The elbow - CH. 23

Question 1

nn innervation for biceps brachii, brachialis, brachioradialis

what other mm innervated by the radial nn?

Answer 1

biceps brachii - muculocutaneous (C5,6)
brachialis - musculocutaneous
brachiradialis - radial

radial nn: wrist extensors, supinator and anconeus

Question 2

carrying angle - due to? normal ranges for female and male

Answer 2

protusion of medial epicondyle

10-15 female
5-10 male

Question 3

explain cozen’s test?

Answer 3

resist wrist ext/flex - indicates med/lat epicondylitis

Question 4

(+) of pinch grip test

Answer 4

anterior interroseus nn entrapment b/w 2 heads of pronator teres

Question 5

difference between osteochondritis dissecans and Panner’s disease

Answer 5

Ostchond. diss. @ elbow usually occur with kids around 10-15 - degeneration of subchondral bone or bony fragments

panner’s disease - occurs in kids younger than 10 yrs

• avascular necrosis of capitulum
• loose bodies require surgery

Question 6

5 types of little league elbow

Answer 6

1. accelerated apophyseal growth and delay in medial epicondyle growth plate
2. traction apophysitis
3. avulsion of medial epicondyle
4. osteochondrosis of capitulum
5. nonunion fracture of olecranon epiphysis

Question 7

4 contributing factors for cubital tunnel syndrome

Answer 7

1. traction of ulnar nn
2. irregularities
3. subluxations of nn due to weakness of ligaments
4. progressive compression of ligament on ulnar nn

Question 8

how to differentiate b/w supracondylar fracture and a dislocation of the elbow?

Answer 8

the lateral and medial epicondyles are still in line with shaft of humerus - for dislocations

for the supracondylar fracture you’ll get a gunstock deformity - where the arm goes into varus instead of valgus (no carrying angle)

Question 9

s/s of volkmann’s contracture

Answer 9

finger flexion and wrist flexion
pain with passive extension of fingers
edema around the forearm
no brachial or radial pulse

Question 10

cause of volkmann’s contracture?

Answer 10

ischemia to the distal structures due to injury

usually brachial artery injury involving the medial nn

Question 11

how long does it take for muscular necrosis?

Answer 11

4-6 hr after start

Question 12

s/s of pronator teres syndrome

Answer 12

N/T down forearm due to entrapment of median nn

hypertrophy of pronator teres