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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

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Chapter 14 – The Elbow and Forearm

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  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

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