KNPE331 > Week 11 > Flashcards

Week 11 Flashcards

(104 cards)

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1
Q

What type of joint is the elbow joint?

A
  • hinge
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2
Q

What three joints make up the elbow joint?

A
  • ulnohumeral
  • radiohumeral
  • proximal radioulnar joint
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3
Q

Elbow ligaments

A
  • ulnar (medial) collateral ligament
  • radial (lateral) collateral ligament
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4
Q

Joints of the hand and wrist

A
  • carpometacarpal joint
  • metacarpalphaleangeal joint
  • proximal interphalangeal joint
  • distal interphalangeal joint
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5
Q

Ligaments of the wrist and hand

A
  • collateral ligaments of wrist and fingers
  • collateral ligaments of fingers
  • intercarpal ligaments (dorsal, palmar)
  • triangular fibrocartilage complex (TFCC)
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6
Q

Collateral ligaments of wrist and fingers

A
  • ulnar (medial) collateral ligament
  • radial (lateral) collateral ligament
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7
Q

Triangular fibrocartilage complex (TFCC) aka triangular disc

A
  • complex made up of load-bearing triangular fibrocartilage articular disc and ligaments on medial aspect of wrist
  • disperses axial load from carpals to ulna
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8
Q

What is the TFCC thickened by?

A
  • ulnar collateral ligament medially
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9
Q

What is TFCC a major stabilizer of?

A
  • ulnocarpal joint
  • distal radioulnar joint
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10
Q

What action does TFCC facilitate?

A
  • articulations at wrist joint
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11
Q

Nerves at the elbow and wrist

A
  • ulnar nerve at elbow and wrist
  • median nerve under flexor retinaculum
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12
Q

Elbow flexors

A
  • biceps brachii ( short and long head)
  • brachialis
  • brachioradialis
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13
Q

What is something to note about biceps brachii?

A
  • long head of bicep also does shoulder flexion
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14
Q

Elbow extensors

A
  • triceps brachii (long head, medial and lateral head)
  • anconeus
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15
Q

Muscles of the forearm, wrist & hand: medial epicondyle

A
  • common flexor tendon origin
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16
Q

Muscles of the forearm, wrist & hand: lateral epicondyle

A
  • common extensor tendon origin
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17
Q

Physiological ROM of elbow

A
  • flexion
  • extension
  • pronation
  • supination
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18
Q

Physiological ROM of wrist

A
  • flexion
  • extension
  • radial deviation
  • ulnar deviation
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19
Q

Physiological ROM of digits

A
  • flexion
  • extension
  • abduction
  • adduction
  • 1st-5th oppositon/reposition
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20
Q

Lateral epicondylitis (tennis elbow) MOI

A
  • overuse of forearm extensors
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21
Q

What sports is lateral epicondylitis common in?

A
  • tennis
  • squash
  • badminton
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22
Q

What are the most common extensors affected in lateral epicondylitis?

A
  • extensor carpi radialis longus
  • extensor carpi radialis brevis
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23
Q

Signs and symptoms of lateral epicondylitis

A
  • TOP common extensor origin
  • pain & weakness with wrist extension
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24
Q

Acute management of lateral epicondylitis

A
  • stretch wrist extensors in elbow extension & flexion
  • PIER
  • tennis elbow brace?
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25
What can the R in PIER mean in some cases?
- altered activity
26
Long term management of lateral epicondylitis
- eccentric strengthening program for forearm extensors
27
Medial epicondylitis (golfer's elbow) MOI
- overuse of wrist flexors
28
What sports is medial epicondylitis common in?
- golfers - baseball pitchers
29
Most common flexors affected in medial epicondylitis
- flexor carpi radialis - pronator teres
30
Signs and symptoms of medial epicondylitis
- TOP common flexor origin - pain & weakness with wrist flexion
31
Acute care of medial epicondylitis
- stretch forearm flexors - PIER
32
Ruptured biceps MOI
- sudden lengthening of contracting muscles - ie sudden load when lifting or catching heavy load
33
Which biceps tendon is most commonly ruptured?
- distal
34
Signs and symptoms of ruptured biceps
- "popeye muscle"/muscle balled up - bruising - pain near insertion of biceps into radial tuberosity - pain and weakness with elbow flexion and supination
35
Acute management of ruptured bicep
- PIER - pressure pad to approximate any remaining fibres - shorten biceps in sling to remove tension - surgical repair
36
DeQuervain's syndrome MOI
- overuse of thumb due to gripping/wringing
37
What does DeQuervain's syndrome lead to?
- inflammation of tendons & sheath around the thumb
38
Which tendons around the thumb may be inflamed in DeQuervain's syndrome?
- extensor pollicis brevis - abductor pollicis longus
39
Signs and symptoms of DeQuervain's syndrome
- pain over tendons of thumb - weakness of thumb abduction or extension - pain with gripping
40
What sport is DeQuervain's syndrome common in?
- golf
41
Special test for DeQuervain's syndrome
- Finkelstein test (positive if pain)
42
Acute management of DeQuervain's syndrome
- PIER - thumb spica brace
43
What could happen if DeQuervain's syndrome is left untreated ?
- can progress to thickening/scarring & reduced ROM
44
Elbow hyperextension injuries MOI
- FOOSH
45
Signs and symptoms of elbow hyperextension injuries
- anterior elbow pain - swelling from ligament/capsule sprain and/or muscle strain - posterior elbow pain from osteochondral lesion
46
What do we need to rule out for elbow hyperextension injuries
- olecranon fracture
47
Acute management of elbow hyperextension injuries
- PIER - shorten injured tissues (elbow flexion) - sling - tape job (very effective)
48
Ulnar collateral ligament (MCL) sprains of the elbow MOI
- FOOSH - overuse by repeat valgus force on elbow
49
Signs and symptoms of ulnar collateral ligament sprains of the elbow
- pain and laxity in medial elbow joint - ulnar nerve symptoms
50
Special test for ulnar collateral ligament sprains of the elbow
- valgus stress test
51
What sports is ulnar collateral ligament sprains of the elbow common in?
- pitchers due to high velocity force
52
Management for ulnar collateral ligament sprains of the elbow
- Tommy John surgery
53
Tommy John surgery
- reconstructs UCL using a graft tendon such as palmaris longus, semitendinosus or gracilis
54
Why is incidence of a ulnar collateral ligament sprains of the elbow increasing?
- happening in younger athletes
55
Collateral ligament sprains of the wrist MOI
- FOOSH, forced forearm rotation
56
Ulnar collateral ligament sprain of the wrist MOI
- valgus force
57
Radial collateral ligament sprain of the wrist MOI
- varus force
58
Signs and symptoms of collateral ligament sprains of the wrist
- pain - swelling & instability on medial or lateral aspect of wrist
59
Special test for ulnar collateral ligament sprain
- valgus stress test
60
Special test for radial collateral ligament sprain
- varus stress test
61
Acute management of collateral ligaments sprains of the wrist
- PIER - wrist wrap - wrist tape job for RTP
62
Ulnar collateral ligament sprain of the thumb (skier's thumb or gamekeeper's thumb) MOI
- traumatic or overuse hyperabduction of the thumb (1st metacarpophaleangeal joint
63
Traumatic ulnar collateral ligament sprain of the thumb MOI
**Skier's thumb** - thumb gets caught - FOOSH - catching ball
64
Overuse ulnar collateral ligament sprain of the thumb MOI
**Gamekeeper's thumb ** - repeat gripping/twisting
65
What can an ulnar collateral ligament sprain of the thumb also result in?
- avulsion fracture
66
Signs and symptoms of ulnar collateral ligament sprain of the thumb
- pain - swelling - instability at 1st MCP joint
67
Acute management of ulnar collateral ligament sprain of the thumb
- PIER - possible x ray to rule out avulsion - brace for healing - thumb tape job/brace for RTP
68
Why is surgery recommended for ulnar collateral ligament sprain of the thumb
- to stabilize joint - prevent osteoarthritis
69
Thumb tape jobs ROM that you may want to limit
- hyperextension - abduction
70
Special test for thumb tape job that is limiting hyperextension
1st MCP instability glide into extension
71
Special test for thumb tape job that is limiting abduction
- valgus stress
72
Triangular fibrocartilage complex tear MOI for acute injury
- FOOSH - forced forearm rotation
73
Triangular fibrocartilage complex tear MOI for overuse injury
- repetitive wrist motions (wrench, hammer, lifting)
74
Signs and symptoms of triangular fibrocartilage complex tear
- medial wrist pain - pain with ulnar deviation & loading through wrist - popping/clicking - wrist weakness
75
Special test for triangular fibrocartilage complex tear
- TFCC compression test - passive ulnar deviation with axial compression- load through disc)
76
Acute management of triangular fibrocartilage complex tear
- PIER - brace as it heals - anti inflammatory injections if needed - surgery for persistent instability
77
Elbow dislocations MOI
- FOOSH
78
Signs and symptoms of elbow dislocations
- deformity - pain - holding elbow - tingling/numbness - shock
79
Acute care of elbow dislocations
- stabilize - splint - monitor/treat for shock - ER/EMS - reduction under sedation
80
Elbow fractures MOI
- direct trauma/fall
81
Signs and symptoms of elbow fractures
- pain - unable or unwilling to move elbow
82
Acute care for elbow fractures
- splint - monitor for shock - ER for x-rays/surgical refer
83
Surgical approach for elbow fracture
- ORIF= open reduction internal fixation
84
Colles' fracture MOI
- FOOSH - distal radius displaced posteriorly
85
Signs and symptoms of Colles' fracture
- "dinner fork deformity" - pain - numbness
86
Acute management of colles' fractrue
- splint - monitor for shock - emerge x rays - surgery if unable to align
87
Scaphoid fractures MOI
- FOOSH
88
Signs and symptoms of scaphoid fractures
- TOP of antatomical snuffbox
89
Scaphoid ability to heal
- poor blood supply so low ability to heal
90
Metacarpal (MC) and finger fractures MOI
- axial compression (jammed) finger - direct trauma - being stepped on
91
Signs and symptoms of metacarpal & finger fractures
- localized pain - swelling - unable to grip
92
Acute care of metacarpal & finger fractures
- fingers: buddy tape to stabilize - hand (MC): SAM splint
93
What can result with metacarpal and finger fractures?
- avulsion fractures - tendon pulls off piece of bone - requires immobilization or surgical repair
94
Cyclist Palsy MOI
- compression from handlebars
95
Signs and symptoms of cyclist palsy
- tingling/numbness/nerve pain - decreased muscle strength of 5th digit - hand cramping
96
Who is cyclist palsy common in?
- new cyclists - distance cyclists
97
Prevention of cyclist palsy
- avoid hyperextension of wrist on handlebars - proper bike fit
98
Acute care for cyclist palsy
- PIER - splint - may require NSAIDs
99
Carpal tunnel syndrome MOI
- overuse of wrist flexor tendons causing pressure in median nerve within carpal tunnel
100
Signs and symptoms of carpal tunnel syndrome
- burning/tingling/numbness in anterior wrist & hand (along medial nerve distribution digits 1-3 and 1/2 of 4) - decreased grip strength
101
Acute care for carpal tunnel syndrome
- bracing - PIER - anti-inflamm treatment - proper ergonomic set up - steroid injection? - surgery to open up tunnel if conservative treatment is unsuccessful
102
Special test for acromioclavicular joint
- scarf test
103
Pre/post test for elbow tape job
- end ROM of elbow extension
104
Pre/post test for wrist tape job
- active ROM of wrist extension
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