descriptions
Sunday, 26 December 2010
elbow injuries
olecranon bursitis (students elbow)
lateral epicondylitis ( tennis elbow)
medial epicondylitis ( golfers/throwers elbow)
hyperextension injury
entrapment of radial nerve - tinels sign for radial nerve
entrapment of ulnar nerve - tinels sign for ulnar nerve
(entrapment of median nerve - phalens Test - can be reversed)
inflammation of biceps tendon
inflammation of triceps tendon
medial elbow ligament strain
elbow dislocation - radius/ulna both - 2nd most common after shoulder - posterior dislocation most common - associated with FOOSH - often associated with fracture - subluxation is small degree - complete dislocation requires manipulation
neurological examination - extended
look - inspect for tremors muscle twitches (fasciltations)
posture ( hypertonia UL flexion LL extension)
feel - muscle wastage
move
look for tone (smooth resistance to passive force)
power ( dominant side normally stronger )
coordination - rapid alternating movements
/ point to point - eyes open => cerebellar - eyes close => proproception
walking - hopping - narrow lunging
romberg - cerebellar/position sense
pronator drift - downward drifting ( mild hemiparesis - less severe than
hemiplegia)
sensation tests ( missing from main
reflexes - biceps reflexes triceps reflex briachoradialis
knee reflex ankle reflex ( babinski )
special tests
objective elbow exam
objective elbow exam
1. Working Hypothesis
2. Plan & Consent
3. Look :
3.1. General Obs
3.2. Acute Obs
4. Neurological screen
5. Feel - Palpation
6. Move :
6.1. A.P.R
A. In standing bilateral arms abducted 90 degrees ask to flex and extend
supination elbows flexed and touching side thumbs up
P omit if no problems in A.
R.
6.2. specialised tests
tinels sign
6.3. functional tests
7. Review
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