Elbow Anatomy Medial Epicondyle Lateral Epicondyle Trochlea and

Elbow Anatomy ® Medial Epicondyle ® Lateral Epicondyle ® Trochlea and Capitulum ® Olecranon Process ® Ulna and Radius ® Radial Head ® Interosseus Membrane ® http: //www. courses. vcu. edu/DANC 291003/elbow_jt. jpg - Pic of Bony Anatomy

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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 ® Not joint 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 Injuries ® General muscular condition ® Restrict pitching/ teach proper form ® Make sure equipment is proper (ie: racquet)- grip size, racquet weight ® Teach shoulder roll method of fallingexample 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 Bursitis ® Olecranon bursa is largest in elbow ® MOI: fall on bent arm, leaning on elbow for long periods, infection ® HOPS ® ______________ ® Tx: ice, compression, pad area If associated with fever: refer _______________

http: //www. aafp. org/afp/97110 1 ap/salzfig 3. jpg http: //www. physsportsmed. com/issues/2000/03_00/mcf arland 4. gif

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; ________________________________

Elbow Dislocations MOI: ______________________________, 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/introtrauma/pics/img 0123. jpg http: //www. angelfire. com/sc 2/seahawksportsmed/inj pix. html

Medial Epicondylitis ® _______________ ® MOI: repetitive tension or valgus forces on the arm ® HOPSSwelling, 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/Golfe r. Elbow. Injury. gif

Lateral Epicondylitis ® _________ ® Most common overuse injury in the adult elbow ® MOI: ____________ ® 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 Tests ® Valgus (UCL)/Varus (RCL) stress test – Positive Sign is laxity ® Tennis Elbow test-(Lateral Epicondylitis) - Positive Sign is increased pain ® Tinel’s sign (Ulnar nerve) – Numbness, Tinkling into Ulnar nerve region.