elbow/forearm

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Author:
jpowell22
ID:
153456
Filename:
elbow/forearm
Updated:
2012-05-11 22:20:36
Tags:
kinesiology
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Description:
elbow/forearm
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  1. What is the primary joint for flexion and extension?
    humeroulnar jt (HU)
  2. What joint moves with flex/ext but primarily affects pronation/supination?
    humeroradial jt (HR)
  3. What joint participates in pronation/supination?
    proximal radioulnar jt (RU)
  4. What 3 joints are commonly considered the elbow joint?
    • humeroulnar
    • humeroradial
    • proximal radioulnar
  5. What are the characteristics of the mid radioulnar jt?
    radius and ulna work together to allow pronation/supination

    not a true joint..soft tissues move
  6. What motions do the distal radioulnar jt allow?
    pronation/supination
  7. What type of jt is the humeroulnar jt?
    modified hinge....really a saddle jt
  8. What are the concave/convex bony partners of the humeroulnar jt?
    • trochlea of humerus - convex (ant/post)
    • trochlea fossa of ulna - concave

    concave bony partner moving
  9. During flexion/extension of the humeroradial jt, in which direction is the slide?
    concave trochlea fossa slides in the same direction as the mvmt of ulna
  10. What mvmt also occurs at the humeroulnar jt to allow for full elbow ROM?
    medial and lateral gliding
  11. What type of angulation occurs with elbow extension?
    valgus
  12. What type of angulation occurs with elbow flexion?
    varus
  13. When the HU jt is moving in a medial/lateral direction, what type of joint does it become, and what are the convex/concave bony partners?
    becomes a saddle jt (varus/valgus)

    • trochlear ridge of ulna - convex
    • trochlear groove of humerus - concave

    sliding motion is opposite of bone mvmt
  14. With the HU jt, what direction is the slide of the ulna during flexion?
    distal/anterior
  15. With the HU jt, what direction is the slide of the ulna during varus angulation (flexion)?
    lateral
  16. With the HU jt, what direction is the slide of the ulna during extension?
    proximal/posterior
  17. With the HU jt, what direction is the slide of the ulna during valgus angulation (extenstion)?
    medial
  18. What is the resting position (loose pack postion) of the HU joint?
    70 flexion, 10 supination
  19. What is the close packed postion of the HU jt?
    full extension and full supination
  20. What is the capsular pattern of the HU jt?
    flex > ext
  21. What type of jt is the humeroradial jt?
    hinge pivot
  22. What are the convex/concave bony partners of the humeroradial jt?
    • capitulum of humerus - convex
    • head of radius - concave

    slide moves in the same direction as the bone mvmt
  23. With the HR joint, which direction is the slide during pronation/supination?
    spin

    • one of the few jts with a true spin
    • transverse plane
  24. With the HR joint, which direction is the slide during flexion?
    anterior
  25. With the HR joint, which direction is the slide during extension?
    posterior
  26. With the HR joint, which direction is the slide during supination?
    spin
  27. With the HR joint, which direction is the slide during pronation?
    spin
  28. What is the resting position for the HR jt?
    elbow extension and full supination

    (closed pack position for the HU jt)
  29. What is the closed pack position for the HR joint?
    90 flexion, 5 supination
  30. What is the capsular pattern for the HR joint?
    flex > ext
  31. What are the convex/concave bony partners int he proximal radioulnar jt?
    • rim of radial head - convex
    • radial notch of the ulna - concave

    slide is opposite the direction of mvmt
  32. With the proximal RU joint, the slide moves in which direction during pronation?
    posterior (dorsal)
  33. With the proximal RU joint, the slide moves in which direction during supination?
    anterior (volar)
  34. During rotation, what does the radius spin on?
    annular ligament and against the capitulum
  35. What are the convex/concave bony partners of the distal radioulnar jt?
    • head of ulna - convex
    • ulnar notch of radius - concave

    slide is the same direction as bone mvmt
  36. With the distal RU jt, which direction is the slide during pronation?
    anterior (volar)
  37. With the distal RU jt, which direction is the slide during supination?
    posterior (dorsal)
  38. When the arm is extended in the anatomical position, the longitudinal axis of the elbow and forearm form a lateral valgus angle called what?
    carrying angle
  39. What is the normal carrying angle?
    • 5 in men
    • 10-15 in women
  40. Where does the carrying angle allow the elbow to fit?
    fit closely into the depression at the waist immediately superior to the iliac crest
  41. What is an abnormal (severe/excessive) carrying angle called?
    cubital valgus

    can be caused by epiphyseal damage secondary to lateral epicondylar fracture and may cause a delayed nerve palsy, which presents in the ulnar nerve distribution in the hand
  42. What is a decrease in the carrying angle of the arm?
    • cubitus varus (gun stock deformity) (varus angle)
    • more common than cubitus valgus

    often a result of trauma such as supracondylar fracture in a child where the distal end of the humerus is subject to either malunion or growth retardation at the epiphyseal plate
  43. What are the characteristics/symptoms of ulnar nerve compression?
    ulnar border of hand, little finger, and ulnar half of ring finger sensory changes (in cutaneous distribution)

    overuse of flexors, pressure of the ulnar nerve at the cubital tunnel

    nerve is superficial to olecranon fossa, post to medial epicondyle and covered by fibrous sheath then passes between the heads of the flexor carpi ulnaris
  44. What are the symptoms/characteristics of radial nerve distribution?
    progressive weakness in the wrist and finger extensor and supinator muscles

    deep branch of nerve may become entrapped as it passes under the edge of the extensor carpi radialis brevis and fibrous slit of supinator, or injured with radial head fracture

    superficial nerve may recieve direct trauma that causes sensory changes in the lateral aspect of the forearm and the radial side of the dorsum of the wrist and hand and radial 3 1/2 digits
  45. What are the symptoms/characteristics of median nerve compression?
    • very common
    • nerve runs deep in the cubital fossa medial to the tendon of the biceps and brachial artery the progresses between the ulnar and humeral head of pronator teres and dips under the flexor digitorum profundus

    • can affect pronation/supination
    • entrapment occurs between head of pronator teres causing sensory changes duplicating carpal tunnel syndrome (palmar aspect of the first 3 fingers and 1/2 the ring finger, and dorsal aspect of the distal phalanges of index and ring finger
  46. What disorder occurs when the radial head is pushes proximally in the annular ligament and impinges against the capitulum, commonly from falling on an outstretched hand?
    pushed elbow

    limited flexion (some) or extension of elbow, linmited wrist flexion and limited pronation
  47. What disorder occurs when the radial head is dislodged down farther from the annular ligament and limits supination?
    pulled elbow

    • pain in elbow region following a forceful traction to the forearm (parent pulling a childs arm)
    • usually seen as acute injury in children
    • AKA "nurse maids elbow"
  48. What disorder causes pain in the common wrist extensor tendons along the lateral epicondyle and radiohumeral joint?
    lateral epicondylitis (tennis elbow)

    activities with repeated wrist extension (tennis, pullin weeds, requires firm wrist stability) can inflame the musculotendinous unit
  49. What disorder causes pain in the common flexor/pronator tendon near the medil epicondyle?
    medial epicondylitis (golfers elbow)

    repetitive mvmts into wrist flexion (golf, pitching, work related grasping)
  50. Which overuse disorder (lateral/medial epicondylitis) is most common?
    lateral
  51. What is the special test for ligamentous stability?
    • check for tears in medial/lateral epicondylitis (check stability)
    • (+) if too much play/too much motion

    hold pts elbow in your hand, and push the sides of the elbow in one direction, check for gapping, repeat on opposite side
  52. What is the special test for the tinel sign?
    • check for elicit tenderness over a neuroma within a nerve
    • (+) if tapping on the ulnar nerve (groove between olecranon and medial epicondyle) creates tingling sensations down the forearm to the ulnar distribution of the hand (reproduces pts symptoms = neuroma/extra senstivity)
  53. What is the special test for the tennis elbow test?
    • check for tennis elbow
    • (+) if reproduces pain of tennis elbow- sudden severe pain at lat epicondyle

    have pt extend arm, and wrist then apply pressure at the wrist (try to force into flexion)

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