Podcast
Questions and Answers
Which of the following best describes the primary biomechanical function of the elbow?
Which of the following best describes the primary biomechanical function of the elbow?
- To function independently without influence from the shoulder or wrist.
- To function as a stable but non-integral part of the upper extremity kinematic chain.
- To act as a buffer reducing stress on the shoulder.
- To serve as an important central link in the upper extremity kinetic chain, facilitating force generation and transfer. (correct)
Which of the following joint articulations are part of the elbow complex?
Which of the following joint articulations are part of the elbow complex?
- Humeroulnar, humeroradial, and proximal radioulnar. (correct)
- Humeroulnar and distal radioulnar.
- Humeroulnar and humeroradial.
- Humeroradial and distal radioulnar.
During an examination of the elbow, which of the following components should be included to provide a comprehensive assessment?
During an examination of the elbow, which of the following components should be included to provide a comprehensive assessment?
- History, Systems Review, Observation, Palpation, Range of Motion, and Passive Articular Motion Testing. (correct)
- History, Observation, Palpation, and Auscultation.
- Systems Review, Observation, Palpation, and Special Tests.
- Symptom Severity, Special Tests, and Diagnostic Imaging.
In the acute phase of elbow injury management, what is the MOST important initial goal?
In the acute phase of elbow injury management, what is the MOST important initial goal?
Which of the following is a primary objective during the functional phase of rehabilitation for an elbow injury?
Which of the following is a primary objective during the functional phase of rehabilitation for an elbow injury?
Which of the following intervention strategies is MOST appropriate for addressing nerve involvement following an elbow injury?
Which of the following intervention strategies is MOST appropriate for addressing nerve involvement following an elbow injury?
Which condition is characterized by tendon degeneration at the lateral aspect of the elbow, often involving the ECRB muscle?
Which condition is characterized by tendon degeneration at the lateral aspect of the elbow, often involving the ECRB muscle?
A patient reports pain and paresthesias in the little and ring fingers that worsen at night. What condition is MOST likely indicated?
A patient reports pain and paresthesias in the little and ring fingers that worsen at night. What condition is MOST likely indicated?
Which of the following is a common symptom associated with high radial nerve compression?
Which of the following is a common symptom associated with high radial nerve compression?
What is the primary presenting symptom of Radial Tunnel Syndrome?
What is the primary presenting symptom of Radial Tunnel Syndrome?
A patient presents with pain on the anterior elbow, radial palm, and the palmar side of the digits. Which condition is MOST likely indicated?
A patient presents with pain on the anterior elbow, radial palm, and the palmar side of the digits. Which condition is MOST likely indicated?
Which of the following conditions involves a pain syndrome triggered by a noxious event but is not limited to a single peripheral nerve?
Which of the following conditions involves a pain syndrome triggered by a noxious event but is not limited to a single peripheral nerve?
According to the five-item classification system for elbow instability, which of the following is a factor considered in the assessment?
According to the five-item classification system for elbow instability, which of the following is a factor considered in the assessment?
What is a common initial conservative intervention strategy for medial epicondylitis?
What is a common initial conservative intervention strategy for medial epicondylitis?
Which of the following bony pathologies is associated with the elbow?
Which of the following bony pathologies is associated with the elbow?
In Wartenberg syndrome, which of the following signs and symptoms would MOST likely be present?
In Wartenberg syndrome, which of the following signs and symptoms would MOST likely be present?
Which of the following is a potential tendon pathology affecting the elbow?
Which of the following is a potential tendon pathology affecting the elbow?
Which of the following is the MOST commonly affected motor impairment with lateral epicondylitis?
Which of the following is the MOST commonly affected motor impairment with lateral epicondylitis?
Which structure is primarily affected in medial epicondylitis?
Which structure is primarily affected in medial epicondylitis?
What symptoms are exacerbated with resisted wrist flexion and pronation during medial epicondylitis?
What symptoms are exacerbated with resisted wrist flexion and pronation during medial epicondylitis?
Which nerve is commonly affected in cubital tunnel syndrome?
Which nerve is commonly affected in cubital tunnel syndrome?
A patient has pain along the posterior-radial forearm, wrist, and thumb, especially during wrist flexion and ulnar deviation. What is the MOST likely diagnosis?
A patient has pain along the posterior-radial forearm, wrist, and thumb, especially during wrist flexion and ulnar deviation. What is the MOST likely diagnosis?
Which nerve is likely involved if a patient reports pain in the wrist or forearm that's worsened with full elbow extension or pronation following a humeral supracondylar process syndrome?
Which nerve is likely involved if a patient reports pain in the wrist or forearm that's worsened with full elbow extension or pronation following a humeral supracondylar process syndrome?
What symptoms might a patient with pronator syndrome display?
What symptoms might a patient with pronator syndrome display?
Which of the following BEST describes Complex Regional Pain Syndrome (CRPS)?
Which of the following BEST describes Complex Regional Pain Syndrome (CRPS)?
Flashcards
Elbow Biomechanics
Elbow Biomechanics
The elbow functions as a central link in the upper extremity kinetic chain, allowing force generation and transfer.
Elbow Articulations
Elbow Articulations
These include the humeroulnar, humeroradial, and proximal radioulnar joints.
Examination components
Examination components
History, systems review, observation, palpation, range of motion, passive articular motion testing, combined motions, resistive testing, neurologic examination, functional assessment, stress tests and special tests.
Acute Phase Goals
Acute Phase Goals
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Functional Phase goals
Functional Phase goals
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Intervention examples
Intervention examples
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Elbow bony pathologies
Elbow bony pathologies
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Collateral Ligament Sprain (Elbow)
Collateral Ligament Sprain (Elbow)
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Elbow Instability Classification
Elbow Instability Classification
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Elbow Tendon Pathologies
Elbow Tendon Pathologies
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Lateral Epicondylitis
Lateral Epicondylitis
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Medial Epicondylitis
Medial Epicondylitis
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Ulnar Nerve Cubital Tunnel Syndrome
Ulnar Nerve Cubital Tunnel Syndrome
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Posterior Interosseous Syndrome
Posterior Interosseous Syndrome
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Radial Tunnel Syndrome
Radial Tunnel Syndrome
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Wartenberg syndrome
Wartenberg syndrome
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Humeral Supracondylar Process Syndrome
Humeral Supracondylar Process Syndrome
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Pronator Syndrome
Pronator Syndrome
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Complex Regional Pain Syndrome (CRPS)
Complex Regional Pain Syndrome (CRPS)
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Study Notes
- Elbow, forearm, wrist, and hand conditions involve medical background, examination, evaluation, diagnosis, differential diagnosis, plan of care, and interventions.
Overview
- The elbow predominately functions as an important central link in the upper extremity kinetic chain, allowing for the generation and transfer of forces.
- The elbow is comprised of three distinct articulations: the humeroulnar joint, the humeroradial joint, and the proximal radioulnar joint.
Examination
- History
- Systems review
- Observation
- Palpation
- Range of motion
- Passive articular motion testing
- Combined Motions
- Resistive Testing
- Neurologic Examination
- Functional Assessment
- Stress Tests
- Special Tests
Acute Phase
- Protection of the injury site
- Restoration of pain-free ROM in the entire kinetic chain
- Improvement of patient comfort by decreasing pain and inflammation
- Retardation of muscle atrophy
- Minimization of the detrimental effects of immobilization and activity restriction
- Maintenance of general cardiovascular fitness
- Ensuring the patient is independent with a home exercise program
Functional Phase
- Restoring normal joint kinematics
- Improving muscle strength to within normal limits
- Improving neuromuscular control
- Restoring the normal strength and relationships of the muscle force couples
Interventions
- Nerve mobilizations
- Movement with mobilization
- Carpal tunnel release
- Tendon gliding exercises
- Place and hold exercises
- Tendon blocking exercises
Bony Pathologies: Elbow
- Traumatic arthritis
- Osteochondritis dissecans capitellum
- Radiocapitellar chondromalacia
- Posterior elbow impingement
Collateral Ligament Sprain: Elbow
- Medial collateral ligament
- Lateral collateral ligament
Elbow Instability
- Five-item classification system used
- Timing: Acute, chronic, or recurrent
- Articulations involved: The humeroulnar (hu) joint is most common.
- Direction of displacement: Valgus, varus, anterior, or posterior
- Degree of displacement: Stage 1 (subluxation), 2 (incomplete), or 3 (full)
- Presence or absence of fractures.
Tendon Pathology: Elbow
- Bicipital tendinosis
- Biceps rupture
- Triceps tendinosis
- Triceps rupture
Lateral Epicondylitis
- Tendon degeneration pain is the lateral aspect of the elbow
- Involves the common extensor tendon origin, especially the ECRB
- Common complaints include diffuse achiness and morning stiffness
- Pain is often related to activities that involve wrist extension & grasp
- Pain-free grip strength is the most commonly affected motor impairment
- Severity types I-II are considered benign while III is semi-benign, IV is semi-harmful, and V-VII are harmful
Medial Epicondylitis
- Tendinopathy of the common flexor origin (FCR and the humeral head of the pronator teres)
- Symptoms are exacerbated with resisted wrist flexion and pronation or passive wrist extension and supination
- Conservative intervention initially involves rest, activity modification, and local modalities
Ulnar Nerve Neuropathies
- Cubital Tunnel Syndrome presents as: pain, paresthesias, numbness involving the 4th and 5th digits that's worse at night
Radial Nerve Neuropathies
- High radial nerve compression causes loss of wrist, finger, & thumb extension, and a decrease in sensibility of the 1st dorsal web space.
- Posterior interosseous syndrome: lateral elbow pain that radiates into the distal forearm aggravated by repetitive pronation and supination.
- Radial tunnel syndrome: Pain that is poorly localized over the radial proximal forearm, is the most common primary presenting symptom
- Wartenberg syndrome: Shooting or burning pain along the posterior-radial forearm, wrist, and thumb, associated with wrist flexion and ulnar deviation
Median Nerve Neuropathies
- Humeral supracondylar process syndrome: pain in the wrist or forearm with full elbow extension or pronation
- Pronator syndrome: pain on the anterior elbow, radial palm, and the palmar side of the involved digits
Other Neuropathies
- Hand-arm vibration syndrome:
- Complex regional pain syndrome: classification of disorders, which can occur even after minor injury to a limb
- CRPS 1 involves a pain syndrome triggered by a noxious event that is not limited to a single peripheral nerve, formerly known as RSD
- CRPS 2 involves a pain syndrome that involves direct partial or complete injury to a nerve or one of its major branches
- Burning pain, edema, stiffness, skin temperature changes, and sweating
- Acute (inflammatory) stage, vascular instability (dystrophic) stage, and cold end (atrophic) stage
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