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 Humeruso Radius-on thumb side of forearmo 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

oBrachialis-major flexoroBiceps Brachii-also supinates handoBrachioradialis

• Extensorso Triceps BrachiioAnconeus

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