describe where the anterior bundle of the UCL origniates and inserts:
list the force for which the anterior bundle is the primary restrain against:
originates: inferior surface of the medial epicondyle
inserts: on the medial aspect of teh cornonid process
primary restraint against: valgus force
posterior band of the anterior bundle is primarly stressed in overhead throwing athletes
describe the origin and instertion of the transverse bundle of the UCL:
origin: medial epicondyle
insertion: cornonid process
does not cross the axis of the elbow and therefore, provides little medial support
describe where the lateral ulnar collateral ligament (LUCL) originates and inserts:
disruption of this ligament results in:
origin: middle of the lateral eipcondyle
inserts: tubercle of the unla
disruption of this ligament results in: rotatory instability
provids lateral support that is independent of the other lateral ligaments
what are the 2 fxns of the radial collateral ligament (RCL):
resists varus stresses
maintains the close relationship between the humeral and radial articulating surfaces
the fibro-osseous structure that permits internal and external rotation of the radial head is called:
describe which motions cause the fibers to become taut:
annular ligament
anterior fibers taut: excessive supination
posterior fibers taut: the end of pronation
what is the fxn of the accessory lateral collateral ligament:
assists the annular ligament adn the RCL in preventing the raidus from separating from the ulna when a varus force is applied
what is the fxn of the interosseous membrane:
to transmit the force absorbed by the radius at the wrist to the ulna
which muscle provides the primary contribution to the movement of the forearm in the following positions...
pronated:
supinated:
neutral:
pronated: brachialis
supinated: biceps brachii
neutral: brachioradialis (contributes to both when forearm is at the end of the opposite motion)
list the 3 primary nerves that cross the elbow:
median nerve
ulnar nerve
radial nerve
list the muscles in which the median nerve supplies:
list the name of the branch that projects off the median nerve:
median nerve suppliespronator teres
pronator quadratus
all of the wrist flexor muscles...
except: flexor carpi ulnaris and flexor digitorum profundus
anterior interosseous nerve projects off the median nerver to pass under the 2 heads of the pronator teres
what type of innervation does the ulnar nerve provide?
sensory and motor innervation to the hand
list the 2 branches of the radial nerve and the innervation which each provides
superficial branch: provides sensation to the dorsum of the wrist, hand and thumb
deep branch: provides motor innervation exclusively to the muscles
it is possible to injury the deep branch without experiencing any sensory loss, however critical motor loss does occur
an elbow that chronically locks, clicks or pops during movement may indicate:
osteochondritis dissecans
-or-
unstable joint
describe the position that patients with acutely injured elbows will assume:
approximately 70 degress of flexion to minimize stresses on the joint
describe 2 limitations in the elbow motion that results in adaptions at the shoulder or wrist:
a limitation in elbow extension may result in increased scapular protraction during elevation
limited pronation or supination may compensate with increased internal an external glenohumeral motion, respectively
complaints of pain during the late cocking and acceleration phases of throwing may invoke stress on:
the ulnar collateral ligament
the angle formed by the long axis of teh humerus and the ulna, ranging from 5 to 15 degrees is called:
cubitus valgus:
cubitus varus:
carrying angle
cubitus valgus: increased carrying angle
cubitus varus: decreased carrying angle
which variation of the carrying angle will baseball pitchers exhibit:
what is this adaption the result of:
cubitus valgus
results of: repeated valgus load during the throwing motion
compression of the radial nerve as it crosses the elbow joint can inhibit:
what is the result of this:
inhibits: wrist extensors
results in: drop wrist syndrome
extension of the elbow beyone 0 degrees is called:
cubital recurvatum
commonly found in women
list the 3 structures that form an isoceles triangle when the elbow is flexed to 90 degrees:
medial epicondyle
lateral epicondyle
olecranon process
these structures form a straight line when the elbow is extended
what type of force can rupture the biceps brachii tendon:
forcefull eccentric contractions
palpation of the medial epicondyle elicits exquisit tenderness in the presence of:
medial epicondylalgia
list 2 forces that may cause a fx of the olercranon process:
forced hyperextension
direct backwards fall on the elbow
a positive tinel's sign, burning, pain, or paresthesia along the medial border of the forearm and little finger during palplation may be the result of inflammation of which never?
ulnar nerve
patients who demonstrate the clinical signs of lateral epicondylagia but are more sensitive to palpation over the radial tunnle should also be examined to rule out:
radial tunnle syndrome
most of the elbows ROM occurs in flexion, ragning from:
145 to 155 degrees
the total ROM of pronation and supination is:
170 to 180 degrees
approx. 90 degress of motion in each direction
list the following end feels...
ulnohumeral and radiohumeral joint..
flexion:
extension:
superior radioulnar joint..
radioulnar supination:
radioulnar pronation:
examination findings for osteochondritis dissecans of the capitellum...
ROM:
MMT:
ROM: decreased extension, felxion contracture possible (both AROM and PROM)
MMT: pain secondary to compression placed throught the joint
dysfunction in the wrist, hand, and fingers can be the result of:
list the various dysfunctions that can occur:
inhibition of the the ulnar, radial, and median nerves in the area of the elbow that causes the symptoms to radiate distally
dysfunctionsparesthesia
decreased grip strenght
inability to actively extend the wrist
a buring sensation in the medial forearm, little finger, and ring finger is the result of:
list the muscles that will demonstrate decreased strength as a result of this:
a buring sensation in the medial forearm, little finger, and ring finger is the result of: ulnar nerve pathology
decreased muscle strengthfinger flexor muscles
lumbricals
interossei
thumb abductors
flexor carpi ulnaris
ulnar nerve compression that exhibits numbess on the dorsal aspect of the hand indicates:
ulnar nerve compression that exhibits numbess on only the palmer aspect of the hand indicates:
dorsal aspect: neuropathy in the area of the elbow
palmer aspect: nerve compression distal to the tunnle of guyor (where the nerve diverges into palmer and dorsal branches)
the inability to maintain adduction of the little finger leaving it resting in an abducted position, caused by ulnar nerve deficit is called:
wartenberg sign
lack of flexion in the fourth and fifth distal interphalangeal (DIP) joint, as a result of ulnar nerve deficit is characterized by:
clawhand position
how does radial tunnel syndrome differ from epicondylalgia?
the symptoms of RTS are located more distally on the forearm
what is the mechanism for radial nerve pathologies:
often injured by deep lacerations of the elbow or secondary to fractures of teh humerus or radius
what is the mechanism of medial nerve pathologies:
mechanism: compression of the distal forearm or cubital fossa
the inability to pinch the tips of the thumb and index fingers together as a result of median nerve pathology is called:
pronator teres syndrome
list the 3 compartments identifiable in the forearm:
list some symptoms of compartment syndrome in the forearm:
volar
dorsal
mobile wads
symptomspressure in the forearm
sensory distruption in hand/fingers
decreased musclar strength
pain during passive elongation of the involved muscles
chronic or increased in severity, a decreased or absence of the radial or ulnar pulses are noted as:
volkmann's ischemic contracture
Motions, such as throwing, place ______ forces on the medial elbow, also place ________ forces on the lateral elbow.
during which phases are these stresses the greatest:
Motions, such as throwing, place tensile forces on the medial elbow, also place compressive forces on the lateral elbow.
greatest stresses
late cocking
accereraltion
it is rare for the other segments of the ulnar collateral ligament to be damaged without 1st damaging this structure:
the anterior oblique portion
acquired elbow laxity can produce either subtle or gross ___________ similar to that seen in the knee or shoulder.
acquired elbow laxity can produce either subtle or gross instability similar to that seen in the knee or shoulder.
because of the # of nerves crossing the elbow, both ___________ and _________ injuires can lead to neurological dysfxn in the wrist, hand, and fingers.
because of the # of nerves crossing the elbow, both acute and repetitive stress injuires can lead to neurological dysfxn in the wrist, hand, and fingers.
which elbow and forearm motions increase the activity of the biceps brachii?
flexion
supination
which 2 peripheral nerves pass thru the cubital fossa?
which artery passes thru the cubital fossa?
tendon thru the cubital fossa?
peripheral nerves: medial nerve and musculocutaneous nerve
artery: brachial artery
tendon: biceps brachii tendon
what are the 4 structures that originate on the medial epicondyle:
palmaris longus
flexor carpi radialis
flexor carpi ulnaris
flexor digitorum
how many degress of freedom does the humeral ulnar joint have?
1 degree of freedom
how does one instruct a pt to make the palpation of the palmaris longus tendon more prominent?
pinch the little finger and the thumb together while flexing the wrist. the small tendon that pops up on the anterior wrist is the palmaris longus
note: some people are bone w/o this muscle
resisting what 2 combined motions makes the flexor carip ulnaris most active?
flexion and ulnar deviation
what 5 muscles originate on the lateral epicondyle:
extensor carpi radialis brevis
extensor carpi ulnaris
extensor digiti minimi
extensor digitorum communis
supinator
what motions occur at the humeroradial joint?
flexion/extension
pronation/supination
which elbow flexor inserts on the radial styloid process?
brachioradialis
which surface is Lister's tubercle palpable from?
dorsal surface
what is the fxn of the annular ligament:
permits internal/external rotation of radial head on the capitellum of the humerus
the most superifical wrist extensor is the:
the most inferior wrist extensor is the:
would these muscles be more active with a backhand or forehand in tennis?
most superficical: extensor carpi radialis longus
most inferior: extensor carpi radialis brevis
more active with a backhand
is the humerulnar joint more stable in flexion or extension?
extension
what motions does the ulnar collateral ligament restrict?
valgus force
which hand bone is located about 1/2 inch distal from the most medial aspect of the ulnar styloid process ?
triquetrum
what forms the lateral humeral articulating surface on the distal border of the lateral epicondyle?
C. capitellum
what is the indention of the lateral epicondyle that accepts the radial head during elbow flexion?
C. radial fossa
the radial tuberosity is the insertion for what muscle?
A. biceps brachii
the radio ulnar joints are classified as what type of joint?
synovial
hinge
syndesmotic
saddle
syndesmotic joint
which elbow ligament is divisible into 3 unique sections?