Transcript Chapter 12
Elbow, Forearm, wrist, and hand
Understand
Anatomy of the elbow, forearm, wrist, and
hand
Principles of rehab exercises
Preventive/supportive techniques and
protective devices
Identify components of evaluation format
Recognize the common injuries
ELBOW
Permits movements of flexion, extension,
pronation, and supination.
Delivers and receives accidental blows
that can cause bruising, fracture,
dislocation or nerve damage.
Excessive stress are placed on elbow in
throwing and racquet sports
Humerus-
largest bone of the upper
extremity.
-two articulating condyles at distal end
Ulna- remains stationary
Radius-rotates on the ulna as the forearm,
wrist, and hand pronate and supinate. The
proximal end has a bony protuberance
called the olecranon process. olecranon
process articulates with the proximal radius.
Very
strong ligamentous and muscular
support
Attach at the condyles of the humerus
Medial condyle articulates with the ulna
for flexion and extension
Lateral condyle articulates with the
radius for pronation and supination
-JOINTS
Humeroulnar
Humeroradial
-LIGAMENTS
Ulnar collateral
Radial collateral
Annular ligaments-adds elbow stability, attaches to the ulna
and completely encircles the head of the radius. Helps keep
the radius and ulna from separating.
Medial collateral-attached to the humerus and the ulna
Lateral collateral-attached to the humerus and the radius
Control elbow- Originate above the elbow on the humerus
and the scapula.
Biceps
Triceps
Brachialis
Control forearm, wrist, and fingers -originate on the two
epicondyles of the humerus.
Flexor carpi radialis (flexion and pronation)
Flexor carpi ulnaris (flexion and pronation)
Flexor digitorum sublimis (flexion and pronation)
Flexor pollicis longus (flextion and pronation)
Extensor digitorum communis (extension and supination)
Extensor carpi radials longus and brevis (extension and
supination)
Extensor carpi ulnaris (extension and supination)
Extensor pollicis longus (extension and supination)
Test for collateral ligaments stability
1. Valgus or abduction stress-(medial
collateral)
2. Varus or adduction stress-(lateral
collateral)
Epicondylitis tests-lateral
1. Resisted wrist extension
2. Resisted long finger extension
3. Palmar flexion-pronation stretch
Epicondylitis tests-medial
1. Resisted wrist flexion
2. Wrist extension-supination stretch
Bony
1.
2.
integrity tests
Anatomical snuffbox compressionfracture of scaphoid
Murphy’s sign-dislocation of lunate
sprains: 1st, 2nd, and 3rd degrees
Olecranon brusitis: inflammation to the olecranon bursa. (direct
blow or overuse) Referral, after evaluated basic treatment.
Carpal tunnel syndrome: pressure on the median nerve caused by
constriction in the carpal tunnel. Treatment: wrist splints, rest, and
medication. Medical re-evaluation is doesn’t get better.
Scaphoid fracture: (navicular) fall extended wrist. Poor blood
supply. Severe pain, medical treatment required.
Dislocation/subluxation: force placed on a outstretched hand with
elbow in extension. Always suspect a fracture. Medical referral.
Epicondylitis: inflammation of the epicondyle and the tissues
adjoining the humerus. Elbow joint medial (pitches elbow) and
lateral (tennis elbow)
Contusion
Subungual hematoma: fingernail receives a contusion (bruise),
accumulation of blood under the fingernail. Ice and medical
referral if swelling is severe.
ROM
Elbow: flexion, extension, supination, pronation
Wrist: flexion, extension, radial deviation, ulnar deviation,
supination, pronation
Fingers: flexion, extension, abduction, adduction, opposition
Resistance/strengthening exercises
Elbow: arm flexion (bicep curls) arm extension (triceps
extension)
wrist, hand, fingers: hand squeeze, finger abduction, pinch
grip, lateral/key pinch grip
Return to competition guidelines
Full ROM
Strength, power, and endurance according to athlete and
sport
No pain in upper extremity during running, jumping, or
cutting