Ch. 20 Elbow and Forearm

Objectives Define the major landmarks of the elbow List major injuries and conditions of the elbow

Anatomy Hinge joint 3 major bones o Humerus o Radius-on thumb side of forearm o Ulna-on pinky side of forearm Ulna is hooked on the end of the humerus Radius rests next to humerus therefore allowing supination and pronation

Ligaments Ulnar Collateral-on the medial side Radial Collateral-on the lateral side Annular-encircles the head of the radius Interosseous Membrane-connects the radius to the ulna

Muscles Flexors o Brachialis-major flexor o Biceps Brachii-also supinates hand o Brachioradialis Extensors o Triceps Brachii o Anconeus

Muscles

Contusion Vulnerable area due to lack of padding Result of direct blow or fall S/S: swelling and/or bruising Treatment: RICE, x-ray if not improving

Olecranon Bursitis Caused by direct blow or fall S/S: swelling, pain Treatment: RICE, can be aspirated by doctor Easily infected due to abrasions on elbow

Ulnar Nerve Contusion Hitting your funny bone The ulnar nerve runs behind the medial epicondyle Caused by a direct blow S/S: pain, burning and tingling sensation down medial side of forearm Should alleviate in mins

Elbow Sprains MOI: hyperextension or valgus/varus stress S/S: ‘pop’, sharp pain, swelling Ulnar collateral sprains are more common due to throwing mechanics Treatment: RICE, strengthen wrist flexor or extensors, surgery if ruptured

Medial Epicondylitis Golfer’s Elbow Little League Elbow Irritation of the wrist flexors causing pain at the medial epicondyle Treat with RICE, NSAIDs, change in mechanics

Lateral Epicondylitis Tennis Elbow Inflammation of the wrist extensors causing pain at the lateral epicondyle Same treatment as medial epicondylitis

Elbow Dislocation Most common is posterior dislocation MOI: falling on outstretched hand Obvious deformity Splint, stabilize, check circulation, check motor and sensory function Refer to doctor

Elbow Fracture Direct blow or falling on arm Common in children S/S: Point tenderness, swelling, increase pain with movement Refer to doctor for x- rays

Volkmann’s Contracture Occurs in the absence of blood flow to the forearm Causes muscles to shorten Usually associated with elbow fractures, bleeding disorders, animal bites