Shared Flashcard Set

Details

MST 1
Upper Extremity
47
Anatomy
Graduate
11/01/2010

Additional Anatomy Flashcards

 


 

Cards

Term

What is Lateral Epicondylitis?

(4 points)

Definition

- Most common overuse injury of the elbow

- Microtears or tissue failure due to repetitive use or eccentric strain of the wrist or forearm

- Occurs more in males

- Typically involves the extensor tendon mass (ECRB, ECRL, EDC)

Term
What Contributes to Lateral Epicondylitis?
Definition

- weak or inflexible shoulder and wrist muscles

- backhand stroke

- chainsaw use, frequent use of hand tools

- hitting wet and heavy balls

Term
Symptoms of Lateral Epicondylitis
Definition

- Gradual aching pain over the lateral elbow

- Pain may radiate from proximal to distal

- Usually unilateral

- Using the arm aggravates it

Term
Clinical Findings with Lateral Epicondylitis
Definition

- Normal AROM

- Painful elbow extension/supination

- Painful resisted wrist extension with elbow flexion

- Painful resisted rad. deviation and ext of 2/3rd fingers

- Decreased wrist ext and grip strength

- Tender over the extensor tendon mass

Term
What is Medial Epicondylitis?
Definition

- Overuse of the medial flexors (Pronator teres and FCR)

Term
What contributes to Medial Epicondylitis?
Definition

- Throwing/pitching

- Heavy suitcase

- Golf swing

- Forceful tennis serve

Term
Clinical Findings in Medial Epicondylitis
Definition

 - Painful resisted wrist flexion

- Painful tight grip

- Painful passive wrist extension abd supination

- Tender over the flexor tendon mass

- Weak grip strength

Term
Interventions for Medial/Lateral Epicondylitis
Definition

- Rest

- Activity modification

- Ice, NSAIDS

- Counterforce brace or wrist cock-up splint

- Stretch wrist extensors

- Strengthen wrist extensors/flexors, biceps, triceps, and grip after acute inflammatory phase

- Cross friction massage and joint mobilizations

- May require surgery if 6 months of conservative management is unsuccessful

Term
Method of injury for an Ulnar Collateral Ligament Sprain/rupture
Definition

- Valgus Extension overload

- Sudden or acute valgus, dislocation, or microtrauma

- Pop if acute

- More common in baseball, tennis, waterpolo, etc.

Term
Cinical Findings with Ulnar Collateral Ligament Sprain
Definition

- Swelling at insertion

- Laxity and pain with valgus stress test

- Tinel sign may be positive if chronic

Term
Interventions for Ulnar Collateral Ligament Sprain
Definition

- Rest/Activity modification

- Grip exercises

- Isometric then concentric and then eccentric

Term
What are common pediatric fractures?
Definition

- Supracondylar Fractures

- Medial Epicondyle

- Radial Head

Term
Associated pathologies with supracondylar fractures
Definition

- Radial Nerve injury

- Males to Females 2:1

Term
Complications with a Supracondylar Fracture
Definition

- ROM loss

- Malalignment

- CRPS

- Brachial Artery compromise

- Volkmann's ischemic contracture (Flexion)

- MO/HO

Term
What is an Essex Laprosti?
Definition

- Dislocation of the distal radial-ulnar joint (DRUJ) and interosseous membrane disruption resulting from a radial head fracture

Term
What is the common cause of a radial head fracture?
Definition
FOOSH
Term
Clinical Biomechanics of Throwing
Definition

- Tensile loads on the medial side

- Compressive loads on the lateral side

Term
What is Little Leaguer's Elbow
Definition

- Medial epicondyle stress fracture

 

Caused by: Repetitive stresses from throwing

Term
Clinical Findings for Little Leaguer's Elbow
Definition

-  Medial elbow pain and a flexion contracture >15 degrees

 

- Local swelling

- Ulnar nerve dysfunction possible

- Widening fragmentation of the epiphyseal line of medial epicondyle

Term
Treatment for Little Leaguer's Elbow
Definition

- Rest

- Sling

- Rest as needed

- Exercise of wrist and hand in sling

- Progressive strengthening

      - Isometric->isotonics->isokinetics->eccentrics->    plyometrics

- Stretching

- Patient Education

Term
What is Panners Disease (Osteochondritis Dessicans of the Capitellum)?
Definition

- AVN of the epiphysis

 

- Caused by:  macrotrauma, decreased circulation or microtrauma

 

- Resolves with growth and development

- Common in children 5-16; M>F

Term
What is Osteochodritis Dessicans (OCD) of Radial Head?
Definition

- Compression of the radial head

- Most common in younger males 15-20

- Often leads to DJD

- Prevention possible by limiting throwing

Term
Elbow Dislocation
Definition

- Most commonly dislocated joint in children

- Posterior dislocation is the most common

- Caused by a FOOSH with hyperextension

Term
Elbow Dislocation Management
Definition

- Splint elbow at 90 degrees ~4 days

- Sling

- Light gripping exercises

- 1st week AAROM is painfree

- Then AROM painfree

- Week 3+ elbow extension ROM, stretch and strengthen, HUJ traction mobs as needed

Term
Joint Mobilizations for Elbow Dislocation
Definition

- HUJ Traction

- HR Dorsal/Volar glide and distraction

- RUJ proximal dorsal/volar glide

- RUJ distal dorsal/volar glide

Term
Prognosis for Elbow Dislocation
Definition

- 1-3 months to regain flexion ROM

- 3-5 months to recover extension ROM/strength

 

(Extension ROM may never be fully regained)

Term
Clinical Findings for Myositis Ossificans and Heterotopic Ossification
Definition

- Swelling

- Tender &/or firmover area

- Limited ROM in one or more planes

- Painful resisted ROM

Term
Interventions for MO/HO
Definition

- Rest in a splint

- NSAIDS

- No massage, passive stretch or resistive exercise

- Surgery as needed to excise heterotopic bone

Term
What is Nursemaid's Elbow?
Definition
- Displaced radial head - often from swinging a child by the hands
Term
Clinical Findings in Nursemaid's Elbow
Definition

- Forearm rests in pronation because the radial head can't slide proximally in the annular ligament when supination is attempted

- Supination ROM is limited

- Pain with movement or inwilling to move

Term
Total Elbow Arthoplasty Indications
Definition

- Constant pain

- Severe loss of function

- Age >60

- RA or macrotrauma

Term
Medial Condyle Muscle Attachments
Definition

Pronator teres

FCU

FCR

FDS

FPL

Term
Lateral Condyle Muscle Attachments
Definition

Supinator

ECU

ECRB

ED

Term
Lateral Supracondylar Ridge Muscle Attachments
Definition

ECRL

Brachioradialis

Term
What is the Functional ROM of the Elbow for most ADLs?
Definition

30-130 degrees of flexion

 

50 degrees for supination and 50 degrees for pronation

Term
What Pathologies come from the Medial Elbow?
Definition
  • Medial Epicondylitis
  • Ulnar nerve neuritis
  • Strain of the pronator teres
  • Little Leaguer's Elbow
  • Fracture of the medial epicondyle
Term
What pathologies of the elbow come from the lateral side?
Definition
  • Lateral epicondylitis
  • LCL injury
  • Fracture of the capitellum
  • Cervical radiculopathy
  • OCD
  • Radial head injury
Term
Special Tests for Lateral Epicondylitis
Definition

Cozen's Test

Mill's Test

Term
Tests for Cubital Tunnel Syndrome
Definition

Tinel's Sign

Elbow Flexion Test

Term
What is an indication for HUJ distraction?
Definition
Increasing elbow flexion and extension
Term
What does HUJ distal glide do?
Definition
Increase flexion of the elbow
Term
What does HRJ distraction do?
Definition
Increase the joint space of the HRJ to correct a pushed elbow.
Term
What does HRJ compression do?
Definition
Decrease the joint space of the HRJ to reduce a pulled elbow (Nursemaid's Elbow)
Term
What does a HRJ Dorsal Glide do?
Definition
Increase elbow extension
Term
What does a HRJ Volar Glide do?
Definition
Increase elbow flexion
Term

What does the P-RUJ Dorsal Glide do?

 

P-RUJ Volar Glide do?

Definition

Dorsal glide increases pronation

 

Volar glide increases supination

Term

What does the D-RUJ Dorsal Glide do?

 

Volar Glide?

Definition

Dorsal Glide increases supination

 

Volar Glide increases pronation

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