humeroradial (flexion/extension)
radioulnar (supination/pronation)
elbow ligaments (3)
-ulnar collateral ligament (MCL/UCL of elbow)
- Radial collateral ligament (LCL/RCL of the elbow)
-annular ligament (around head of radius & ulna)
muscles acting at the elbow (7)
biecps brachii
brachialis
brachioradialis
supinator
pronator teres
anconeus
action at the elbow: biceps brachii
elbow flexion
supination
shoulder flexion (long head)
action at the elbow: brachilais
elbow flexion
action at the elbow: triceps brachii
elbow extension
shoulder extension
action at the elbow: supinators
forearm supination
action at the elbow: pronator teres
forearm pronation
action at the elbow: anconeus
elbow extension
origins of bicep brachii long head & short head
long head- runs within bicepital groove on humerus
short head- coracoid process
tricep head origins (3)
long head- scapula
lateral head & medial head- humerus
forearm flexors & extensors origin
medial epicondyle
wrist extensor & supinators origin
lateral epicondyle
nerves of the elbow (3)
median nerve
ulnar nerve
radial nerve
arteries of the elbow
brachial artery
radial artery
ulnar artery
ROM: extension through flexion
pronation through supination
hyperextension
extension- flexion= 0-135 degrees
pronation- supination= 70-90 degrees
hyperextension= 5degrees
what protects the elbow from overuse & traumatic injuries (3)
boney limitations
ligaments support
muscular stability
Bursitis of elbow: Eitology
-very common in athletic activities
-involves olecranon bursa
Bursitis of elbow: MOI
direct blow
overuse
pressure
infection (cut over elbow)
Bursitis of elbow: S/S
-painful & localized pain
-rapid swelling
-bruising
-limited ROM
-ulnar neuropraxia in 4/5th phalanges (numbess & weakness)
Bursitis of elbow: treatment
-PIER, sling support
-x ray to rule out fracture if have MOI
- modalities
-pad support for return to play/ pressure sleeve
-note to rule out infection (swelling, redness, warm, fever, red streaks of bursa)
Sprains: Etiology
- valgus instabilities (UCL sprains)
-varus instabilities 9Radial collateral sprains)
-FOOSH or throwing mechanism
Sprains: MOI for UCL & RCL
UCL sprain
-FOOSH w/ valgus force
-overhead throwing
RCL
-FOOSh w/ varus force
-correlated with elbow dislocations
Sprains: S/S UCL sprain
-depends on degree of ligament damage
-sharp apin over medial aspect of elbow
-pulling, ripping or tearing sensation over medial elbow
-swelling & ecchymosis over medial elbow
- pain on palpation
-positive valgus stress test to elbow
Sprains: S/S RCL sprain
-rule out dislocation
-depends on the degree of ligament damage
-similar to UCL sprain
Strains: etiology & MOI
-repetitive tensile stresses to the elbow muscles
-forceful contraction of over stretching
-constant use of forearm in physically demanding ways
Strains: S/S
-point tenderness
-pain w/contratction (AROM) or stretching (PROM)
-weakness
-swelling bruising, possible deformity (if full rupture)
Strains: treatment
-PEIR
-NSAIDs
- protect & rest w/ sling
-x-ray to rule out fracture
elbow & forearm fractures (3)
distal humerus
proximal radius
proximal ulna
define displaced fractures of the humerus, radius and ulna
bone endings do not line up
define undisplaced fractures of the humerus, radius and ulna
bone endings still line up
Elbow & forearm fractures: MOI
violent compressive forces caused by:
-direct trauma
-fall on flexed elbow or outstretched hand without valgus/varus stress
-tensile forces associated with throwing
-forced hyperflexion
Elbow & forearm fractures: S/S
-painful, swollen, discoloured elbow
-deformity may be seen
-inability to extend elbow against gravity (hallmark sign)
Elbow & forearm fractures: treatment
-assess PMSC
-splint & support the joints above & below the injury in the most comfortable position
-arrange transport to hospital
define epicondylitis
inflammation at the elbow involving the attachment of the common flexor or extensor tendons of the forearm muscles
describe medial epicondylitis (3)
-involves inflammation of the flexor tendons
-seen in activities involving pronation & supination and loading of flexor muscles
-golfers elbow
describe lateral epicondylitis (3)
-inflammation of the extensors tendons
-caused by eccentric loading of extensor muscles
-tennis elbow
Epicondylitis: MOI (2)
- direct trauma (not very common)
- overuse & improper mechanics involving wrist movement where there is repeated eccentric loads
Lateral epicondylitis: Etiology (8)
-eccentric loading of extensors during deceleration phase of throwing or tennis
-poor technique backhand stroke
-racquet size inappropriate for participant
-racquet grip is too small/too big
-racquet string tension too high
-hitting wet ball
-missing the “sweet spot”
-age of participant
how to measure hand for proper racquet size
measure from proximal crease of the palm to the tip of the ring finger.
-if between sizes, choose the smaller option
epicondylitis: treatment
-limit pain & inflammation (RICE/NSAIDs)
-avoid activities leading to pain
-immobilize (splint) if necessary
-maintain ROM & strength at wrist & shoulder
-other therapies (ice massage, contrast baths, ultrasound, electrical stimulation)
lateral epicondylitis: why find would what makes them have pain?
important to know if it is from muscle strength reason, or if they have an inappropriate racquet size or hitting technique. Then you can fix that and they won’t have pain anymore.
