Chapter 14

1
Chapter 14 The Elbow and Forearm

• Pages 497 - 506

2
Clinical Evaluation of the Elbow and Forearm

• Valgus/varus stress
• Hyperextension
• Direct blow
• Overuse

3
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

4
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

5
Inspection of Medial Structures

• Medial epicondyle
• Flexor muscle group
• Loss of girth may be due to immobilization or
  disuse

6
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

7
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

8
Palpation

• Many structures of the upper extremity insert or
  originate at elbow

9
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

10
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)

11
Range of Motion

• RROM
• Box 14-2, page 506
• Figure 14-17, page 507