Name: elbow injury checks and stability tests
Uploaded: 2023-04-30T06:46:04.000Z
Duration: 10 min 9 s
Channel: JoVE

K12 Standards

new-york-state-science-learning-standards

New York State Science Learning Standards

High School

Life Science

Structure and Function

HS-LS1-3.

Elbow Exam

1. inspection
<ol>
	<li>Lors de l’inspection du coude, comparez avec le côté non impliqué tout en recherchant de gonflement, rougeur, chaleur et transportant l’angle.</li>
	<li>Si l’enflure est présente, déterminer s’il est dans la bourse ou dans l’articulation. Gonflement de l’articulation du coude apparaîtra antérieurement à la fosse brachiale. Le site plus courant de gonflement au niveau du coude est postérieur, à la bourse olécrânienne.</li>
	<li>Remarque Si une rougeur ou chaleur est présent ; elles peuvent suggérer Bursite rétro-olécrânienne ou infection.</li>
	<li>Comparez la taille des coudes, à la recherche d’atrophie. N’oubliez pas qu’il est fréquent de voir hypertrophie adaptative du coude dominant dans un lanceur.</li>
	<li>Notez l’angle comptable, qui est formé par le bras supérieur et inférieur en position anatomique. Il est normalement 5 à 10° chez les mâles et 10-15° chez les femelles. Cet angle peut être modifié par fracture supracondylienne préalable ou d’infection.</li>
</ol>
2. la palpation
Palpation est extrêmement utile pour repérer la source de douleur au coude. Il est utile de localiser généralement douleur au coude à l’antérieur, postérieur, médial ou latéral.
Palper les structures importantes suivantes dans chacun de ces domaines :
<ol>
	<li>Coude antérieur<ol>
		<li>Tendon du biceps : palper un cordon serré en la face médiale du coude antérieur (meilleur ressenti avec le coude plié à 90°).</li>
		<li>Artère brachiale : sentir la pulsation juste médial pour le tendon du biceps.</li>
		<li>Palpate pour tendresse sur le nerf médian situé en dedans de l’artère brachiale.</li>
		<li>Palpate pour tendresse sur la capsule articulaire antérieure.</li>
	</ol>
	</li>
	<li>Coude postérieure<ol>
		<li>Triceps : Palper le long du bras postérieur à la pointe du processus olécrânienne.</li>
		<li>Processus d’olécrânienne : palper la bosse importante au niveau de coude postérieure.</li>
		<li>Fosse olécrânienne : se sentir la dépression juste supérieur au processus olécrânienne.</li>
		<li>Olécrânienne : palper postérieurement à l’ulna proximal ; Cela peut seulement se faire sentir si enflammée et gonflée.</li>
	</ol>
	</li>
	<li>Coude médial<ol>
		<li>Épicondyle médial : palper la protubérance osseuse au niveau du coude médial.</li>
		<li>Les muscles fléchisseurs et pronateur de poignet : se sentir pour les tendons à l’épicondyle médial.</li>
		<li>Ligament collatéral médial (MCL) : palpation de l’épicondyle médial de l’olécrânienne. La MCL se trouve profondément aux muscles fléchisseurs-pronateur.</li>
		<li>Nerf cubital : palpation de l’épicondyle médial au processus olécrânienne juste au-dessus de la MCL du coude. Taraudage sur le nerf peut causer des sensations inconfortables lorsque enflammées (signe de Tinel).</li>
	</ol>
	</li>
	<li>Coude latéral<ol>
		<li>Épicondyle latéral : sentir la protubérance osseuse sur le coude latéral.</li>
		<li>Les muscles extenseurs et supinateur : palper les tendons attachés à l’épicondyle latéral.</li>
		<li>Tête radiale : palper au coude latéral, meilleur ressenti tout en supination et en pronation du poignet.</li>
		<li>Radialcapitellar joint : palper proximale par rapport à la tête radiale.</li>
		<li>Palper les quatre doigts distal par rapport à l’épicondyle latéral pour tendresse : douleur dans cette région est associée à la compression du nerf interosseux postérieur.</li>
	</ol>
	</li>
</ol>
3. gamme de mouvement (ROM)
La ROM au niveau du coude doit être évaluée par comparaison entre les deux parties. Un manque de mouvement suggère la raideur (causées par des blessures ou l’arthrite) ou un blocage mécanique au sein de l’articulation (en raison d’un corps de lâche). ROM normal est indiqué entre parenthèses. Recherchez les propositions suivantes :
<ol>
	<li>Extension (0°) : demander au patient d’étendre le coude, donc le bras est droit. Gardez à l’esprit, il est courant de voir une contracture légère flexion dans un lanceur.</li>
	<li>Flexion (150°) : demander au patient de fléchir le coude en essayant de toucher la main à l’épaule.</li>
	<li>Pronation (70°) : avec le patient les de coude plié à 90° et le pouce vers le haut, demandez au patient de tourner à la main jusqu'à la paume vers le bas vers le plancher.</li>
	<li>Supination (90°) : avec le patient les de coude plié à 90° et le pouce vers le haut, demandez au patient de tourner à la main si la paume est vers le haut (comme si essayer de retenir la soupe dans la paume).</li>
</ol>
4. tests de force
Test de résistance est fait en vérifiant les mouvements résistés décrits ci-dessus. Douleur avec ces motions résistées est généralement due à une tendinite ou épicondylite. La force doit être évaluée dans les propositions suivantes :
<ol>
	<li>Supination de l’avant-bras (voir ci-dessus) : résistance aggravera l’épicondylite latérale (supinateur tendons attachent à l’épicondyle latéral).</li>
	<li>Pronation de l’avant-bras (voir ci-dessus) : résistance aggravera Épicondylite médiale (non-pronateurs tendons attachent à l’épicondyle médial).</li>
	<li>Extension du poignet : avec le poignet du patient droite et la paume vers le bas, déplacez la main du patient vers le haut. Résistance aggravera la douleur de l’épicondylite latérale (poignet extenseurs attachent à l’épicondyle latéral).</li>
	<li>Flexion des poignets : avec le poignet du patient droite et la paume vers le bas, déplacez la main du patient vers le bas. Résistance aggravera la douleur de l’Épicondylite médiale (poignet fléchisseurs attachent à l’épicondyle médial).</li>
	<li>Résista longtemps extension de doigt : avec le poignet du patient droite et la paume vers le bas, déplacer le doigt du milieu du patient vers le haut. La résistance va aggraver la douleur de l’épicondylite latérale.</li>
	<li>Coude de flexion (voir ci-dessus) : résistance permettra de tester la force de biceps, et la douleur suggère une tendinite.</li>
	<li>Coude de rallonge (voir ci-dessus) : résistance testeront essais triceps force, et la douleur suggère une tendinite.</li>
</ol>
5. étendre les Tests
Ces tests aggravera les douleurs causées par l’épicondylite médial ou latéral en tirant sur l’épicondyle.
<ol>
	<li>Étirer le poignet en flexion ou en pronation (décrit ci-dessus) ; il arrache l’épicondyle latéral et aggrave la douleur de l’épicondylite latérale.</li>
	<li>Étirer le poignet en extension ou en supination (décrit ci-dessus) ; il arrache l’épicondyle médial et aggrave la douleur de l’Épicondylite médiale.</li>
</ol>
6. Ligament latéral stable
Les ligaments collatéraux du coude doivent être évalués pour la douleur et/ou de laxisme. Le ligament collatéral médial se blesse beaucoup plus fréquemment que les latéraux.
Deux tests sont utilisés pour évaluer ces ligaments :
<ol>
	<li>Contrainte de varus/valgus<ol>
		<li>Passivement faire pivoter les épaules du patient vers l’extérieur (rotation externe complète) et Fléchissez le coude à 30° pour déverrouiller l’olécrânienne sur la fosse olécrânienne.</li>
		<li>Placer une paume sur coude latéral et le pousser médialement avec l’autre main du patient (stress valgus est appliquée pour évaluer le ligament collatéral médial).</li>
		<li>Effectuez varus stress test pour évaluer le ligament en plaçant votre paume sur coude médial du patient et en poussant en direction latérale.</li>
		<li>Recherchez les douleurs et/ou de laxisme.</li>
		<li>Grade la gravité de la lésion ligamentaire. Classe I (ligament étiré) : douleur avec aucun manque de fermeté. Classe II (déchirure partielle) : douleur avec laxisme minime. Point de terminaison souple. Grade III (déchirure complète) : douleur avec aucun point de terminaison bon.</li>
	</ol>
	</li>
	<li>Manœuvre de traite : plier le coude touché à 90° et supination complète avec le pouce étendu. Atteindre le bras opposé sous le coude impliqué et saisir le pouce. Tirant latéralement sur le pouce crée le stress valgus dans le ligament collatéral médial du coude touché.</li>
</ol>

Examen du coude est mieux fait en suivant une approche progressive avec le patient en position assise. Il est important d’avoir le patient Retirez suffisamment vêtements afin que cette anatomie de surface peut être vu et par rapport au côté non impliqué. L’examen doit commencer par l’inspection, à la recherche d’une asymétrie entre le coude impliqué et non impliqué. Ensuite, palpation des structures clés est fait, la recherche de tendresse, un gonflement ou une déformation.
Il est suivi en éva...

examen du coude

Source : Robert E. Sallis, MD. Kaiser Permanente, Fontana, Californie, é.-u.
Le coude est une articulation charnière qui implique l’articulation de 3 OS : humérus, du radius et du cubitus. C’est une articulation beaucoup plus stable que l’épaule et de ce fait, le coude a moins d’amplitude de mouvement. Le coude et ses structures sont sujettes à des blessures importantes, notamment avec mouvements répétitifs. Épicondylite latérale et médiale (également appelé coude de tennis et elbow Golf) est les deux Diagnostics fréquents et se produire souvent en raison d’activités professionnelles.
Lorsqu’on examine le coude, il est important de dévêtir suffisamment pour que l’ensemble épaule et du coude peuvent être inspectés. Il est important de comparer le coude blessé sur le côté non impliqué. Une évaluation systématique du coude comprend l’inspection, palpation, gamme de mouvement (ROM) et des essais spéciaux, y compris les manœuvres destinées à évaluer la stabilité ligamentaire et étirer les essais pour accentuer les douleurs causées par l’épicondylite.

Examen du coude

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA
The elbow is a hinged joint that involves the articulation of 3 bones: the ...

Education

Enseignement

JoVE Science Education

Clinical Skills

Compétences cliniques

Physical Examinations III

Examens physiques III

elbow injury checks and stability tests

The elbow is a hinge joint made by the humerus, radius, and ulna. It is more stable than the shoulder, so it has less range of motion. The elbow and nearby structures can still be injured, especially with repetitive motion.

Lateral epicondylitis and medial epicondylitis are two common elbow problems. Lateral epicondylitis is also called tennis elbow, and medial epicondylitis is also called golfer's elbow. These conditions often develop from occupational activities.

A full elbow exam starts with enough clothing removed to inspect the shoulder and elbow. The injured elbow should be compared with the uninjured side. The exam then includes inspection, palpation, range of motion testing, and special tests.

Special tests can check ligament stability and stretch the area to bring out pain from epicondylitis. This systematic approach helps evaluate elbow injury and pain in a clear, organized way.

Elbow Injury Checks and Stability Tests

cranial nerves exam i (i-vi)

Cranial Nerve Exam: Eye and Face Checks

Cranial nerve testing uses careful observation to check how the eyes, face, and related muscles are working. Some problems are easy to spot. A patient may report loss of smell or double vision, and facial nerve palsy can also be seen on exam. Other issues, such as sixth nerve palsy, may be subtle and need a careful neurological exam to find them. Cranial nerve problems can also appear when a person has changes in mental status. Some neurodegenerative disorders and brain lesions can affect...

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Testing Cranial Nerves VII-XII

Cranial nerves VII-XII are tested as part of the neurological exam after the mental status evaluation. The examination begins with simple observations made during the first greeting. Facial weakness may already be visible, since the facial muscles are controlled by cranial nerve VII. Cranial nerve VII is the facial nerve. It also carries taste from the anterior two-thirds of the tongue and part of the external auditory canal. If facial weakness is paired with taste loss on the same side, that...

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Motor Function Assessment Basics

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Neurological Reflexes, Coordination, and Gait

Neurological motor exams often include testing reflexes, coordination, and gait. These parts of the exam help localize neurologic problems and show how the nervous system is working. Reflex testing includes deep tendon reflexes and superficial reflexes. A deep tendon reflex, or DTR, begins when a stretch-sensitive receptor in a neuromuscular spindle is stimulated. That signal travels through a single synapse to a motor nerve and produces a muscle contraction. DTRs are often increased in...

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Sensory Pathways and Nerve Mapping

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Cervical Spine and Neck Injury

The neck contains the cervical spine, a group of seven vertebrae arranged in a gentle C-shaped curve. These bones, joints, and ligaments make the neck complex to examine. The cervical spine supports the head and helps protect the nerves that come from the brain and spinal cord. Each vertebra has a thick bony body at the front. Intervertebral discs connect the bodies above and below, and they add stability and shock absorption. The back part of each vertebra includes the laminae, transverse and...

shoulder exam i

Shoulder Exam: Joint Structure and Motion

Shoulder exam starts with understanding the joints and muscles that control shoulder movement. The shoulder is made up of four separate joints: the glenohumeral (GH) joint, the acromioclavicular (AC) joint, the sternoclavicular joint, and the scapulothoracic joint. The GH joint is the main joint for shoulder motion. It is also the most mobile joint in the body. Because it is shaped like a golf ball sitting on a tee, it can be prone to instability. The GH joint is held in place by the four...

shoulder exam ii

Shoulder Strength and Instability Tests

The shoulder exam continues with strength testing of the rotator cuff muscles and the biceps tendons. These tests help assess common sources of shoulder pain and guide the next steps in the exam. The rotator cuff includes the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. These muscles act as compressors that hold the humeral head in place against the glenoid. Injury and wear of the rotator cuff tendons are among the most common causes of shoulder pain. Strength is...

elbow exam

The elbow is a hinge joint made by the humerus, radius, and ulna. It is more stable than the shoulder, so it has less range of motion. The elbow and nearby structures can still be injured, especially with repetitive motion. Lateral epicondylitis and medial epicondylitis are two common elbow problems. Lateral epicondylitis is also called tennis elbow, and medial epicondylitis is also called golfer's elbow. These conditions often develop from occupational activities. A full elbow exam starts...

wrist and hand examination

Wrist and Hand Injury Exam

The wrist and hand injury exam checks bones, joints, tendons, nerves, and blood flow. The wrist is a complex joint made of 8 carpal bones and many ligaments. The hand has 5 metacarpal bones, and the fingers have 14 phalanges. Tendons and muscles lie over these bones and help move the hand and fingers. Wrist and hand problems can follow impact, weight-bearing activities such as gymnastics, or twisting and throwing motions. The exam starts with inspection. The examiner then looks for tenderness...

lower back exam

Lower Back Pain Evaluation

The lower back exam checks for pain, injury, and changes in the spine and nearby tissues. Back pain is a common source of pain in the body. Because the lower back includes bones, discs, ligaments, nerves, and muscles, each of these structures can contribute to symptoms. The exam starts with inspection and palpation. Inspection means looking for signs of deformity or inflammation. Palpation means feeling the area with the hands to check for tenderness or swelling. The exam also includes range...

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Assessing Hip Pain and Movement

The hip is a ball-and-socket joint made by the femoral head fitting into the acetabulum. The hip ligaments help make it a very strong and stable joint. Even so, the hip still has a wide range of motion and can wear down over time or after injury. Hip pain can affect people of many ages. It may be linked to problems inside the joint or outside the joint. The location of pain in the hip region can give early clues about the cause. A hip exam looks for asymmetry, swelling, and changes in gait,...

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Knee Injury Assessment

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ankle exam

How to Assess an Injured Ankle

The ankle exam helps assess an injured ankle by checking the joint, the ligaments, and the surrounding foot. The ankle and foot form the base for body support and upright movement. Because this area bears weight, ankle injuries are common in athletes and in the general population. Ankle injuries can happen after sudden trauma or from repeated overuse, such as running. The ankle is a fairly simple joint. It includes the distal tibia, the talus, and the fibula on the lateral side. Its main...

foot exam

Assessing Foot Pain and Injury

Foot pain and injury can be evaluated by checking the foot carefully from side to side. The foot is a complex structure made of many bones and joints. It gives the body flexibility, serves as the main point of contact for walking, and helps absorb shock. Because the foot supports the weight of the whole body, it is often prone to pain and injury. A full exam starts by removing shoes and socks on both feet. This lets the examiner inspect the entire foot and compare the painful or injured side...

physical examinations iii

Cette collection couvre l'examen physique de deux systèmes majeurs de notre corps : le système neurologique et le système musculo-squelettique. Elle inclut des vidéos décrivant les parties du corps concernées, la logique des différentes étapes et l'interprétation des résultats de l'examen.

Explore how the elbow is examined, from comparing both sides to testing motion, ligament stability, and pain from tennis elbow or golfer's elbow.

Elbow Injury Checks and Stability Tests | JoVE K12

Robert E. Sallis

Kaiser Permanente

Overview

Inspection and Palpation

Range of Motion Testing

Strength Testing

Special Tests

Summary

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Construct an explanation based on evidence for how the structure of DNA determines the structure of proteins which carry out the essential functions of life through systems of specialized cells.

HS-LS1-1.

Elbow Injury Checks and Stability Tests

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