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kinesiology test > The Elbow & Scapular MMT > Flashcards

The Elbow & Scapular MMT Flashcards

1
Q

Objectives

9: Differentiate among ROM, AAROM, AROM and FROM
11: Perform PROM on the trunk, UEs and Cspine
12: Measure functional, active, and passive ROM with a goniometer and accurately record
13: Discuss manual muscle testing principles
14: Recognize a variety of muscle strength scales used in PT
15: Demonstrate accurate technique for performing manual muscle tests
16: Interpret results from a manual muscle test

A

FYI

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2
Q

Bones and Landmarks of the Elbow

The scapula:

A
  • Infraglenoid tubercle – attachment of the long head of the triceps
  • Supraglenoid tubercle – attachment of the long head of the biceps
  • Coracoid process – attachment of the short head of the biceps
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3
Q

Bones and Landmarks of the Elbow

The humerus:

A
  • Trochlea – articulates with the ulna
  • Capitulum – articulates with the radial head
  • Medial epicondyle – attachment of pronatorteres
  • Lateral epicondyle – attachment of anconeus and supinator
  • Lateral supracondylar ridge – attachment of the brachioradialis
  • Olecranonfossa – articulates with the ulna
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4
Q

Bones and Landmarks of the Elbow

The ulna:

A
  • Olecranon process – articulates with the humerus
  • Trochlear notch – articulates with the humerus
  • Coronoid process – attachment of the brachialis
  • Radial notch – articulation for the radial head
  • Ulnartuberosity – attachment for the brachialis
  • Styloid process – distal end of the posterior medial surface
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5
Q

Bones and Landmarks of the Elbow

The radius:

A
  • Head – articulates with the humerus
  • Radial tuberosity – attachment for the biceps
  • Styloid process – attachment for the brachioradialis
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6
Q

what are the Ligaments and Structures OF THE ELBOW?

A
  1. Medial collateral ligament
  2. Lateral collateral ligament
  3. Annular ligament
  4. Joint capsule
  5. Interosseous membrane
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7
Q

triangular shaped and spans the medial side of the elbow

A

Medial collateral ligament

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8
Q

triangular shaped and spans the lateral portion of the elbow

A

Lateral collateral ligament

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9
Q

attaches anteriorly and posteriorly to the radial notch of the ulna and encompasses the radial head

A

Annular ligament

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10
Q

attaches around the distal end of the humerus, encompassing the trochlea and capitulum and fossas located above them

A

Joint capsule

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11
Q

broad, flat membrane located between the radius and ulna

A

Interosseous membrane

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12
Q

Muscles of the elbow and forearm

YOU WILL BE RESPONSIBLE FOR THE FOLLOWING MUSCLES AND THEIR OIAN’S

A
  1. Brachialis
  2. Brachioradialis
  3. Biceps
  4. Supinator
  5. Triceps
  6. Anconeus
  7. Pronatorteres
  8. Pronatorquadratus
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13
Q

Fun Facts:

A
  • The humerus articulates with the radius and ulna forming a hinge joint
  • Ligaments, nerves and muscles aid in movement of the elbow
  • Very prone to repetitive and overuse injuries
  • Activities that place the arm in extension tend to cause most injuries
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14
Q

what did Ben say?

A 
If the elbow had been placed closer to the hand, the forearm would have been to short to bring a glass to your mouth and if the elbow had been closer to the shoulder, the forearm would have been too long and it would have carried a glass beyond the mouth
 Benjamin Franklin (1706-1790)
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15
Q

Common injury to the elbow as a result of a direct blow to the area
Signs and Symptoms:

  • Brusing
  • Subsequent bleeding
  • Pain
  • Stiffness during function and active range of motion

Can result in myositisosssificans in which bone grows into the skeletal muscle

A

Contusions

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16
Q

Bursitis is an inflammation of the bursa

  • Bursa is a tiny, fluid filled sac that functions as a gliding surface to reduce friction between tissues of the body
  • Major bursae are located adjacent to the tendons near the large joints such as shoulders, elbow, hips and knees

Caused by a direct blow to the subcutaneous olecranon process of the ulna

A

Olecranon Bursitis

17
Q

Olecranon Bursitis: Signs and Symptoms

A

Inflammation/Swelling
Palpable bursa
Pain
Possible infection of the bursa if an abrasion is present

18
Q
  • Nearly everyone has suffered an ulnar nerve contusion
  • The ulnar nerve passes behind the medial epicondyle of the humerus and subcutaneously runs in a grove and passes through the cubital tunnel
  • The lack of bony protection makes the ulnar nerve vulnerable to trauma
  • A direct blow to the area may cause immediate pain and burning sensations shooting down the ulnar side of the forearm to the ring and little finger
  • “Hitting the funny bone”
A

Ulnar Nerve Contusion

19
Q

Elbow strains are common athletic injuries that occur to the muscles and other structures
Divided into acute and chronic types

  • Acute – when a sudden overload is applied to the elbow joint
  • Chronic – overuse and repetitive injuries

Most common areas of acute strain are the common flexor tendon around the medial epicondyle and the common extensor tendon around the lateral epicondyle

A

Elbow Strain

20
Q

Elbow Strain:Signs and Symptoms: Acute

A
  • Incident of sudden excessive overload followed by tenderness over the involved area
  • Pain with function or resisted motion
  • If there is a ruptured tendon, there may be a palpable gap, bunching of ruptured muscle or loss of efficient motion of the affected muscle
21
Q

Elbow Strain: Signs and Symptoms: chronic

A
  • Overuse injuries
  • Irriation of muscle fibers resulting in microscopic tears
  • Degenerative changes in the joint
  • Pain
22
Q
  • Chronic strains commonly occur in the region of the lateral and medial epicondyle
  • Usually caused by repeated overload of the musculotendinous units attaching to one of the epicondyles
  • Faulty techniques or mechanics, weak muscle groups and inappropriate equipment can aggravate this condition
A

Epicondylitis

23
Q

Nicknamed “Tennis Elbow” was first recognized in tennis players.

A

Lateral Epicondylitis

24
Q

Nicknamed “Golfer’s Elbow” because it was first seen in golfers

A

Medial Epicondylitis

25
Q

Epicondylitis: Signs and Symptoms:

A
  • Local tenderness over the involved epicondyle
  • Pain with use of the involved muscles
  • Swelling
  • Resisted wrist motion will reproduce pain
26
Q
  • Moderately common in athletics
  • The elbow is relatively stable an injuries involving the ligamentous system of the elbow most commonly result from forced hyperextension or valgus/varus (side to side) forces
A

Sprains

27
Q

Sprains: Signs and Symptoms:

A
  • “Click” or “Pop” along with sharp pain at the time of injury
  • Tenderness at the site of injury
  • Localized swelling and pain on attempt to reproduce MOI
  • Swelling and muscle spasms limit full extension
  • Pain is usually relieved by flexing the elbow
28
Q
  • The elbow is the second most frequently dislocated major joint (after the shoulder)
  • Not common, but can be serious
  • Posterior dislocation is most common, typically resulting from a fall on an outstretched hand (FOOSH)
  • As the elbow is forced into hyperextension, the olecranon process is levered against the humerus which can force the ulna backwards
  • Severely stretches or ruptures the collateral ligaments but the annular ligament remains intact
A

Dislocations

29
Q

Dislocations: Signs and Symptoms:

A
  • Obvious deformity with the olecranon process abnormally prominent
  • Loss of elbow function
  • Considerable pain
  • Loss of a radial pulse
  • Decrease in sensory and motor function
30
Q
  • Typically results from direct trauma to the forearm or elbow or indirect stresses transmitted through the upper extremity
  • Frequent in children and skeletally immature athletes
  • Many involve the distal humerus, proximal ulna or radius
  • Simple avulsions or serious and traumatic fractures
A

Fractures

31
Q

Fractures: Signs and Symptoms:

A
  • May or may not visually show a deformity
  • Point tenderness
  • Varying amounts of hemorrhaging or swelling are common
  • Demonstrates limited ROM
  • Disability at the elbow or hand
  • Increase in pain at the fracture site upon attempted movement
32
Q
  • A serious condition that occurs in the absence of blood flow or ischemia to the forearm.
  • Can be caused by increased pressure in the arm from swelling, trauma, decreased blood flow to the arm
  • If left undiagnosed, the decrease in blood flow will injure the muscle, causing it to shorten
  • When the muscle shortens, it pulls on the joint at the end of the muscle as it would if it were normally contracting
  • The joint remains bent and it cannot be straightened
A

Volkmann’s Contracture

33
Q
  • The ulnar nerve passes through the cubital tunnel (important) in the posterior aspect of the medial epicondyle covered by fascial bands
  • Repetative movement of the ulnar nerve (swinging, throwing) can become irritated, compressed or entrapped in this tunnel
  • Called cubital tunnel syndrome
A

Ulnar Nerve Injury

34
Q

Ulnar Nerve Injury: Signs and Symptoms:

A
  • Pain along the inner aspect of the elbow
  • Tenderness over the medial epicondylar groove
  • Paresthesia in the distribution of the ulnar nerve in the hand
    • Little and ring fingers
35
Q
  • Passes anteriorly to the lateral epicondyle and lies in a tunnel formed by several muscles and tendons
  • The radial nerve can become entrapped in the tunnel area, especially during activities that require repetitive pronation and supination of the forearm
  • Called radial tunnel syndrome
  • Occurs infrequently but should be considered in the assessment of lateral epicondylitis
A

Radial Nerve Injury

36
Q

Radial Nerve Injury: Signs and Symptoms:

A
  • Pain over the lateral aspect of the elbow
  • Tenderness may be present over the anterior radial head instead of the common extensor tendon (with entrapment)
  • Symptoms reproduced by resisting supination with the elbow flexed to 90 degrees or resisting extension of the middle finger with the elbow extended
37
Q
  • Median nerve crosses the anterior elbow and passes between the heads of the pronatorteres muscle just distal to the joint
  • Vulnerable to entrapment or compression d/t hypertrophy of the pronatorteres or activites that involve repetitive pronation
  • Referred to as pronatorteres syndrome
A

Median Nerve Injury

38
Q

Median Nerve Injury: s/s

A
  • Pain radiating down the anterior forearm
  • Numbness and tingling in the thumb, index and middle fingers
  • Resistive pronation may increase pain

kinesiology test (16 decks)

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