Elbow AnatomyMedial EpicondyleLateral EpicondyleTrochlea and CapitulumOlecranon ProcessUlna and RadiusRadial Head Interosseus Membranehttp://www.courses.vcu.edu/DANC291-

003/elbow_jt.jpg - Pic of Bony Anatomy

© 2007 McGraw-Hill Higher Education. All rights reserved.

Elbow Anatomy http://images.main.uab.edu/healthsys/ei_0153.jpg

Elbow Anatomy (2) Humeroulnar joint

______________ Trochlea of humerus _______________

Flexion (0 – 150) Extension (0)-some hyperextension(-5 to -15) Ligaments:

_________________________ _________________________

Elbow Anatomy (3)Radioulnar joint

Not part of elbow but associated with __________________________

Supported by the annular ligament which binds the head of the radius to the radial notch of the ulna forming the joint

___________________________

Muscular Anatomy______________________Brachioradialis (flexion with arm neutral)Brachialis (flexion w/ pronation)______________________Pronator Group (pronation)______________________http://images.main.uab.edu/healthsys/ei

_0153.jpg - biceps attachment

Bursa, Blood and Nerve Supply

Bursa- _____________________Blood supply

Brachial artery ___________ ___________

Nerve supply Brachial plexus extends into the radial and

ulna nerve***

Prevention of InjuriesGeneral muscular conditionRestrict pitching/ teach proper formMake sure equipment is proper (ie:

racquet)- grip size, racquet weightTeach shoulder roll method of falling-

example volleyball players rolling after a dig

Contusions MOI: Direct contact HOPS

__________________________________ Limited range of motion

TX Rule out fracture first Ice, wrap and pad area Avoid aggressive stretching and strengthening Watch for ectopic bone formation

________________________________

Olecranon BursitisOlecranon bursa is largest in elbowMOI: fall on bent arm, leaning on elbow

for long periods, infectionHOPS

____________________________Tx: ice, compression, pad area

If associated with fever: refer_____________________________

http://www.physsportsmed.com/issues/2000/03_00/mcfarland4.gif

http://www.aafp.org/afp/971101ap/salzfig3.jpg

Elbow Sprains (1 – UCL) MOI: valgus force, repetitive stress HOPS:

Pain over medial joint especially in cocking phase or acceleration phase of throwing

Point tenderness over joint line ____________________________________

____________________________ Tx: rest, general strengthening of flexors/

pronators; _________________________ ________________________________

http://www.digisys.net/fhspub/97-98/feb27/assets/images/pitching.gif

Elbow DislocationsMOI: ____________________________

______________________________, falling on outstretched hand

HOPS Obvious deformity Snapping or cracking sensation Severe pain Forearm in flexion and appears shortened

Tx: immobilize and refer MED EMERGENCY Check neurovascular status

-http://www.worldortho.com/database/intro-trauma/pics/img0123.jpg http://www.angelfire.com/sc2/seahawksportsmed/injpix.html

Medial Epicondylitis ______________________________ MOI: repetitive tension or valgus forces on

the arm HOPS-

Swelling, ecchymosis over medial epicondyle Pain aggravated by pronation and resisted flexion

of wrist _________________________________

Tx: RICE, Strengthening/Stretching, look at technique

http://www.esportmed.com/smrn/figures/GolferElbowInjury.gif

Lateral Epicondylitis__________________Most common overuse injury in the

adult elbowMOI: _______________________

______________________Precursor: too large tennis racquet,

gripping racket too tightly, excessive string tension, faulty mechanics

Lateral Epicondylitis (2) HOPS

Pain over lateral epicondyle Pain with resisted wrist extension + tennis elbow test

Tx RICE __________________________________

_________________________ Counter force brace

Impingement of Ulnar nerve Ulnar nerve passes behind humerus in ulnar

groove _______________ HOPS

_________________ Can be caused from a medial elbow injury “crazy bone” or “funny bone” Tingling and numbness in ring and little finger __________________

Refer if chronic

Strength Testing

Elbow flexion Elbow extension Wrist flexion and extension Pronation Supination

Stress TestsValgus (UCL)/Varus (RCL) stress test –

Positive Sign is laxityTennis Elbow test-(Lateral Epicondylitis)

- Positive Sign is increased painTinel’s sign (Ulnar nerve) – Numbness,

Tinkling into Ulnar nerve region.