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KNPE331 > Week 11 > Flashcards

Week 11 Flashcards

1
Q

What type of joint is the elbow joint?

A
  • hinge
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2
Q

What three joints make up the elbow joint?

A
  • ulnohumeral
  • radiohumeral
  • proximal radioulnar joint
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3
Q

Elbow ligaments

A
  • ulnar (medial) collateral ligament
  • radial (lateral) collateral ligament
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4
Q

Joints of the hand and wrist

A
  • carpometacarpal joint
  • metacarpalphaleangeal joint
  • proximal interphalangeal joint
  • distal interphalangeal joint
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5
Q

Ligaments of the wrist and hand

A
  • collateral ligaments of wrist and fingers
  • collateral ligaments of fingers
  • intercarpal ligaments (dorsal, palmar)
  • triangular fibrocartilage complex (TFCC)
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6
Q

Collateral ligaments of wrist and fingers

A
  • ulnar (medial) collateral ligament
  • radial (lateral) collateral ligament
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7
Q

Triangular fibrocartilage complex (TFCC) aka triangular disc

A
  • complex made up of load-bearing triangular fibrocartilage articular disc and ligaments on medial aspect of wrist
  • disperses axial load from carpals to ulna
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8
Q

What is the TFCC thickened by?

A
  • ulnar collateral ligament medially
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9
Q

What is TFCC a major stabilizer of?

A
  • ulnocarpal joint
  • distal radioulnar joint
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10
Q

What action does TFCC facilitate?

A
  • articulations at wrist joint
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11
Q

Nerves at the elbow and wrist

A
  • ulnar nerve at elbow and wrist
  • median nerve under flexor retinaculum
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12
Q

Elbow flexors

A
  • biceps brachii ( short and long head)
  • brachialis
  • brachioradialis
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13
Q

What is something to note about biceps brachii?

A
  • long head of bicep also does shoulder flexion
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14
Q

Elbow extensors

A
  • triceps brachii (long head, medial and lateral head)
  • anconeus
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15
Q

Muscles of the forearm, wrist & hand: medial epicondyle

A
  • common flexor tendon origin
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16
Q

Muscles of the forearm, wrist & hand: lateral epicondyle

A
  • common extensor tendon origin
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17
Q

Physiological ROM of elbow

A
  • flexion
  • extension
  • pronation
  • supination
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18
Q

Physiological ROM of wrist

A
  • flexion
  • extension
  • radial deviation
  • ulnar deviation
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19
Q

Physiological ROM of digits

A
  • flexion
  • extension
  • abduction
  • adduction
  • 1-5th oppositon/reposition
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20
Q

Lateral epicondylitis (tennis elbow) MOI

A
  • overuse of forearm extensors
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21
Q

What sports is lateral epicondylitis common in?

A
  • tennis
  • squash
  • badminton
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22
Q

What are the most common extensors affected in lateral epicondylitis?

A
  • extensor carpi radialis longus
  • extensor carpi radialis brevis
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23
Q

Signs and symptoms of lateral epicondylitis

A
  • TOP common extensor origin
  • pain & weakness with wrist extension
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24
Q

Acute management of lateral epicondylitis

A
  • stretch wrist extensors in elbow extension & flexion
  • PIER
  • tennis elbow brace?
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25
Q

What can the R in PIER mean in some cases?

A
  • altered activity
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26
Q

Long term management of lateral epicondylitis

A
  • eccentric strengthening program for forearm extensors
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27
Q

Medial epicondylitis (golfer’s elbow) MOI

A
  • overuse of wrist flexors
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28
Q

What sports is medial epicondylitis common in?

A
  • golfers
  • baseball pitchers
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29
Q

Most common flexors affected in medial epicondylitis

A
  • flexor carpi radialis
  • pronator teres
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30
Q

Signs and symptoms of medial epicondylitis

A
  • TOP common flexor origin
  • pain & weakness with wrist flexion
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31
Q

Acute care of medial epicondylitis

A
  • stretch forearm flexors
  • PIER
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32
Q

Ruptured biceps MOI

A
  • sudden lengthening of contracting muscles
  • ie sudden load when lifting or catching heavy load
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33
Q

Which biceps tendon is most commonly ruptured?

A
  • distal
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34
Q

Signs and symptoms of ruptured biceps

A
  • “popeye muscle”/muscle balled up
  • bruising
  • pain near insertion of biceps into radial tuberosity
  • pain and weakness with elbow flexion and supination
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35
Q

Acute management of ruptured bicep

A
  • PIER
  • pressure pad to approximate any remaining fibres
  • shorten biceps in sling to remove tension
  • surgical repair
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36
Q

DeQuervain’s syndrome MOI

A
  • overuse of thumb due to gripping/wringing
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37
Q

What does DeQuervain’s syndrome lead to?

A
  • inflammation of tendons & sheath around the thumb
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38
Q

Which tendons around the thumb may be inflamed in DeQuervain’s syndrome?

A
  • extensor pollicis brevis
  • abductor pollicis longus
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39
Q

Signs and symptoms of DeQuervain’s syndrome

A
  • pain over tendons of thumb
  • weakness of thumb abduction or extension
  • pain with gripping
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40
Q

What sport is DeQuervain’s syndrome common in?

A
  • golf
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41
Q

Special test for DeQuervain’s syndrome

A
  • Finkelstein test (positive if pain)
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42
Q

Acute management of DeQuervain’s syndrome

A
  • PIER
  • thumb spica brace
43
Q

What could happen if DeQuervain’s syndrome is left untreated ?

A
  • can progress to thickening/scarring & reduced ROM
44
Q

Elbow hyperextension injuries MOI

45
Q

Signs and symptoms of elbow hyperextension injuries

A
  • anterior elbow pain
  • swelling from ligament/capsule sprain and/or muscle strain
  • posterior elbow pain from osteochondral lesion
46
Q

What do we need to rule out for elbow hyperextension injuries

A
  • olecranon fracture
47
Q

Acute management of elbow hyperextension injuries

A
  • PIER
  • shorten injured tissues (elbow flexion)
  • sling
  • tape job (very effective)
48
Q

Ulnar collateral ligament (MCL) sprains of the elbow MOI

A
  • FOOSH
  • overuse by repeat valgus force on elbow
49
Q

Signs and symptoms of ulnar collateral ligament sprains of the elbow

A
  • pain and laxity in medial elbow joint
  • ulnar nerve symptoms
50
Q

Special test for ulnar collateral ligament sprains of the elbow

A
  • valgus stress test
51
Q

What sports is ulnar collateral ligament sprains of the elbow common in?

A
  • pitchers due to high velocity force
52
Q

Management for ulnar collateral ligament sprains of the elbow

A
  • Tommy John surgery
53
Q

Tommy John surgery

A
  • reconstructs UCL using a graft tendon such as palmaris longus, semitendinosus or gracilis
54
Q

Why is incidence of a ulnar collateral ligament sprains of the elbow increasing?

A
  • happening in younger athletes
55
Q

Collateral ligament sprains of the wrist MOI

A
  • FOOSH, forced forearm rotation
56
Q

Ulnar collateral ligament sprain MOI

A
  • valgus force
57
Q

Radial collateral ligament sprain MOI

A
  • varus force
58
Q

Signs and symptoms of collateral ligament sprains of the wrist

A
  • pain
  • swelling & instability on medial or lateral aspect of wrist
59
Q

Special test for ulnar collateral ligament sprain

A
  • valgus stress test
60
Q

Special test for radial collateral ligament sprain

A
  • varus stress test
61
Q

Acute management of collateral ligaments sprains of the wrist

A
  • PIER
  • wrist wrap
  • wrist tape job for RTP
62
Q

Ulnar collateral ligament sprain of the thumb (skier’s thumb or gamekeeper’s thumb) MOI

A
  • traumatic or overuse hyperabduction of the thumb (1st metacarpophaleangeal joint
63
Q

Traumatic ulnar collateral ligament sprain of the thumb MOI

A
  • skier’s thumb
  • thumb gets caught
  • FOOSH
  • catching ball
64
Q

Overuse ulnar collateral ligament sprain of the thumb MOI

A
  • gamekeeper’s thumb
  • repeat gripping/twisting
65
Q

What can an ulnar collateral ligament sprain of the thumb also result in?

A
  • avulsion fracture
66
Q

Signs and symptoms of ulnar collateral ligament sprain of the thumb

A
  • pain
  • swelling
  • instability at 1st MCP joint
67
Q

Acute management of ulnar collateral ligament sprain of the thumb

A
  • PIER
  • possible x ray to rule out avulsion
  • brace for healing
  • thumb tape job/brace for RTP
68
Q

Why is surgery recommended for ulnar collateral ligament sprain of the thumb

A
  • instability to stabilize joint
  • prevent osteoarthritis
69
Q

Thumb tape jobs ROM that you may want to limit

A
  • hyperextension
  • abduction
70
Q

Special test for thumb tape job that is limiting hyperextension

A

1st MCP instability glide into extension

71
Q

Special test for thumb tape job that is limiting abduction

A
  • valgus stress
72
Q

Triangular fibrocartilage complex tear MOI for acute injury

A
  • FOOSH
  • forced forearm rotation
73
Q

Triangular fibrocartilage complex tear MOI for oversue injury

A
  • repetitive wrist motions (wrench, hammer, lifting)
74
Q

Signs and symptoms of triangular fibrocartilage complex tear

A
  • medial wrist pain
  • pain with ulnar deviation & loading through wrist
  • popping/clicking
  • wrist weakness
75
Q

Special test for triangular fibrocartilage complex tear

A
  • TFCC compression test
  • passive ulnar deviation with axial compression- load through disc)
76
Q

Acute management of triangular fibrocartilage complex tear

A
  • PIER
  • brace as it heals
  • anti inflammatory injections if needed
  • surgery for persistent instability
77
Q

Elbow dislocations MOI

78
Q

Signs and symptoms of elbow dislocations

A
  • deformity
  • pain
  • holding elbow
  • tingling/numbness
  • shock
79
Q

Acute care of elbow dislocations

A
  • stabilize
  • splint
  • monitor/treat for shock
  • ER/EMS
  • reduction under sedation
80
Q

Elbow fractures MOI

A
  • direct trauma/fall
81
Q

Signs and symptoms of elbow fractures

A
  • pain
  • unable or unwilling to love elbow
82
Q

Acute care for elbow fractures

A
  • splint
  • monitor for shock
  • ER for x-rays/surgical refer
83
Q

Surgical approach for elbow fracture

A
  • ORIF= open reduction internal fixation
84
Q

Colles’ fracture MOI

A
  • FOOSH
  • distal radius displaced posteriorly
85
Q

Signs and symptoms of Colles’ fracture

A
  • “dinner fork deformity”
  • pain
  • numbness
86
Q

Acute management of colles’ fractrue

A
  • splint
  • monitor for shock
  • emerge x rays
  • surgery if unable to align
87
Q

Scaphoid fractures MOI

88
Q

Signs and symptoms of scaphoid fractures

A
  • TOP of antatomical snuffbox
89
Q

Scaphoid ability to heal

A
  • poor blood supply so low ability to heal
90
Q

Metacarpal (MC) and finger fractures MOI

A
  • axial compression (jammed) finger
  • direct trauma
  • being stepped on
91
Q

Signs and symptoms of metacarpal & finger fractures

A
  • localized pain
  • swelling
  • unable to grip
92
Q

Acute care of metacarpal & finger fractures

A
  • fingers: buddy tape to stabilize
  • hand (MC): SAM splint
93
Q

What can result with metacarpal and finger fractures?

A
  • avulsion fractures
  • tendon pulls off piece of bone
  • requires immobilization or surgical repair
94
Q

Cyclist Palsy MOI

A
  • compression from handlebars
95
Q

Signs and symptoms of cyclist palsy

A
  • tingling/numbness/nerve pain
  • decreased muscle strength of 5th digit
  • hand cramping
96
Q

Who is cyclist palsy common in?

A
  • new cyclists
  • distance cyclists
97
Q

Prevention of cyclist palsy

A
  • avoid hyperextension of wrist on handlebars
  • proper bike fit
98
Q

Acute care for cyclist palsy

A
  • PIER
  • splint
  • may require NSAIDs
99
Q

Carpal tunnel syndrome MOI

A
  • overuse of wrist flexor tendons causing pressure in median nerve within carpal tunnel
100
Q

Signs and symptoms of carpal tunnel syndrome

A
  • burning/tingling/numbness in anterior wrist & hand (along medial nerve distribution digits 1-3 and 1/2 of 4)
  • decreased grip strength
101
Q

Acute care for carpal tunnel syndrome

A
  • bracing
  • PIER
  • anti-inflamm treatment
  • proper ergonomic set up
  • steroid injection?
  • surgery to open up tunnel if conservative treatment is unsuccessful
102
Q

Special test for acromioclavicular joint

A
  • scarf test
103
Q

Pre/post test for elbow tape job

A
  • end ROM of elbow extension
104
Q

Pre/post test for wrist tape job

A
  • active ROM of wrist extension

KNPE331 (13 decks)

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