MS II 10 elbow

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MS II 10 elbow
2013-04-10 21:08:19
MS II 10 elbow

spring rosen and pivko
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  1. muscles of elbow flexion
    • biceps
    • brachialis
    • brachioradialis
  2. muscles of elbow ext
    • triceps
    • anconeous
  3. muscles of pronation
    • pronator teres
    • pronator quadratus
    • brachioradialis
  4. muscles of sup
    • supinator
    • biceps
    • brachioradialis
  5. humero ulnar jt distraction -- start w elbow in what pos?
    flex 70 sup 10
  6. 3 ways to do humero-ulnar jt distraction
    • in all - pt supine and in 1 and 2 arm flex 70 sup 10
    • 1) strap down the pt, cup two hands on prox ulna using ulnar border, lean back
    • 2) stabilize hum with one hand, distract with one hand
    • 3) put your arm in the elbow joint and flex the pt's arm over yours ... be careful to not put your ulnar bony ridge on pt's bicep. Only for strong bones!
  7. when would you do humero-ulnar valgus and varus strain?
    for testing only, not for tx
  8. how to do humero-ulnar jt valgus strain
    • put elbow 5 degrees shy of its full ext
    • fixate distal lat hum
    • apply force on prox med forearm and press laterally to increase the valgus angle
  9. how to do humero-ulnar joint varus strain
    • put elbow 5 degrees shy of its full ext
    • fixate distal med hum
    • apply force on prox lat forearm and press med to increase the varus angle
    • (small motion)
  10. humero-ulnar med glide - how - 2 methods
    • 1) pt supine or seated
    • arm in resting pos (flex 70 sup 10)
    • fixate med distal hum, mobilize on lat prox forearm

    • have the distal UE wedeged btwn yr elbow and ribs
    • have your hands very close to joint, your thumbs in a row

    • 2) pt side-lying, shoulder and elbow at 90, so the arm is by the ears
    • wedge under prox forearm
    • press down on distal hum
  11. med glide of ulna at elbow increased __ which is a component of __
    valgus -- ext
  12. lat glide of ulna at elbow increased __ which is a component of __
    • varus
    • flex
  13. lat glide of hum-ulnar jt, 2 methods
    1) arm in resting pos (70/10), pt supine, stabilize distal lat hum, press prox med forearm

    2) sidelying, arm by ear in ER, wedge under hum in line w elbow crease, depress forearm
  14. humero-radial jt distraction - pt position?
    • pt supine
    • jt in resting pos of sup RU joint - flex 70 sup 35
  15. humero-radial jt distraction - how?
    • fixate distal hum
    • hold distal radius with a key grip btwn thum & flexed index
    • put yr elbow in line w radius
    • (creates traction in HR jt and inf glide in prox RU jt)
  16. humero-radial compression/approximation -- pt pos?
    • supine
    • elbo flexed to 90 (almost close-packed)
  17. humero-radial compression/approximation - how?
    • fixate distal lat hum while palpating radial head and joint space
    • graps pt's hand so thumbs are linked, thenar eminences are in contact
    • extend and radially deviate pt's wrist
    • press radius longitundinally
  18. dorasl glide of radial head at RH jt - pt pos? how?
    • resting pos - ext and sup
    • seated or supine
    • fixate dorsal distal humerus
    • gras pradial head w thumb and index and glide dorsally
  19. dorsal glide of radial head in HR resting pos increases what?
  20. dorsal and volar glide of radius at prox ulnar jt -- pos? how?
    • seated or supine
    • flex 70 sup 35 (resting pos of prox RU jt)
    • stabilize humerus, get a pincer grasp on radial head, and glide
  21. prox RU jt, volar/dorsal radial glide helps with what?
    • volar - supination
    • dorsal - pronation
  22. ventral or dorasl glide at inf RU jt - pos and how
    • sup 10 degrees
    • fixate disatl ulna (mind you, it's small)
    • stabilize against table
    • mobilize by holding dital radius btwn thumb and index
  23. inf RU jt - ventral/dorsal radial glide stims what?
    • ventral - pronation
    • dorsal - sup
  24. how to do lat epicondylitis test method 1, testing for tennis elbow, "Cozen's test"
    • (resistive)
    • stabilize elbow
    • have pt make a fist, pronate, and radially deviate
    • now have pt try to extend against resistance
    • (y're looking for pain)
  25. test 2 for lat epicondylits / "Mill's Test"
    • (stretching)
    • palpate lat epicondyle
    • flex wrist and extend elbow -- no resistance, just seeing if this position of stretching the extensors hurts
  26. method 3 for testing for tennis elbow
    resist ext of 3rd finger at the PIP w wrist in neutral, forearm pron, elbow ext
  27. Golfer's elbow test / medial epicondylitis
    • elbow and wrist ext and sup
    • resist/stretch wrist flexion
  28. Phalen's test
    • for carpal tunnel
    • press dorsums of hands together
  29. Tinel's sign
    tap the ulnar nerve to see if there's tingling or dysesthesia
  30. Wartenberg's sign
    pt tries to hold fingers together while PT tries to pull pinky and ring finger apart -- tests the ulnar nerve