Elbow and Forearm | ||||
History Location of the symptoms Onset of the symptoms Mechanism of injury Most elbow injuries tend to be caused by repetitive low-loaded stress Technique Associated sound and sensations Locks, clicks, or pops indicate osteochondritis dessicans or an unstable joint. Previous history General medical health Inspection Anterior Structures Carrying angle Long axis of the humerus and ulna 10 -15 degree of valgus in women 5-10 degree of valgus in men Increased this angle causes cubitus Valgus Decreased this angle causes cubitus varus Cubital fossa Medial Structures Medial epicondyle Flexor muscle mass Muscle mass decreases with immobilization or long-term tendinitis Lateral Structures Alignment of the wrist and forearm Compression of radial nerve causes drop wrist syndrome (wrist extensor) Cubital Recurvatum (Beyond 0 degree extension) Extensor muscle mass The mass decreases with immobilization, long-term tendinitis, or radial nerve involvement Posterior Structures Bony alignment Isosceles triangle (medial & lateral epicondyle, and olecranon process) Olecranon process and bursa Acute injury or overuse conditions may cause olecranon bursa to rupture, swell, or inflame, masking outline of olecranon. Palpation Anterior Structures Biceps brachii Cubital fossa (Median and musculocutaneous nerves pass through this area) Brachioradialis (Most lateral of elbow flexors) Wrist flexor group Pronator quadratus Medial Structures Medial epicondyle (The common wrist flexor tendon attaches at the epicondyle) Ulna Ulnar collateral ligament Lateral Structures Lateral Epicondyle (The common wrist extensors attaches at the epicondyle) Radial head (Posterior aspect of wrist extensor / Identified with pronated & supinated forearm) Lateral ulnar collateral ligament Capitellum (The crepitus indicates radiocapitular Chondromalacia) Annular ligament Radial collateral ligament Posterior Structures Olecranon process Olecranon fossa Triceps brachii Anconeus Ulnar nerve Wrist extensors Finger extensors Thumb musculature Range of Motion Tests AROM/PROM/RROM (Flexion, extension, pronation, supination) Ligamentous Tests Valgus stress test (Ulnar collateral ligament) Varus stress test (Radial collateral ligament) Neurologic Tests Radial nerve Medial nerve Ulnar nerve Special Tests Elbow Sprains Posterolateral rotary instability test Epicondyllitis Tennis elbow test Nerve trauma Tinel’s sign (tapping on the ulnar or radial nerve results in a burning sensation in the hand) |