Presentation on theme: "Elbow, Forearm, wrist, and hand"— Presentation transcript:
1Elbow, Forearm, wrist, and hand Chapter 12Elbow, Forearm, wrist, and hand
2Educational Objectives UnderstandAnatomy of the elbow, forearm, wrist, and handPrinciples of rehab exercisesPreventive/supportive techniques and protective devicesIdentify components of evaluation formatRecognize the common injuries
3AnatomyELBOWPermits movements of flexion, extension, pronation, and supination.Delivers and receives accidental blows that can cause bruising, fracture, dislocation or nerve damage.Excessive stress are placed on elbow in throwing and racquet sports
4Anatomy Humerus- largest bone of the upper extremity. -two articulating condyles at distal endUlna- remains stationaryRadius-rotates on the ulna as the forearm, wrist, and hand pronate and supinate. The proximal end has a bony protuberance called the olecranon process. olecranon process articulates with the proximal radius.
5Ligaments, Tendons, Joints Very strong ligamentous and muscular supportAttach at the condyles of the humerusMedial condyle articulates with the ulna for flexion and extensionLateral condyle articulates with the radius for pronation and supination
6Ligaments, Tendons, Joints HumeroulnarHumeroradial-LIGAMENTSUlnar collateralRadial collateralAnnular ligaments-adds elbow stability, attaches to the ulna and completely encircles the head of the radius. Helps keep the radius and ulna from separating.Medial collateral-attached to the humerus and the ulnaLateral collateral-attached to the humerus and the radius
7Muscles- control forearm and elbow’s movement Control elbow- Originate above the elbow on the humerus and the scapula.BicepsTricepsBrachialisControl forearm, wrist, and fingers -originate on the two epicondyles of the humerus.Flexor carpi radialis (flexion and pronation)Flexor carpi ulnaris (flexion and pronation)Flexor digitorum sublimis (flexion and pronation)Flexor pollicis longus (flextion and pronation)Extensor digitorum communis (extension and supination)Extensor carpi radials longus and brevis (extension and supination)Extensor carpi ulnaris (extension and supination)Extensor pollicis longus (extension and supination)
8Tests Elbow Test for collateral ligaments stability Valgus or abduction stress-(medial collateral)Varus or adduction stress-(lateral collateral)Epicondylitis tests-lateralResisted wrist extensionResisted long finger extensionPalmar flexion-pronation stretchEpicondylitis tests-medialResisted wrist flexionWrist extension-supination stretch
9Wrist test Bony integrity tests Anatomical snuffbox compression-fracture of scaphoidMurphy’s sign-dislocation of lunate
10Common injuries sprains: 1st, 2nd, and 3rd degrees Olecranon brusitis: inflammation to the olecranon bursa. (direct blow or overuse) Referral, after evaluated basic treatment.Carpal tunnel syndrome: pressure on the median nerve caused by constriction in the carpal tunnel. Treatment: wrist splints, rest, and medication. Medical re-evaluation is doesn’t get better.Scaphoid fracture: (navicular) fall extended wrist. Poor blood supply. Severe pain, medical treatment required.Dislocation/subluxation: force placed on a outstretched hand with elbow in extension. Always suspect a fracture. Medical referral.Epicondylitis: inflammation of the epicondyle and the tissues adjoining the humerus. Elbow joint medial (pitches elbow) and lateral (tennis elbow)ContusionSubungual hematoma: fingernail receives a contusion (bruise), accumulation of blood under the fingernail. Ice and medical referral if swelling is severe.
11Rehabilitation ROM Elbow: flexion, extension, supination, pronation Wrist: flexion, extension, radial deviation, ulnar deviation, supination, pronationFingers: flexion, extension, abduction, adduction, oppositionResistance/strengthening exercisesElbow: arm flexion (bicep curls) arm extension (triceps extension)wrist, hand, fingers: hand squeeze, finger abduction, pinch grip, lateral/key pinch gripReturn to competition guidelinesFull ROMStrength, power, and endurance according to athlete and sportNo pain in upper extremity during running, jumping, or cutting