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40 Cards in this Set
- Front
- Back
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name the joints at the elbow
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HR
HU prox RU distal RU |
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what is the primary role of these joints?
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to provide stability at the elbow and mobility of the hand and wrist for maximum functional use of the UE
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primary movement of the true elbow joint is
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flexion and extension
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supination
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ulnar head migrates volarly and volar ligament --> taut
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pronation
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ulnar head migrates dorsally and dorsal ligament --> taut
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what muscles flex at the elbow?
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brachialis
biceps BR |
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flexor pronators
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Pronator teres
palmaris longus flex dig sup flex carpi radialis FCU |
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elbow extensors
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triceps brachii
anconeus |
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extensor-supinators
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ECR-B
ECR-L supinator ECU EDM |
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pronators of the forearm
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pronator teres
pronator quadratus, FCR |
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supinators of the forearm
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supinator
biceps EPL? |
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muscles off MEC
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flexors and pronator
PT Palmaris longus FCU FCR FDS |
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muscle off the LEC
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anconeus
supinator extensors ECR-B ECR-L EDC ECU |
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muscles that cross elbow, wrist, hand
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FPL, FDP, FCR,
FCU FDS EPL, EPB, APL, EDM, EI, ED |
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tendinopathies at the elbow
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Lateral epicondylitis
medial epicondylitis |
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failure
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biceps tendon rupture
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Lateral Epicondylitis
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tennis elbow
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medial epicondylitis
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golfer's elbow
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extrinsic factors in LE/ME
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the tasks (forced overload to the wrist in the elbow motions or static movement of elbow, low levels of load without rest, microtraumatic), activity (wrist flexion and ulnar deviation puts a lot of stress on elbow)
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intrinsic factors in LE/ME
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biomechanics
alignment disrupt the line of force you can cause the pathologies age in the 30s and 40s as soft tissue becomes more stiff and you set yourself up for repetitive overuse vascularization: robust musculature in FA compromises integrity b/c it takes alot of blood away from the tendon causing disorders in the neck |
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LE/ME microtrauma causes
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reduction of blood flow
tendinosis recurrent stress, attempt to repair at tendinous junction and myotendinous junction low level of fracturing you dont need inflammation to start it, start low level and it is chronic |
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LE/ME
test of function |
have them perform an ADL or task that shows abnormality
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LE/ME
after TOF, P/A |
contractile lesion
should feel better with passive support -compress to rule out intraarticular -provoke with contraction, stretch, palpation (for irritability) |
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Differential Diagnosis
ME v LE |
spinal nerve
peripheral n instability |
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LE spinal nerve
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c6
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Class of: prazocin?
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Alpha-1 blockers
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LE peripheral nerve
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lateral AB cutaneous , radial
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ME peipheral nerve
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ulna, median, anteior interosseous
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Le instability located
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post-lat
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ME instability
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valgus overload
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intervention EdURep
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education- 5 A's assess, advise, agree, assist, arrange
Unloading- taping, bracing, activity modification reloading- tissue healing exercise prevention |
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whats the best invention for a tendinopathy such as LE/ME
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eccentric contraction (overload) and stretch to the tendon
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injections v PT manual therapy
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PT manual therapy outdid it
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manual therapy
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radial head manip
lateral cervical glides (seem to be better) wouldnt do friction massage stretch tissue thru manip: causes immediate change in neuro, decreased neuro-sensitivty |
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can you exercise LE/ME in pain?
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yes but you have to use good judgement
start with VAS: ask them where their level of pain is, if they say 4, don't want them to go higher than a 6. More often than not it goes down |
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Motor control issues
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people with Le have fine motor task loss, caused by UE overusage
promote variability in movement to decrease stress on only a few muscles |
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what are the advantages of bracing
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changes the distribution of force/pressure
improves grip strength |
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disadvantages of bracing
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decreases vascularity, this compression could be a bad thing if already low in vascularity
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biceps tendon rupture-distal
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boys get it, weekend warrior over 50
causes by rapid eccenrtic overload beyond what tendon can tolerate |
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goal of PT for biceps tendon rupture
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already needs surgery
at elbow, PROM and active contraction of but not active biceps -you can do resisted pronation and passive supinators until tendon has gotten firm |
