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Movement Science Exam 2 > The Elbow Complex > Flashcards

The Elbow Complex Flashcards

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1
Q

The elbow joint is made up of which 2 other joints?

A

Humeroulnar and humeroradial

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2
Q

How many degrees of freedom does the elbow joint have?

A

1

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3
Q

What type of joint is the elbow joint?

A

Loose hinge joint

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4
Q

Which plane and axis contain the elbow joint

A

Sagittal plane
Coronal axis

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5
Q

How many degrees of freedom do the PRUJ and DRUJ allow? What are the motions?

A

1
Supination/Pronation

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6
Q

What type of joint are the PRUJ and the DRUJ?

A

Diarthrodial pivot-type joint

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7
Q

Where is the trochlea located on the humerus (medial or lateral)? What kind of articulation is it (humeroradial or humeroulnar)?

A

Medially located
Humeroulnar articulation

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8
Q

What is the purpose of the coronoid fossa?

A

To receive the coronoid process of ulna at end of elbow flexion

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9
Q

When it comes to the elbow joint itself, is it proximal or distal? What kind of articulation is the capitulum (humeroradial or humeroulnar)?

A

Proximal humeroradial articulation

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10
Q

What is the function of the radial fossa?

A

Receives head of radius in full elbow flexion

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11
Q

What is the name of the structure that separates the capitulum from the trochlea?

A

Capitulotrochlear groove

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12
Q

What is the function of the olecranon fossa?

A

To receive the olecranon process of ulna in full elbow extension

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13
Q

What makes up the distal joint surface of the elbow?

A

Radius and ulna

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14
Q

What is the name of the concavity in the proximal ulna?

A

Trochlear notch

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15
Q

What structure “cuts” the trochlear notch in half?

A

Trochlear ridge

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16
Q

What is the name of the proximal end of the trochlear notch?

A

Olecranon process

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17
Q

What is the name of the distal end of the trochlear notch?

A

Coronoid process

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18
Q

What is the name of the concavity that articulates with the radial head? Where on the ulna is it located?

A

Radial notch
Lateral to coronoid process

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19
Q

What is the cup shaped surface on top of the radius called?

A

Fovea

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20
Q

The radial head is surrounded by a convex rim. Where on the humerus does it fit into?

A

Capitulotrochlear groove

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21
Q

Do the trochlear notch and the trochlea ever come in contact? If yes, how many newtons of force are required to do so?

A

Yes, but only when there is at least 500 N of force applied

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22
Q

In the humeroulnar joint in full flexion, which process goes into which fossa?

A

Coronoid process enters coronoid fossa

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23
Q

In the humeroulnar joint in full extension, which process goes into which fossa?

A

Olecranon process enters olecranon fossa

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24
Q

In the humeroradial articulation, the radial head and the capitulum articulate. Which is convex and which is concave?

A

Radial head: concave
Capitulum: convex

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25
Q

In the humeroradial joint in full flexion, which “protrusion” goes into which fossa?

A

Rim of radial head slides into radial fossa

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26
Q

In the humeroradial joint in full extension, the radial head makes contact with which area?

A

There is NO CONTACT between head and capitulum in full extension

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27
Q

The elbow joint capsule encloses which 3 joints that make up the elbow joint?

A

Humeroulnar joint
Humeroradial joint
Superior (proximal) radioulnar joint

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28
Q

The elbow joint capsule is (large or small), (tight or loose), (strong or weak)

A

Large
Loose
Weak

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29
Q

Which collection of ligaments is the joint capsule continuous with and reinforced by?

A

Collateral ligaments

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30
Q

The synovial layer in the elbow joint lines which 3 fossas?

A

Coronoid
Radial
Olecranon

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31
Q

Hypertrophy in the joint capsule can be the cause for what dysfunctions of the elbow?

A

Lateral epicondylalgia
Inflammation
Degenerative changes

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32
Q

For someone who has lateral epicondylalgia, what can aggravate their symptoms/pain?

A

Repetitive activities such as gripping, wrist extension, and push ups

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33
Q

For someone who has lateral epicondylalgia, what can improve their symptoms/pain?

A

Distraction of the humeroradial joint

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34
Q

How many bundles make up the medial (ulnar) collateral ligament, and what are they called?

A

3
Anterior bundle
Posterior bundle
Transverse bundle

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35
Q

What is the main function the anterior bundle of the UCL?

A

Primary restrain to valgus stress from 20-120º of flexion

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36
Q

Where does the Anterior bundle of the MCL attach and what does it contribute to (stability-wise)?

A

Attaches to capsule and radial head and it contributes to medial joint stability

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37
Q

What is the main function the posterior bundle of the UCL?

A

Limits elbow extension, and less restraint to valgus stability (than anterior bundle)

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38
Q

What is the main function of the transverse bundle of the UCL?

A

Helps to keep joint surfaces in approximation which means that it will keep those surfaces together

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39
Q

How many ligaments make up the lateral collateral ligament (LCL) complex, and what are they?

A

3
Lateral radial collateral ligament
Lateral ulnar collateral ligament
Annular ligament

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40
Q

What is the function of the lateral radial collateral ligament?

A

Reinforces humeroradial articulation
Some protection against varus stress

41
Q

What is the main function of the lateral ulnar collateral ligament and the annular ligament?

A

Secondary restraint to combined forced varus and supination stress

42
Q

What muscles work to flex the elbow?

A

Brachialis (in pronation)
Biceps (in supination)
Brachioradialis (in neutral)

43
Q

Which muscles serve to extend the elbow?

A

Triceps and anconeus

44
Q

What is the normal carrying angle?

A

Between 5-15º

45
Q

What is considered cubitus valgus?

A

15º or Over

46
Q

What is considered cubitus varus?

A

5º or Under

47
Q

What is the elbow AROM in flexion?

A

135-145º

48
Q

Is there more or less flexion of the elbow in supination?

A

More

49
Q

What is the elbow PROM in flexion?

A

150-160º

50
Q

What contributes to stability of the elbow joint in full extension?

A

50% from bone and 50% from LCL and capsule of varus stress

51
Q

What contributes to stability of the elbow joint in full flexion?

A

Coronoid process with fossa and rim of radial head

52
Q

What contributes to stability of the elbow joint in 90º of flexion?

A

Anterior part of MCL resists valgus and distraction stress

Resistance to varus stress mostly osseus, but some from LCL and capsule

53
Q

In which angle does the Brachialis have the greatest moment arm?

A

100º

54
Q

In which angle does the Biceps have the greatest moment arm?

A

80-100º

55
Q

In which angle does the Brachioradialis have the greatest moment arm?

A

100-120º

56
Q

When is the biceps the least effective elbow flexor?

A

In full extension

57
Q

Of the 3 flexors of the elbow, which are mobility muscles and which are compressing muscles?

A

Mobility: Biceps & Brachialis
Compressing: Brachioradialis

58
Q

In which position is the triceps in its active insufficiency?

A

Full extension of elbow and hyperextension of the shoulder

59
Q

What is the PRUJ composed of?

A

Radial notch
Annular ligament
Radial head
Radial fovea
Humeral capitulum

60
Q

What is the DRUJ composed of?

A

Ulnar notch
Radioulnar disc (TFCC - triangular fibriocartilage complex)
Head of ulna

61
Q

What ligaments are found in the PRUJ?

A

Annular ligament
Quadrate ligament
Oblique cord

62
Q

Where is the annular ligament and what is the purpose of it?

A

Encircles radial head
Adds stability and has NO LIMITATIONS

63
Q

What is the purpose of the quadrate ligament?

A

Reinforces inferior aspect of joint capsule
Helps maintain radial head to radial notch
Limits spin of radial head in supination and pronation

64
Q

In which direction does the oblique cord run and what is the main purpose of it?

A

Fibers run at right angles to fibers of interosseous membrane
May assist in preventing separation of radius and ulna

65
Q

Which ligaments and discs are part of the DRUJ?

A

Dorsal and palmar ligaments
TFCC and DRUJ capsule
Interosseous membrane

66
Q

Where do the dorsal and palmar ligaments insert? And where do they run

A

They insert into ulnar fovea and base of ulnar styloid
They extend along margins of TFCC

67
Q

What is the purpose of the TFCC and DRUJ capsule?

A

To provide stability to carpals
Transmit compression and tension forces

68
Q

What is the purpose of the interosseous membrane?

A

To stabilize PRUJ and DRUJ
Force transmission especially through weight-bearing

69
Q

When does the interosseous membrane become taut?

A

During rotation to keep radius and ulna from splaying
During weightbearing

70
Q

Which muscles serves to pronate the forearm, and which one is a 2 joint* muscle?

A

Pronator teres*
Pronator quadratus

71
Q

Which muscles serve to supinate the arm?

A

Biceps
Supinator

72
Q

Which Pronator muscle stabilizes proximal joint?

A

Pronator teres

73
Q

Which Pronator muscle dynamically stabilizes distal joint?

A

Pronator quadratus

74
Q

In which positions is the supinator active?

A

In all positions

75
Q

What limits supination?

A

Tension in palmar radioulnar ligament and oblique cord

76
Q

What limits pronation?

A

Bone on bone
Dorsal radioulnar ligament and posterior fibers of MCL

77
Q

What is the ROM for pronation/supination?

A

150º

78
Q

Is supination/pronation measured in elbow flexion or extension?

A

Flexion

Extension could induce shoulder IR/ER

79
Q

What muscles in the DRUJ contribute to radioulnar stability?

A

PQ
ECU tendon

80
Q

Which muscle stabilizes the forearm in pro/sup and gripping activities?

A

ECRB

81
Q

How much joint play is allowed at the radioulnar joint before full resistance from the ligaments ensues?

A

~5mm

82
Q

In which position is the dorsal radioulnar ligament taut?

A

Pronation

83
Q

In which position is the palmar radioulnar ligament taut?

A

Supination

84
Q

During weight-bearing on the hand, where do the forces go?

A

Forces go thru hand to radius, then to the interosseous membrane, then then the ulna, then humerus

85
Q

What is the functional ROM required for most activities?

A

100º of elbow flexion (30-130º)
100º of forearm rotation (50º each pro/sup)

86
Q

In children, which is stronger: bone or ligaments?

A

Ligaments

87
Q

In adults, which is stronger, bone or ligaments?

A

Bone

88
Q

What are the ossification centers of the elbow in order of age of ossification?

A

Capitulum
Radial head
Internal (medial) epicondyle
Trochlea
Olecranon
External (lateral) epicondyle

89
Q

What is the age of ossification for the capitulum?

A

6 months - 2 years

90
Q

What is the age of ossification for the radial head?

A

3-6 years

91
Q

What is the age of ossification for the internal (medial) epicondyle?

A

4-7 years

92
Q

What is the age of ossification for the trochlea?

A

7-10 years

93
Q

What is the age of ossification for the olecranon?

A

6-12 years

94
Q

What is the age of ossification for the external (lateral) epicondyle?

A

10-14 years

95
Q

What can result in compression injuries of the elbow?

A

Bony: FOOSH with elbow in extension
Muscular: repetitive contractions of flexor carpi ulnaris may compress ulnar nerve

96
Q

What can result in distraction injuries of the elbow?

A

Nursemaid’s elbow - radius is pulled inferiorly from annular ligament

97
Q

What can result in varus/valgus injuries of the elbow?

A
  • UCL and medial joint instability secondary to repetitive valgus stresses, such as with pitching
  • Compression of one side and distraction of the other
  • Ulnar neuritis
  • Medial/lateral epicondylitis
  • Ulnar collateral ligament instability causes increased carrying angle and radial head compression on capitulum (ex. Throwing) – can lead to avascular necrosis of capitulum
98
Q

Why does the elbow have the highest incidence rate of peripheral neuropathy?

A

The superficial positioning of nerves and mechanical/repetitive stress on elbow

Movement Science Exam 2 (2 decks)

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