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BELLWORK List various injuries to the elbow, wrist, or hand.

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Presentation on theme: "BELLWORK List various injuries to the elbow, wrist, or hand."— Presentation transcript:

1 BELLWORK List various injuries to the elbow, wrist, or hand.

2 The Elbow, Wrist, and Hand
Chapter 20 The Elbow, Wrist, and Hand

3 Objectives Upon completion of this chapter, you should be able to:
Define the major components of the elbow List major injuries and conditions of the elbow, wrist, and hand List the different bones of the hand

4 The Elbow, Wrist, and Hand
Many activities would be impossible without healthy functioning of the elbow, wrist, and hand This area of the body is one of the most intricate, yet most vulnerable to injury

5 Elbow Anatomy Bones: Humerus Ulna Radius hinge joint

6 Elbow Anatomy FLEXORS Biceps brachii Brachialis Brachioradialis
EXTENSORS Triceps brachii Anconeus

7 Common Injuries of the Elbow
Contusions Involve forearm muscles and subcutaneous bony prominences of the elbow Direct blows can result in bruising, bleeding, and stiffness Treatment: RICE and protective padding

8 Common Injuries of the Elbow (cont’d.)
Olecranon bursitis Inflammation of bursa located over olecranon process Can be caused by direct blow or infection Treatment: ice compresses, rest, and anti-inflammatory, pain medications, and occasionally aspiration of fluid

9 Common Injuries of the Elbow (cont’d.)
Ulnar nerve contusion Blow or contusion to ulnar nerve “hitting the funny bone” Elbow strain Acute or chronic Acute occurs with sudden overload

10 Common Injuries of the Elbow (cont’d.)
Epicondylitis Chronic strain commonly occurring in medial and/or lateral epicondyles (bony ends of the humerus) Caused by overload, faulty techniques, weak muscle groups, inappropriate equipment Tennis elbow (lateral epicondylitis) Pitcher’s elbow, golfer’s elbow (medial epicondylitis) Symptoms: local tenderness and resisted wrist motion causes pain Treatment: prevention, appropriate equipment, limited stress, stretching, RICE, and activity modification

11 Common Injuries of the Elbow (cont’d.)
Elbow sprains Commonly result from forced hyperextension or valgus/varus (side-to-side) forces Symptoms: pain, a “pop”, tenderness, and swelling Treatment: same as elbow strains Dislocations of the elbow Normally occurs as a result of a fall Signs: obvious deformity, loss of function, and pain Treatment: transport to medical facility

12 Ouch!!!

13 Common Injuries of the Elbow (cont’d.)
Fractures of the elbow and forearm Result of direct trauma, or indirect stresses transmitted through upper extremity “FOOSH” = Falling On Out-Stretched Hand Symptoms: deformity, point tenderness, hemorrhaging, swelling, limited range of motion, disability, and pain Treatment: immobilization, ice, elevation, and physician referral

14 Common Injuries of the Elbow (cont’d.)
Volkmann’s contracture Absence of blood flow (ischemia) to the forearm Caused by swelling, trauma, or fracture  blood flow  shortens muscles  joint bends  cannot be straightened (contracture) Mild, moderate, or severe Symptoms: pain, swelling, decreased sensation, weakness, and skin paleness

15 Common Injuries of the Elbow (cont’d.)
Nerve injuries Ulnar nerve Symptoms: pain and tenderness Radial nerve Median nerve Symptoms: pain, numbness and tingling

16 Wrist & Hand Anatomy Bones Phalanges (14) Metacarpals (5) Carpals (8)
Scaphoid (“anatomical snuffbox”)

17 Wrist & Hand Anatomy Wrist flexors Wrist extensors
Anterior portion of forearm Originate at medial epicondyle Wrist extensors Posterior portion of forearm Originate at lateral epicondyle 26 muscles move wrist, thumb, and fingers!

18 Hand and Wrist Injuries
Fractures Finger fractures Boxer’s fracture (5th metacarpal) Mallet (Baseball) finger (tearing of extensor tendon) Jersey finger (tearing of flexor tendon, normally ring finger) Scaphoid fracture Colles’s fracture (in radius, just above wrist) Treatment: RICE, support, and medical evaluation

19 Fractures Colles’s fracture Jersey finger Mallet finger

20 Hand and Wrist Injuries (cont’d.)
Dislocations and subluxations Dislocation: displacement of any bone from normal position Subluxation: abnormal movement of a bone that constitute a joint Symptoms: pain, swelling, and unable to bend or straighten Treatment: ice, immobilization, and immediate consultation with a physician

21 Hand and Wrist Injuries (cont’d.)
Contusions Caused by direct blows or falling onto a hard surface Sprains Injury to a ligament Gamekeeper’s thumb (tearing of ulnar collateral ligament at MCP joint)  thumb becomes very unstable Medial & lateral collateral ligaments of fingers

22 BELLWORK What is the common name for lateral epicondylitis?
What does “FOOSH” stand for? How many bones are in the hand?

23 Hand and Wrist Injuries (cont’d.)
Tendonitis Inflammation of tendons Caused by overuse or repetitive stress deQuervain’s tenosynovitis (tendonitis at base of thumb) Symptoms: aching or pain at the wrist Treatment: rest, ice, and anti-inflammatory medication

24 Hand and Wrist Injuries (cont’d.)
Nerve impingement and carpel tunnel (passageway from forearm to wrist) Carpal tunnel syndrome Inflammatory disorder of tissues & nerves around median nerve Caused by repetitive stress, physical injury, or conditions that cause median nerve tissue swelling Symptoms: pain, numbness, tingling, and weakness Treatment: rest, ice, splinting or bracing, and sometimes surgical decompression

25 Carpal Tunnel

26 Hand and Wrist Injuries (cont’d.)
Ganglion cyst of the wrist Small, usually hard lump above a tendon or in the capsule that encloses a joint Treatment: if painless, no treatment necessary

27 Hand and Wrist Injuries (cont’d.)
Boutonnière deformity Extensor tendon injury affecting proximal interphalangeal joint (PIP) and distal interphalangeal joint (DIP) Symptoms: inability to flex and extend the finger, pain, and tenderness Treatment: immediate medical attention

28 Strengthening Exercises
Wrist flexion Wrist extension

29 Special Tests Varus test (LCL) Valgus test (MCL)
Finkelstein’s test (deQuervain’s) Tinel’s carpal tunnel Phalen’s test (carpal tunnel)

30 Conclusion The elbow, wrist, and hand contain some of the most intricate and complex joints in the body Understanding the anatomy, biomechanics, and mechanisms of injury will ensure appropriate treatment Elbow and forearm injuries are common The elbow is prone to overuse injuries

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