AT Chapter 23

True or false: The bicipital bursa cushions the tendon when the forearm is supinated.

False

What is the shape of the trochlea in the elbow joint?

It is spool-shaped

Jack is a young baseball pitcher. Initially, he experiences a weakness of the right triceps muscle and a tightness of the related anterior joint capsule. He also complains of pain in the right arm with valgus stress. In this scenario, Jack has the symptoms of _____.

Little League elbow

Identify a scenario that illustrates the symptoms of osteochondritis dissecans.

Neha, a javelin thrower, complains of a history of valgus stress in the elbow followed by several weeks of pain and stiffness with some swelling.

In the lateral epicondylitis test for assessing an injury to the elbow, the elbow is _____ to 45 degrees.

flexed

Chronic ulnar collateral ligament injuries can be managed by _____.

including video assessment to correct any existing faulty mechanics

A true statement about Volkmann's contracture is that _____.

irreversible muscle necrosis begins after 4 to 6 hours

An athletic trainer can distinguish dislocation of the elbow from the supracondylar fracture by observing that the _____.

lateral epicondyle is normally aligned with the shaft of the humerus

Tennis elbow is another name for _____.

lateral epicondylitis

Medial epicondylitis occurs from _____.

repeated forceful wrist flexion

The _____ artery becomes the brachial artery, whose branches supply blood to the elbow.

subclavian

Little League elbow is characterized by a(n) _____.

traction apophysitis

The most common dislocation of the elbow is one in which both the _____.

ulna and the radius are forced backward

In cubital tunnel syndrome, the _____ nerve is subject to a variety of problems because of the exposed position of the medial humeral condyle.

ulnar

The _____ ligament provides the primary resistance to valgus stresses that occur during the late cocking and early acceleration phases of throwing.

ulnar collateral

Match the stress tests to check for an injury to the elbow (in the left column) to their descriptions (in the right column).

-A valgus stress test - It checks for sprain of the ulnar collateral ligament. -A varus stress test - It checks for sprain or instability of the radial collateral ligament.

Match the glides (in the left column) with their roles in rehabilitation of an injured elbow (in the right column). Instructions

-Anterior radial glide - Increases flexion -Posterior radial glide - Increases extension

Match the deformities of the elbow (in the left column) to the deviations in the carrying angle (in the right column).

-Cubitus valgus - The carrying angle is abnormally increased. -Cubitus varus - The carrying angle is abnormally decreased.

Match the articulations of the elbow (in the left column) to their descriptions (in the right column).

-The humeroulnar joint -The articulation between the distal humerus medially and the proximal ulna -The humeroradial joint - The articulation of the lateral distal humerus and the proximal radius -The proximal radioulnar joint - The articulation between the radial notch of the proximal lateral aspect of the ulna, the radial head, and the capitulum of the distal humerus

Identify the most important bursae in the area of the elbow. (Check all that apply.)

-The olecranon bursa -The bicipital bursa

Identify the bones of the elbow joint. (Check all that apply.)

-The ulna -The humerus -The radius

Match the ligaments of the elbow (in the left column) to their features (in the right column).

-The ulnar collateral ligament - It is composed of a strong anterior band with weaker transverse and middle sheets. -The radial collateral ligament - It does not attach to the radius, which is free to rotate. -The annular ligament - It is attached to the anterior and posterior margins of the radial notch and encircles the head and neck of the radius.

In the context of the lateral and medial epicondylitis test, match the movements of the elbow (in the left column) to the parts that experience more pain during those movements (in the right column).

-When wrist extension is resisted - Pain increases at the lateral epicondyle. -When wrist flexion is resisted - Pain increases at the medial epicondyle.

Which of the following is true of the management of a contusion of the elbow?

A contused elbow should be treated immediately with cold and pressure for at least 24 hours.

Identify a scenario that illustrates pronator teres syndrome.

A table tennis player experiences numbness, tingling, and pins and needles sensations in thumb, index, and middle fingers and half the ring finger.

Identify a scenario that illustrates Little League elbow.

A young baseball player exhibits loss of full elbow extension, tightness in the anterior joint capsule, and weakness of the triceps in his right arm.

Osteochondritis in children younger than ten is usually referred to as _____.

Panner's disease

The ulnar collateral ligament is most often injured as a result of _____.

a valgus force from repetitive trauma

Nerves stemming from the _____ plexus innervate the muscles that control movement around the elbow joint.

brachial

An anterior soft tissue structure in the elbow that should be palpated for deformities and swelling is the _____.

brachioradialis

A soccer player falls and injures her left elbow while tackling. Consequently, she experiences intermittent paresthesia and burning and tingling in the fourth and fifth fingers of the left hand. When she tries to hyperflex her affected elbow, she reports of tenderness. She also complains of pain on the medial aspect of the elbow. In this scenario, the soccer player has the symptoms of _____.

cubital tunnel syndrome

In pronator teres syndrome, the median nerve becomes entrapped due to _____ of the pronator teres muscle.

edema

The _____ bursa is the most frequently injured bursa in the elbow.

olecranon

A contusion of the elbow may cause rapid swelling resulting from _____.

olecranon bursitis

The _____ is a bony landmark that should be palpated for deformities in the elbow.

olecranon process

A factor that can lead to cubital tunnel syndrome is _____.

subluxation of the ulnar nerve

The _____ is a posterior soft tissue structure in the elbow that should be palpated for deformities and swelling.

supinator

True or false: Adults have a much higher rate of sustaining elbow fractures than children or young individuals.

False

True or false: The olecranon bursa is protected from acute or chronic injury by virtue of its location in the elbow.

False

The normal elbow carrying angle in males is _____ degrees.

5 to 10

Match the movements of the elbow (in the left column) to the positions of the radius and the humerus during those movements (in the right column).

-Flexion - The radius is in contact with the radial fossa of the distal humerus. -Extension - The radius and the humerus are not in contact.

Match the muscle strains around the elbow joint (in the left column) with their locations (in the right column).

-Lateral compartment strains - The supinator, brachioradialis, extensor carpi radialis longus, and the common extensor tendon -Medial compartment strains - The pronator teres, flexor carpi radialis, or palmaris longus -Strains in the anterior compartment - The biceps brachii and brachialis muscles -Strains in the posterior compartment - The triceps and anconeus

Match the muscle strains around the elbow joint (in the left column) with the movements that cause the strains (in the right column).

-Lateral compartment strains - wrist extension -Medial compartment strains - wrist flexion -Strains in the anterior compartment - elbow flexion -Strains in the posterior compartment - elbow extension

Identify the functional activities that enhance the healing and performance of the elbow. (Check all that apply.)

-Swimming -Interval throwing program -Push-ups

Identify the elbow flexors. (Check all that apply.)

-The biceps brachii -The brachialis -The brachioradialis muscles

Match the heads of the biceps brachii (in the left column) to their points of origin in the shoulder (in the right column).

-The long head - The supraglenoid tuberosity of the scapula -The short head - The coracoid process of the scapula

The normal elbow carrying angle in females is _____ degrees.

10 to 15

In the context of the steps of a functional progression for throwing for the elbow, how should a patient practice the throwing motion during the warm-up?

At a slow velocity

_____ involves entrapment of the median nerve either at or just above the elbow.

Pronator teres syndrome

_____ results from insufficient arterial perfusion and venous stasis followed by ischemic degeneration of the muscle.

Volkmann's contracture

A condylar fracture at the elbow may cause a(n) _______ _______, in which the forearm, when extended, creates an angle with the upper arm relative to the long axis of the upper arm that resembles a gunstock.

gunstock deformity

Tennis elbow stems from a(n) _____.

backhand stroke

Medial epicondylitis is a condition that involves _____.

degenerative changes in the tendons that originate from the medial epicondyle

A muscle that is usually involved in lateral epicondylitis of the elbow is the _____.

extensor digitorum communis

During the valgus and varus stress tests to check for an injury to the elbow, a patient complains of severe pain on the medial aspect of the elbow that becomes relieved by _____ the elbow.

flexing

During rehabilitation of an injured elbow, humeroulnar traction increases elbow _____.

flexion

During a hockey tournament, an opponent player accidentally hits Rex's left elbow. After a few days, Rex complains of pain in the affected area during and after any activity. Gradually, weakness develops in his left hand and wrist, accompanied by intense pain. After diagnosing the affected elbow, the athletic trainer concludes that Rex has lateral epicondylitis. In this scenario, the athletic trainer should suggest Rex to _____.

immediately use ice, compression, and elevation and take rest

A feature of Little League elbow is that it _____.

is caused by repetitive microtrauma that occurs from throwing

While examining for deformities, the elbow is bent to a 45-degree angle and observed from the rear to determine whether the two epicondyles and olecranon process form a(n) _____.

isosceles triangle

A bony landmark that should be palpated for deformities in the elbow is the _____.

lateral epicondyle

Lauren, a gymnast, loses balance while practicing a routine exercise and falls on her right arm, consequently injuring her elbow. The affected elbow loses its normal range of motion. She complains of pain in the affected area during and after activity. Gradually, she experiences weakness in the right hand and wrist and also an intense pain. An examination by an athletic trainer reveals pain on resisted dorsiflexion of the wrist and full extension of the right elbow. In this scenario, Lauren has the symptoms of _____.

lateral epicondylitis

Jane, who is in her early teens, is a state-level badminton player. Lately, she has been complaining of swelling, pain, and crepitation in the right elbow. During an examination of the affected arm, she complains of a history of valgus stress followed by several weeks of pain and stiffness with some swelling. An X-ray of the affected elbow reveals a flattened capitellum, a crater in the capitellum, and loose bodies. The range of motion of her right elbow is less in full extension. In this scenario, Jane has the symptoms of _____.

osteochondritis dissecans

In the pinch grip test, an inability to touch the thumb and index finger indicates entrapment of the anterior interrosseous nerve between the two heads of the _____.

pronator muscle

A construction worker slips from a ladder and injures his right elbow. Consequently, he is unable to flex and oppose the thumb and fingers of the right hand. He also experiences tingling and pins and needles sensation in the thumb, index and middle fingers, and half the ring finger of his affected arm. The symptoms are reproduced when the athletic trainer instructs him to grip tightly with resisted pronation of the arm from the right elbow to full extension. In this scenario, the construction worker has the symptoms of _____.

pronator teres syndrome

A cause of elbow osteochondritis dissecans is _____.

repetitive microtrauma in the movements of elbow rotation

The cause of lateral epicondylitis is _____.

repetitive microtrauma with overuse of the extensor muscles

A patient is instructed to pinch the _____ in the pinch grip test.

tips of the thumb and index finger together

Valgus elbow stability depends mainly on the integrity of the _____ ligament.

ulnar collateral

In baseball players, surgical repair of the _____ has been referred to as a "Tommy John" procedure.

ulnar collateral ligament

A discus thrower sustains an elbow injury. An athletic trainer examines the affected area and confirms that the discus thrower has cubital tunnel syndrome. In this scenario, the athletic trainer should suggest the player to _____.

undergo transposition of a subluxating ulnar nerve