Upper Extremity - Arm and Elbow

Question 1

The arm can be divided into 2 compartments

Answer 1

anterior

posterior

Question 2

what nerve supplies the anterior compartment of the arm?

Answer 2

musculocutaneous N. (C5, C6)

Question 3

what nerve supplies the post compartment of the arm?

Answer 3

radial N.

Question 4

name the muscles of the anterior compartment of the arm

Answer 4

biceps brachii
brachialis
coracobrachialis

Question 5

biceps brachii

Answer 5

O: supraglenoid tubercle (long head); tip of coracoid process of scapula (short head)
I: radial tuberosity and deep fascia of forearm through bicipital aponeurosis
A: supination of forearm and flexion of elbow

Question 6

Brachialis

Answer 6

O: distal half of anterior surface of humerus
I: ulnar tuberosity
A: PRIME MOVER for flexion of elbow

Question 7

what muscle is in the post compartment of the arm?

Answer 7

triceps brachii

Question 8

Triceps Brachii

Answer 8

O: infraglenoid tubercle (long head), post surface of shaft of humerus above and below the radial groove (lateral and medial heads) respectively
I: olecranon process
N: radial N
A: PRIME MOVER for extension of elbow and GH joint (long head only)

Question 9

the brachial artery is the continuation of the ______after the lower border of teres major

Answer 9

axillary A.

Question 10

the brachial artery descends in the _______

Answer 10

medial bicipital groove

Question 11

what artery supplies the triceps and the elbow?

Answer 11

deep brachial A

Question 12

what nerve penetrates coracobrachialis?

Answer 12

musculocutaneous N.

direct branch of the lat cord of brachial plexus

Question 13

draw the sensory innervation of the arm and forearm

Answer 13

see notes

Question 14

Radial N.

Answer 14

direct branch from the post cord of brachial plexus

Question 15

the radial nerve descends in the ______

Answer 15

radial (spiral) groove of the humerus

Question 16

complete a diagram of the UE innervation

Answer 16

see notes

Question 17

complete a diagram of the UE arterial supply

Answer 17

see notes

Question 18

the joint capsule of the elbow is supported by?

Answer 18

the ulnar (medial) collateral lig
the radial (lateral) collateral lig
anterior oblique lig (runs inferiorly and laterally)

Question 19

Before the age of 10 there is a high risk for radial dislocation, why?

Answer 19

head of radius not developed fully

annular ligament cannot hold the radius in place against the ulna

Question 20

what are some sources of elbow pain?

Answer 20

anterior: biceps tendon, brachialis, loose bodies, fx pain
posterior: triceps tendinopathy, olecranon bursa, posterior impingement (less common), fx, loose body

Laterally: C5, C6, C7 referred pain , wrist extensors (ECRL, ECRB), OA, LCL lig, abnormal neural tension, pulled elbow

medially: wrist flexors, MCL

Question 21

What are some MOIs for the elbow?

Answer 21

FOOSH
Overuse activity? (dominant arm)
Sport? Change in training volume? (throwing)
Pop? Ligamentous injury?
Occupational demands (lifting, carrying, sorting, etc.)
Functional limitations
How long ago? What’s changed?
consider age: lat epicondyle (~35y); osteochondritis dessicans (older); pulled elbow (very young)

Question 22

capsular patterns of the elbow

Answer 22

JOINT CAPSULAR PATTERN
Humeroulnar Flexion > Extension
Radiohumeral Flexion > Extension > supination > pronation
Proximal Radioulnar Supination > Pronation
Distal Radioulnar Full ROM, pain at extremes of rotation

Question 23

what is tennis elbow?

Answer 23

lateral epicondylitis of the elbow

the muscles that attach -wrist extensors

Question 24

what is golfer’s elbow?

Answer 24

medial epicondylitis of the elbow

the muscles that attach - wrist flexors

Question 25

what are some sources of elbow pain?

Answer 25

anterior: biceps tendon, brachialis, loose bodies, fx pain posterior: triceps tendinopathy, olecranon bursa, posterior impingement (less common), fx, loose body Laterally: C5, C6, C7 referred pain , wrist extensors (ECRL, ECRB), OA, LCL lig, abnormal neural tension, pulled elbow medially: wrist flexors, MCL

Question 26

complete a diagram of the UE innervation

Answer 26

see notes

Question 27

complete a diagram of the UE arterial supply

Answer 27

see notes

Question 28

the joint capsule of the elbow is supported by?

Answer 28

``` the ulnar (medial) collateral lig the radial (lateral) collateral lig anterior oblique lig (runs inferiorly and laterally) ```

Question 29

Before the age of 10 there is a high risk for radial dislocation, why?

Answer 29

head of radius not developed fully | annular ligament cannot hold the radius in place against the ulna

Question 30

what are some sources of elbow pain?

Answer 30

anterior: biceps tendon, brachialis, loose bodies, fx pain posterior: triceps tendinopathy, olecranon bursa, posterior impingement (less common), fx, loose body Laterally: C5, C6, C7 referred pain , wrist extensors (ECRL, ECRB), OA, LCL lig, abnormal neural tension, pulled elbow medially: wrist flexors, MCL

Question 31

What are some MOIs for the elbow?

Answer 31

FOOSH Overuse activity? (dominant arm) Sport? Change in training volume? (throwing) Pop? Ligamentous injury? Occupational demands (lifting, carrying, sorting, etc.) Functional limitations How long ago? What’s changed? consider age: lat epicondyle (~35y); osteochondritis dessicans (older); pulled elbow (very young)

Question 32

capsular patterns of the elbow

Answer 32

JOINT CAPSULAR PATTERN Humeroulnar Flexion > Extension Radiohumeral Flexion > Extension > supination > pronation Proximal Radioulnar Supination > Pronation Distal Radioulnar Full ROM, pain at extremes of rotation

Question 33

what is tennis elbow?

Answer 33

lateral epicondylitis of the elbow | the muscles that attach -wrist extensors

Question 34

what is golfer's elbow?

Answer 34

medial epicondylitis of the elbow | the muscles that attach - wrist flexors

Question 35

what is the resting position of the humeroulnar joint during traction?

Answer 35

70 deg of flexion, 10 deg of supination

Question 36

what is the resting position of the humeroradial joint during manual therapy?

Answer 36

full extension and supination

Question 37

what is the resting position of the proximal radioulnar joint during manual therapy?

Answer 37

70 deg of flexion, 35 deg of supination

Question 38

to increase flexion at the humeroradial joint in what glide would you use?

Answer 38

anterior glide

Question 39

to increase extension at the humeroradial joint what glide would you use?

Answer 39

posterior glide

Question 40

to increase supination at the proximal radioulnar joint what glide would you use?

Answer 40

anterior glide

Question 41

to increase pronation at the proximal radioulnar joint what glide would you use?

Answer 41

posterior glide