1. Elbow Anatomy Medial Epicondyle Lateral Epicondyle
Trochlea and Capitulum
Olecranon Process
Ulna and Radius
Radial Head
Interosseus Membrane
- Pic of Bony Anatomy

2. © 2007 McGraw-Hill Higher Education. All rights reserved.

4. Elbow Anatomy

5. Elbow Anatomy (2) Humeroulnar joint Flexion (0 – 150)
______________
Trochlea of humerus
_______________
Flexion (0 – 150)
Extension (0)-some hyperextension(-5 to -15)
Ligaments:
_________________________

6. Elbow Anatomy (3) Radioulnar joint
Not part of elbow but associated with __________________________
Supported by the annular ligament which binds the head of the radius to the radial notch of the ulna forming the joint
___________________________

7. Muscular Anatomy ______________________
Brachioradialis (flexion with arm neutral)
Brachialis (flexion w/ pronation)
Pronator Group (pronation)
- biceps attachment
Pronator Teres and Quadratus

9. Bursa, Blood and Nerve Supply
Blood supply
Brachial artery
___________
Nerve supply
Brachial plexus extends into the radial and ulna nerve***

10. Prevention of Injuries
General muscular condition
Restrict pitching/ teach proper form
Make sure equipment is proper (ie: racquet)- grip size, racquet weight
Teach shoulder roll method of falling- example volleyball players rolling after a dig

11. Contusions MOI: Direct contact HOPS TX
__________________________________
Limited range of motion TX
Rule out fracture first
Ice, wrap and pad area
Avoid aggressive stretching and strengthening
Watch for ectopic bone formation
________________________________

12. Olecranon Bursitis Olecranon bursa is largest in elbow
MOI: fall on bent arm, leaning on elbow for long periods, infection
HOPS
____________________________
Tx: ice, compression, pad area
If associated with fever: refer
_____________________________

14. Elbow Sprains (1 – UCL) MOI: valgus force, repetitive stress HOPS:
Pain over medial joint especially in cocking phase or acceleration phase of throwing
Point tenderness over joint line
____________________________________ ____________________________
Tx: rest, general strengthening of flexors/ pronators; _________________________ ________________________________

16. Elbow Dislocations
MOI: ____________________________ ______________________________, falling on outstretched hand
HOPS
Obvious deformity
Snapping or cracking sensation
Severe pain
Forearm in flexion and appears shortened
Tx:
immobilize and refer MED EMERGENCY
Check neurovascular status

17. -

18. Medial Epicondylitis ______________________________
MOI: repetitive tension or valgus forces on the arm
HOPS-
Swelling, ecchymosis over medial epicondyle
Pain aggravated by pronation and resisted flexion of wrist
_________________________________
Tx: RICE, Strengthening/Stretching, look at technique

20. Lateral Epicondylitis
__________________
Most common overuse injury in the adult elbow
MOI: _______________________ ______________________
Precursor: too large tennis racquet, gripping racket too tightly, excessive string tension, faulty mechanics

21. Lateral Epicondylitis (2)
HOPS
Pain over lateral epicondyle
Pain with resisted wrist extension
+ tennis elbow test Tx
RICE
__________________________________ _________________________
Counter force brace

23. Impingement of Ulnar nerve
Ulnar nerve passes behind humerus in ulnar groove
_______________
HOPS
_________________
Can be caused from a medial elbow injury
“crazy bone” or “funny bone”
Tingling and numbness in ring and little finger
__________________
Refer if chronic

24. Strength Testing Elbow flexion Elbow extension
Wrist flexion and extension
Pronation
Supination

25. Stress Tests
Valgus (UCL)/Varus (RCL) stress test – Positive Sign is laxity
Tennis Elbow test-(Lateral Epicondylitis) - Positive Sign is increased pain
Tinel’s sign (Ulnar nerve) – Numbness, Tinkling into Ulnar nerve region.