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Paper 4
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Golfer’s elbow (medial epicondylitis) is less common than tennis elbow (lateral epicondylitis). It is characterised by pain across the flexor aspect due to inflammation of the flexor tendons insertion at the medial epicondyle of the humerus.
Examination of Pediatric Elbow
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Karthick Rangasamy, Nirmal Raj Gopinathan, Pebam Sudesh
These examination techniques are helpful for evaluating a certain group of chronic pathological conditions of the elbow, such as the development of valgus instability following malunion or non-union of a fracture at the medial epicondyle of the humerus. The development of posterolateral ligamentous instability follows certain conditions like dislocation of the elbow with injury to the lateral collateral ligament secondarily and also in cases with cubitus varus deformity following supracondylar humerus fracture in childhood.10
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The muscles of the elbow and forearm can be divided into five groups: the muscles of the arm that are involved with movements at the elbow joint, and four groups in the forearm (Figure 10; Table 2). The forearm muscles are divided into anterior and posterior groups, and then subdivided further into superficial and deep groups. The muscles of the arm that cross the front of the elbow and are responsible for flexing it are: biceps brachii, the large muscle on the front of the arm; brachialis which is deep to biceps brachii; and brachioradialis, a smaller muscle that inserts into the base of the radial styloid process. The biceps also contributes to supinating the forearm and stabilizing the shoulder joint. The biceps also crosses the front of the shoulder and is a weak shoulder flexor. The muscles arising from the medial epicondyle of the humerus are the superficial flexors of the forearm that flex the wrist and can also contribute to flexing the elbow. The extensors of the elbow cross the back of the joint and are the triceps brachii on the back of the humerus and the small anconeus.
Flexors activity of affected upper extremity in stroke patients during different standing conditions and their relationships with clinical scales: a cross-sectional study
Published in Neurological Research, 2020
Sheng Wang, Xin Chen, Ren Zhuang, Zhiwei Yang, Wenjun Jiang, Tong Wang
Wireless surface electromyography (Noraxon Inc., Scottsdale, USA) recorded the electromyographic activities of eight upper extremity muscles on both sides, including bilateral biceps brachii, triceps brachii, flexor carpi radialis and extensor carpi radialis. According to the criterion of ‘The ABC of EMG’, 75% alcohol was wiped on the target areas, and skin preparation was needed for subjects with dense body hair. Single EMG Electrodes (Noraxon, USA) were attached to the upper 90% of the line between the second metacarpal bone and the medial epicondyle of the humerus (flexor carpi radialis), the upper 90% of the line between the second metacarpal bone and the lateral epicondyle of the humerus (extensor carpi radialis) in the pronation of the forearm [26], and the lower one-third of the line between the acromion and the elbow fossa (biceps brachii), midpoint between acromion and olecranon of ulna (triceps brachii) [27]. The wireless sensor was affixed with double-sided adhesive beside the electrodes. While meeting the test requirements, the position of the sensor was adjusted appropriately to ensure that the subject did not rub the sensor while moving, so as to avoid abnormal EMG signal interference.
The relationship between thoracic posture and ultrasound echo intensity of muscles spanning this region in healthy men and women
Published in Physiotherapy Theory and Practice, 2023
Tamara Prushansky, Lihi Kaplan-Gadasi, Jason Friedman
After signing the informed consent, subjects were given explanations regarding the procedure. The spinous processes of C7, T5 and T12 were then uniformly palpated in standing position, and marked with small color stickers to serve as anatomical landmarks for the measurements. Additional stickers were placed on the right and left anterior arm, 2/3 of the distance between the axillary fold and the medial epicondyle of the humerus.
High elasticity of the flexor carpi ulnaris and pronator teres muscles is associated with medial elbow injuries in youth baseball players
Published in The Physician and Sportsmedicine, 2022
Akira Saito, Kyoji Okada, Kazuyuki Shibata, Hiromichi Sato, Tetsuaki Kamada
High elasticity of the forearm flexor-pronator muscles likely affected the occurrence of medial elbow injuries. Brogdon et al. [30] have reported that traction force by the forearm flexor-pronator muscles also causes medial epicondylar fragmentation, not only by the UCL. In a study of isolated frog muscles, Murayama et al. [31] found a linear relationship between muscle elasticity and muscle tension. In a growth period, the medial epicondyle apophysis is the weakest structure on the medial side of the elbow and thus vulnerable to injury by repetitive stress [3]. As a consequence, high elasticities of the FCU and PT increase the sum of stresses on the medial epicondyle of the humerus by repetitive throwing motions and may have caused medial epicondylar fragmentation. However, youth baseball players with elbow pain had high elasticity of the FCU than those without elbow pain, which is probably defense reaction. Previous studies have shown that high muscle elasticity reduces joint flexibility [32,33]. Moreover, Ando and Suzuki [34] reported that high muscle elasticity contributes to rapid force generation. In an anatomical study, Davidson et al. [35] reported that the FCU overlies the UCL and is in an optimal position to act against elbow valgus force. Thus, the high elasticity of the FCU may reduce the flexibility of the elbow joint and allow the generation of rapid muscle force against elbow valgus when applying elbow valgus load, resulting in protection of the medial epicondyle of the humerus. Because continuous stretching of the muscle reduces muscle elasticity [33,36,37], stretching of the FCU and PT may prevent medial elbow injuries in healthy youth baseball players. In contrast, in youth baseball players with medial elbow injuries, stretching of the FCU may increase the stress on the medial epicondyle of the humerus. It may be important to remove factors that increase the elbow valgus load leading to high elasticity of the FCU. However, further studies are required to determine whether the high elasticity of the forearm flexor-pronator muscles causes elbow injuries or protects against elbow valgus stress.