Elbow and Forearm Examination 2024 PDF

Elbow & Forearm Examination  Objectives Review relevant anatomy Discuss typical movement patterns at the elbow/forearm Describe relevant principles of examination related to the elbow Practice psychomotor performance of goniometric measurement and MMT at...

Elbow & Forearm Examination  Objectives Review relevant anatomy Discuss typical movement patterns at the elbow/forearm Describe relevant principles of examination related to the elbow Practice psychomotor performance of goniometric measurement and MMT at the elbow/forearm  Elbow and forearm Examination History: – What are anticipated functional limitations? Systems review: – What have we already screened prior to further tests & measures? Considerations: – Must examine above & below: cervical spine, shoulder, hand/wrist  https:// d1yboe6750e2cu.cloudfront.ne t/i/ 7f5adaa26b11f09790be3989b3 cac2f7735b6328  Carrying angle Anatomical position Male: 10-12 degrees Female: 13-17 degrees Children have smaller carrying angles until reaching age of puberty Greater: cubitus valgus Less: cubitus varus https://www.mypbanj.com/portal/patienteducation/elbow-joint/default.aspx Implications?  Elbow Anatomy Hinged synovial joint Humeroulnar – Convex trochlea (anterior medial distal humerus)  concave trochlear notch of proximal ulna Humeroradial https://homes.bio.psu.edu/ faculty/strauss/anatomy/skel/ humerusup2.htm – Convex capitulum (anterior lateral distal humerus)  Concave radial head on proximal radius https://www.ossurwebshop.co.uk/ media/wysiwyg/Static-Content- Imagery/shutterstock_88094230.jpg  Joint Capsule of Elbow Large, loose, weak Medial and lateral collateral ligaments (MCL, LCL) reinforce sides of the capsule and increase stability Capsular pattern: Flexion more limited than extension. Rarely supination/pronation http://picture-inc.com/fibrous-capsule-of-elbow-joint.html  Osteokinematics of Elbow 1 degree of freedom FLEXION – EXTENSION Moves in the sagittal plane about a M-L Axis “Modified hinge” joint due to slight frontal plane motion ulna during flexion https://i.ytimg.com/vi/3l3-5Ij3JZ8/maxresdefault.jpg  Muscles of Elbow Movement Elbow Flexion – Biceps brachii: tested in supination – Brachialis: tested in pronation – Brachioradialis: tested in neutral (thumbs up) Elbow Extension – Triceps brachii – Anconeus http://elliotthulse.com/wp-content/uploads/2010/03/elbow-203x300.jpg  Forearm Anatomy Proximal and Distal Radioulnar joints (PRUJ, Proximal- shares joint DRUJ) capsule with humeroulnar and humeroradial joints Radial head stabilized by annular ligament Radius small proximally and enlarges distally https://medicalartlibrary.com/radioulnar-joint/  Distal Radioulnar Joint Distal radioulnar joint (DRUJ): Articular disc Triangular fibrocartilagenous complex (TFCC) – Located between distal ulna & proximal carpal row – Extensive fibrous connections – Includes the disc http://teachmeanatomy.info/upper-limb/joints/radioulnar-joints /  head neck Radioulnar Radial Joints tuberosity Oblique cord Interosseous membrane Ulnar Notch of Radius Styloid process of radius  Osteokinematics of Forearm Mechanically linked between PRUJ And DRUJ 1 degree of freedom PRONATION – SUPINATION In pronation: radius crosses over ulna In supination: radius is parallel to ulna http://medical-dictionary.thefreedictionary.com/pronation Capsular pattern: Supination limitation = pronation limitation  Muscles of Forearm Supination – Supinator – Biceps brachii Pronation – Pronator teres – Pronator quadratus Netter’s flash cards Goniometry Considerations: Elbow http://at.uwa.edu/gon/elru.htm Goniometry Considerations: Forearm http://at.uwa.edu/gon/elru.htm Let’s Practice!