ESAT Elbow
Degrees of extension of elbow and arthrokinematic movement
0-5 degrees, roll and glide
Degrees of flexion of elbow and arthrokinematic movement
135 to 165, roll and glide
Flexion and extension movements occur around an axis that passes through the centers of arcs described by the trochlear sulcus and the capitlum permitting how many degrees on the active and passive movements>
145 degrees on the active and 160 degrees of passive movements from full extension to flexion.
How many degrees of movement occur from pronation to supination?
175-180 degrees.
What are the normal carrying angles of men and women?
5 degrees in men and 10-15 degrees in women.
The forearm forms an angle with the arm ranging how many degrees?
5-15 degrees, which is commonly referred as carrying angle.
What movement causes humeroradial joint to be in a closed pack position?
90 degrees of flexion with 5 degrees of supination.
Degrees of pronation of elbow and arthrokinematic movement
90, rotation and glide
Degrees of supination of elbow and arthrokinematic movement
90, rotation and glide
What is composed of 80% of the articular surface around the proximal radioular joint?
A fibrous-osseous ring, which is part of the annular ligament.
What kind of flexion is limited by compression of the soft tissues in the anterior aspect of the forearm and arm?
Active flexion
What encircles the head of the radius and maintains its contact with the ulna?
Annular ligament
Shape of trochlear articular surface?
Asymmetric, which direct the ulna, and hence the forearm, into an abducted position on full extension.
The elbow is largely derived from C__ and C___
C6 and C7
What stress causes deep aching pain on the attachments of the interosseous membrane of the forearm?
Compressive and distractive forces
The superior surface of the radial head is what shape to articulate with what structure?
Concave, to accept spherical capitulum.
What does the proximal end of the ulna contain?
Coronoid process and olecranon process, with the trochlear notch lying between.
Arthrokinematics of the elbow are dictated by what?
Dictated by the spiral shape of the articular surface of the trochlea.
Action of Trcieps?
Extension
What movement causes supination in a closed packed position for the humeroradial joint
Extension
Action of brachialis?
Flexion
Medial epicondylitis is also referred to as
Golfers Elbow
What kind of injury results from the activity of the wrist extensors?
Lateral epicondylitis
Action of wrist extensors?
Lateral stability and some flexion
What limits the extension of the arm?
Limited by the contact of the olecranon process in the olecranon fossa.
Action of wrist flexers?
Medial stability and some extension
Trauma to the posterior aspect of the elbow, either by fall on flexed elbow or recurrent irritation can lead to inflammation of?
Olecranon bursitis
What kind of flexion is limited by the tension of the posterior joint capsule and tension in the triceps?
Passive flexion
Action of pronator quadratus
Pronation
Which bone crosses over during supination and pronation?
Radius
the distal radioulnar joint has a convex ulnar head fitting into a shallow concavity on what?
Radius
Action of brachioradialis
Rapid flexion or flexion with loads
Action of pronator teres?
Rapid pronation or pronation with loads
Action of supinator and biceps
Supination
Supination of the arm is produced by the contraction of what muscles?
Supinator and, to a lesser degree, the biceps.
What two ligaments reinforce the joint capsule of the elbow?
The medial and lateral collateral ligaments
Location of the olecranon bursa and its function?
The olecranon bursa lies between the skin and olecranon process to reduce friction between the large bony process and the skin.
What muscles provide the contractive force for the pronation of the arm>
The pronator quadratus and pronator teres
On the anterior surface of the olcranon fossa on the posterior surface, what two structures allows an increased range of flexion and extension by delaying impact of the respective bony prominences on the humeral shaft?
The radial fossa and coronoid fossa
How does the elbow allow movement from extension to flexion?
The radius and ulna must undergo roll and glide movements in relation to the capitulum and the trochlea
Flexion and extension ovements occur on the elbow between?
The trochlea of the humerus and the trochlear notch of the ulna.
The distal end of the humerus contains two articular surfaces, what are they?
Trochlea (resembles an hourglass on its side, and capitulum (spherical)
The surface of the ulna articulates with?
Trochlea of humerus.
True or False? The clinical picture of medial epicondylitis is the same as for lateral epicondylitis, but the pain is medial and follows the wrist flexors.
True
True or false? A common cause of elbow problems is a result of muscle activity across the joint.
True
Which bone is essentially stationary through the movements of supination and pronation?
Ulna
Ayoung person who is forcibly pulled up from the floor by grabbing the wrist can create traction on the ________ ligament
annular
What is a common cause of lateral epicondylitis?
backhand stroke in tennis - tennis elbow
Where is the bicipitalradial bursa lied?
between the tendon of the biceps muscle and radius.
Elbow flexion is accompanied by what muscles?
brachialis, brachioradialis, and biceps brachii
How is the pain intensified in wrist extensor injuries?
by resisted extension of the wrist and fingers and by shaking hands
When the arm is extended in its anatomic position, the longitudinal axis of the forearm forms a lateral (valgus) angle of the elbow known as what?
carrying angle
The extensor mass rubs and rolls over the lateral epicondyle and radial head during forced _____ of the muscle
contraction
Contusion by direct blow, stretched by valgus force, entrapment in scar tissue, irritation by bone spurs of the ulnar nerve can create a peripheral entrapment called
cubital tunnel syndrome
An increased angulation of the carrying angle can be caused how?
epiphyseal damage secondary to lateral epicondylar fracture which may cause a delayed nerve palsy, which presents as an ulnar nerve distribution in the hand.
Action of biceps?
flexion in supination
Medial epicondylitis occurs because of
forced muscle activity of the wrist flexors
A decrease in the carrying angle is often the result of trauma, such as supracondylar fracture in childhood is know as what?
gunstock deformity
How do you evaluate the carrying angle?
have the patient straighten his or her supinated elbows and measure the angle from the junction of the longitudinal axis
What are the three primary ligaments that stabilize the elbow?
humeroulnar joint, radiohumeral joint, and radioulnar joint
The ligamentous stability of the elbow can be breached causing an elbow sprain in _______,_______,______
hyperextension, hyperabduction, and hyperadduction
In elbow flexion, the condyles and olecranon should lie
in an isoceles triangle with apex pointing downward
In elbow extension the condyles and olecranon should lie
in line
The radius and ulna are bound by what?
interosseous membrane
The wrist extensors cross the elbow to attach to what epicondyle?
lateral
Olecranon bursitis is frequently seen in individuals such as students who do what?
lean on their elbows on a hard surface for long periods
The ulnar nerve is vulnerable to trauma as it passes through the ulnar groove on the _____ aspect of the elbow
medial
The wrist flexors cross the elbow to attach to what epicondyle?
medial
The medial and lateral collateral ligaments restrict what motions of the ulna on the humerus?
medial and lateral angulation and glide.
The forced contractions of the muscle group produce tugs on the origin, resulting in
microtears in the tendon and a pulling away of the periosteum
Describe the elbow joint
modified hinge, classified as a compound paracondylar joint in that one bone, the humerus, articulates with two others that lie side by side by way of two distinct facets.
structural integrity of the elbow joint can be evaluated through the relationship of the_________to the ___________
olecranon process humeral epicondyles
The patient will usually refuse to use the arm and it will hand limp at the side with hand in______
pronation
What is this condition called
pulled elbow or nursemaid's elbow
Because of this derivation, it can be a site of
referred pain and a source of referral pain to to other structures
Pulled elbow/nursemaids elbow results in limitation of __________ and tenderness over the _________
supination radial head
What are the cardinal symptoms of ulnar nerve injury
tingling, burning of little finger and ulnar half of ring finger motor function of opponens digiti minimi and interosseous muscles may be impaired
Extension of the elbow occurs through the action of what muscle?
triceps brachii, although the anconeus is thought to provide some extension.
The distal ulnar articulates with triangular fibrocartilage forming part of the?
ulnocarpal joint.
Pain follows the _______ in medial epicondylitis
wrist flexors