Chapter 14 – The Elbow and Forearm
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Transcript of Chapter 14 – The Elbow and Forearm
Chapter 14 – The Elbow and Forearm
Pages 497 - 506
Clinical Evaluation of the Elbow and Forearm
Valgus/varus stress Hyperextension Direct blow Overuse
History
Location of symptoms (Table 14-2, pg 498)
Onset of symptoms Mechanism of injury
Repetitive stresses Technique Associated sound and sensation Previous history General medical health
Inspection of Anterior Structures Carrying Angle
Women - 10 to 15 degrees of valgus Men – 5 to 10 degrees of valgus Figure 14-9, page 499 Cubital valgus and varus
Cubital Fossa Marked by brachioradialis (lat) and pronator teres
(med) Brachial artery, radial and ulnar arteries, median
nerve, musculocutaneous nerve Figure 14-10, page 499
Inspection of Medial Structures
Medial epicondyle Flexor muscle group
Loss of girth may be due to immobilization or disuse
Inspection of Lateral Structures
Alignment of wrist and forearm Cubital recurvatum
Figure 14-11, page 500 Extensor muscle group
Loss of girth may be due to immobilization or disuse
Inspection of Posterior Structures
Bony alignment When flexed to 90 degrees – medial
epicondyle, lateral epicondyle, and olecranon process form isosceles triangle
When extended – structures lie in straight line
Olecranon process and bursa Figure 14-12, page 500
Palpation
Many structures of the upper extremity insert or originate at elbow
Range of Motion
AROM Goniometry, Box 14-1, page 504 Flexion and Extension
145-155 degrees of flexion Extension at 0 degrees, hyperextension
common Pronation and supination
Neutral position Total ROM – 170-180 degrees
Range of Motion
PROM Flexion and Extension
Figure 14-16, page 505 End-feels
Pronation and supination End-feel
Pronation – hard or firm (stretching of radioulnar ligaments)
Supination – Firm (stretching of radioulnar ligaments)
Range of Motion
RROM Box 14-2, page 506 Figure 14-17, page 507