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
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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
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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