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What are the bony landmarks of the elbow
- Humerus
- Lateral epicondyle
- Medial epicondyle
- Capitellum
- Trochlea
- Radial head
- Radius
- Olecranon
- Ulna
- Coronoid
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What is the range of movement of the elbow
- Flexion
- Extension
- Pronation
- Supination
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What should be felt during an elbow examination
- Shoulder
- Humerus
- Medial epicondyle
- Lateral epicondyle
- Olecranon
- Radial head
- Ulna
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Sensory function of the ulnar nerve
Palmar and dorsal aspect of the little finger and ulna border of the ring finger
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What is the sensory function of the medial nerve
- Palmar aspect -thumb, index, middle and radial border of the ring finger
- Dorsal aspect - distal phalages of the thumb, index, middle, and radial border of the ring finger
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What is the radial nerve sensory function
Dorsal aspect - first web space
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What is the ulnar nerve motor function
- Fanning
- Crossing
- Thumb adduction
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What is the median nerve motor function
- Thumb abduction
- Thumb opposition
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What is the radial nerve motor function
Dorsiflexion against resistance
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What is CRITOL
Classification of ossification centres in the elbow
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Does ossification at the elbow generally occur earlier or later in girls
Earlier
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What is the order for CRITOL
- Capitellum (1)
- Radial head (3)
- Internal (medial epicondyle) (5)
- Trochlea (7)
- Olecranon (9)
- Lateral epicondyle (11)
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What does the capitellum articulate with
Radial head
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What does the trochlea articulate with
Ulna
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Which fat pad may be classed as normal unless displaces anteriorly
Anterior fat pad
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Which fat pad, if raised nearly always indicates a fracture
Posterior fat pad
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On a lateral X-ray, where should the capitellum lie in relation to the anterior humeral line
With approx 1/3 of the capitellum anterior to the anterior humeral line
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On an AP and lateral X-ray, how should the radial capitellar line lie in relation to the radius and capitellum
The radiacapitellar line should go through the centre of the radius and the capitellum
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What constitutes an adequate elbow X-ray
- Distal 1/3 humerus
- Proximal 1/3 radius and ulna
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In which direction do elbows most commonly dislocate
Posterior
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What fractures of the elbow are associated with dislocations
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What do raised fat pads often indicate
- Radial head fractures
- Radial neck fractures
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If fat pads are raised but no fracture is seen how should the elbow be treated
As if fractured
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On X-ray, what may a crack through the coronoid suggest
A reduced dislocation
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What may the absence of fat pads indicate
- A complete rupture of the joint capsule
- Ie. A relocated elbow
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When must the radio capitellar line always be evaluated
- Ulna shaft fractures
- May be an associated radial head dislocation
- Monteggia
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What may be indicated if less than 1/3 of the capitellum lies anterior to the anterior humeral line
- Supracondylar fracture
- Distal fragmentdispleased posteriorly
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What is more important, the age of ossification or the order
- The order
- Can work out what should be where, based on what is already there, if one is missing it is probably displaced into the joint
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