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18 Cards in this Set
- Front
- Back
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Elbow Intro |
3 synovial joints, surrounded by one capsule. Middle link in kinematic chain, stability and power, hand positioning. Responds poorly to trauma/improper treatment. Second to shoulder for overuse injuries and dislocations. |
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Bones of the elbow |
Humerus, ulna, radius. Ulna is fixed. |
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Articulations of te elbow |
Humeroulnar- elbow joint, hinge. Humeroradial - gliding joint, F/E Proximal radioulnar - pivot joint, pronation/supination. |
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Anatomy - joint structures |
Ligaments - Ulnar (medial) collateral, Radial (lateral) collatera, annular, quadrate ligament, oblique cord Bursae - olecranon |
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Anatomy - muscles |
Triceps brachii, biceps brachii, pronator teres, supinator. |
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Neurovascular anatomy |
Musculocutaneous nerve, median and radian nerves. Subclavian artery, brachial artery, ulnal recurrent and radian recurrent a. Cephalic v., median cubital, axillary v. Note:Bundle is v close to bone so dislocation can cause disruption in innervation and blood supply. |
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Functional Anatomy |
Functional ROM: Extension - flex - 0-145 degrees Pronation/sup - 70-90 degrees Hyperextension - 5 degrees Bony limitations, ligaments and muscular stability help to protect elbow from overuse and trauma injuries. Non weight baring but sustains loads. Carrying angle - angle between humerus and ulna is 10-15 degrees, greater angle in females. |
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Injury prevention |
Vulnerable to acute and chronic injuries Acute - FOOSH, direct blow Chronic - repetitive motions, incorrect mechanics. Use: protective pads, braces. Physical conditioning, flexibility and strength, proper equipment, skill and technique. |
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Common elbow injuries |
Acute: Contusions, olecranon bursitis, sprains, strains, dislocations, fractures. Chronic: Tennis elbow (Lateral epichondylitis) Golfer's elbow (medial epichondylitis Olecranon bursitis |
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Contusions |
E: Direct blow/ repetitive blows. S&S: Swelling rapidly(irritation of bursa or synovial membrane), localized pain, bruising, decreased ROM. Possible paraesthesia. M: RICE 24 hrs, xray. |
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Olecranon bursitis |
E: Acute/chronic. Direct blow or repetitive pressure/friction. S&S: Pain, swelling, pt tendernes. Limited ROM, especially flexion. M: RICE, compression pad, NSAIDS, may need to be aspirated. |
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Strains - Elbow |
E: movement beyond normal ROM, sudden eccentric loading, repetitive microtears. S&S: Pt tenderness in muscle, swelling, bruising, possible deformity, pain w/ active and resistive motions. M: RICE, sling. |
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Sprain - elbow |
E: FOOSH (hyperextn) valgus or varus force, repetitive forces. S&S: Joint tenderness, pain ROM, laxity w stress test, swelling, decreased ROM M: RICE, tape, brace or sling, NSAIDS. Surgery may be necessary. |
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Elbow dislocation |
E: FOOSH, severe twist while flexed Bones may be displaced A/P or laterally S&S: Swelling, severe pain, disability, deformity, snapping or cracking sensation. Possible neurovascular complications. May involve radial head fracture. Anterior displacement - elbow break Posterior displacement - elbow dislocation M: Cold and pressure immediate sling. Hospital for reduction, monitor neurovascular function, strengthening exercises hand and shoulder, myositis ossificans complication. |
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Elbow fracture |
E: FOOSH, on flexed elbow, direct blow. Outstretched hand fall = gunstock deformity (arm goes straight dont bend it). Repetitive or sudden contraction of flexor-pronator group = avulsion = little league elbow. S&S: may not result in visual deformity, hemorrhaging, swelling, muscle spasm, pain. M: Monitor neurovascular status. Volkmann's contracture (blood flow cut off so tissue starts to die). Immobilize and transport. Surgery for unstable ones. |
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Lateral epicondylitis |
E: Repetitive microtrauma to insertion of extensor muscles of lateral epicondyle, tendinosis without inflammation. (Incorrect racquet size, grip, tension technique). Eccentric loading of exttensor during deceleration phase. S&S: Aching pain in region after activity. Pain worsens and weakness in hand/wrist starts. Elbow decreased ROM, pain w/ resistive wrist ext. M: RICE, NSAIDS, rest. ROM exercises, deep friction massage, mobilization in pain free range. Counter force & neoprene sleeve, mechanics and skiss training. New pivot pt brace to remove force from epicondyles. |
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Medial epicondylitis |
E: Repetitive forceful flex of wrist and extreme valgus force to elbow. May involve pronator teres, flexor capri radialis and ulnaris and palmaris longus tendons. Ulnar nerve neuropathy. S&S: Pain produced w/ forceful fex/ext Pt tenderness and mild swelling, Passive mvmt of wrist seldom = pain, active mvmt does. M: Sling, rest, cryotherapy, heat, ultrasound. analgesics/NSAIDS, curvilinear brace below elbow to reduce stressing, severe cases may require splinting and complete rest 7-10 days. |
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Upper body rehab |
Restore motion - opposite hand to supply load Restore proprioception and balance - closed chain exercises (distal limb planted) Muscular strength, endurance, power - open chain exercises, PNF resisted exercises CV fitness. Strengthening and plyometric exercises. |
