Transcript lecture 8 elbow

Lecture 8
The Elbow
Anatomy Review
The elbow is made up of three joints
- Humeroulnar joint Flexion / Extension
- Humeroradial jointFlexion / Extension
- Superior radioulnar joint Pronation /
supination
Humeroulnar joint
Trochlea of the humerous and
trochlear fossa of the ulna
Uniaxial hindge joint – synovial
Leads to the carrying angle of the
elbow
Resting position 70 degrees of elbow
flexion
Forearm supinated 10 degrees
Humeroradial joint
Capitulum of humerus and head of
radius
Uniaxial hinge joint – synovial
(gliding)
Resting position – full extension and
fully supinated
Elbow Ligaments
Ulnar collateral ligament (medial) –
fan shaped
Radial collateral ligaments (lateral) cord like
Ulna nerve passes through the cubital
tunnel
Superior radioulnar joint
Uniaxial pivot joint – synovial
Head of radius articulates with the
ulna
Resting position 35 degrees
supination and 70 degrees flexion
Head of radius held in position by
Annular ligament
Rom of Elbow / End Feels
Flexion/Extension
Pronation /Supination
Muscles?
Functionally the elbow is an integral part of
the kinetic chain
Daily functions need 140 degrees of elbow
flexion to reach the head
Special Tests
Valgus
MCL – UCL
Elbow slightly flexed examiner pushes in
(medially) on the elbow (should do at
different angles)
Positive test - pain and medial laxity
http://www.youtube.com/watch?v=f6YvPS
Vk6G8&feature=PlayList&p=C38CC3815C
1A2523&index=10
Varus
RCL – LCL
Elbow slightly flexed examiner pushes out
(laterally) on the elbow ( should do at
different angles)
Positive test - pain and lateral laxity
http://www.youtube.com/watch?v=jUKxFw
h5QjU&feature=PlayList&p=C38CC3815C
1A2523&index=9
Lateral Epicondylitis (Tennis Elbow)
Extensors of the elbow
Forearm is pronated
Athlete is asked to make a fist and to
extend their wrist
Examiner tries to push wrist into a
flexed position
Positive test is - pain and weakness
in the area of the lateral epicondyle
http://www.youtube.com/watch?v=futWq8mXzUo&fe
ature=PlayList&p=C38CC3815C1A2523&index=8
Medial Epicondylitis (Golfers Elbow)
Flexers of elbow
Forearm is supinated
Athlete is asked to make a fist and to
flex their wrist
Examiner tries to push wrist into a
extended position
Positive test - is pain and weakness
in the area of the medial epicondyle
Tinnels Sign
Ulnar nerve
Examiner taps between the olecranon
process and the medial epicondyle in the
cubital tunnel
Positive test - tingling sensation down into
the hand (medial half of forth and all of fifth
finger)
Sport Specific Functional Tests
Elbow is the middle of the upper kinetic
chain
must function properly to position the hand
for daily activities , combing hair brushing
teeth…or sports activities .. throwing ,
lifting, pushing ..