Deck 22: Orthopedic Management of the Elbow

Question 1

When can an athlete anticipate returning to an interval sports program following surgery for a lateral collateral ligament injury?

A) 2 months
B) 4 months
C) 6 months
D) 8 months or longer

Answer 1

4 months

Question 2

What complication of distal humerus fracture results from arterial and venous obstruction that might not be noticed until the end of immobilization?

A) Comminuted fracture with deformity
B) Malunion
C) Nonunion
D) Volkmann ischemic contracture

Answer 2

Volkmann ischemic contracture

Question 3

What recommendations should a PTA make to a patient experiencing medial valgus stress overload?

A) Return to normal sports activities as soon as the pain and swelling are gone
B) Rest and protect the injured elbow by omitting the activities that produce medial valgus stress
C) Exercise the wrist,hand,and shoulder of the affected arm regularly
D) B and C

Answer 3

B and C

Question 4

Which fracture of the elbow may be commonly seen in someone who fell on an outstretched arm?

A) Radial head
B) T or Y
C) Distal humerus
D) Shoulder

Question 5

For how many weeks is an isolated posterior elbow dislocation placed in a splint?

A) 2-4
B) 3-6
C) 4-8
D) 6-10

Question 6

Which of the following is NOT a symptom indicating vascular obstruction?

A) Severe pain in the forearm muscles
B) Limited and extremely painful finger movement
C) Purple discoloration of the hand with prominent veins
D) Loss of the radial pulse and loss of capillary return
E) Complaints of pain in the shoulder

Question 7

How many weeks is a distal humerus fracture typically immobilized?

A) 2
B) 4-6
C) 10
D) 12 or more

Question 8

Which of the following injuries occurs from repetitive overuse and affects the common wrist extensor origin of the extensor carpi radialis longus and brevis,and extensor digitorum and digiti minimi?

A) Lateral epicondylitis
B) Medial epicondylitis
C) Medial valgus stress overload
D) Fracture of the distal humerus

Question 9

When does nonoperative rehabilitation for a lateral collateral ligament injury begin?

A) Immediately
B) 2-5 weeks after injury
C) 4-8 weeks after injury
D) 12 weeks after injury

Question 10

In the initial healing stage,what actions does the physical therapist assistant (PTA)take to promote healing in lateral epicondylitis?

A) Encourage the patient to use the elbow and wrist normally
B) Make short-term modifications in activities of daily living (ADL)and job-related activities
C) Encourage exercises such as holding a hammer at the end of the shaft to promote greater control,strength,and torque
D) Encourage the patient to work through the pain to promote healing

Question 11

Following surgical repair for a lateral collateral ligament injury,after how many weeks can full passive range of motion (PROM)be expected?

A) 2-4
B) 4-6
C) 6-8
D) 8-10

Question 12

How can the PTA enhance the effectiveness of low-load,long-duration static stretching?

A) Premedicate the patient with nonsteroidal antiinflammatory drugs (NSAIDs)before to treatment
B) Use moist heat or ultrasound
C) Use prestretching exercises that are pain-free
D) None of the above

Question 13

Why is early protection needed following the diagnosis of lateral epicondylitis?

A) The patient is in a high degree of pain and movement worsens the pain
B) The elbow is inflamed and movement will cause more inflammation
C) Excessive tissue scarring and random collagen fiber alignment would limit normal motion and function of the elbow and wrist
D) Active and passive range of motion (ROM)exercises for the elbow and wrist are needed from the splinted position

Question 14

An 18-year-old patient comes to therapy complaining of painful finger movement and numbness in her forearm and hand.What would you do first?

A) Notify the physical therapist (PT).
B) Explain that this is a normal side effect of having a cast on the arm.
C) Elevate the extremity and perform gentle ROM exercise on the affected hand.
D) Continue with the prescribed therapy.

Question 15

What is the normal degree of flexion for the elbow?

A) 20-100
B) 0-145
C) 75-85
D) 30-130

Question 16

Which of the following injuries are you more likely to see in a baseball pitcher versus a golfer?

A) Lateral epicondylitis
B) Medial epicondylitis
C) Medial valgus stress overload
D) Lateral collateral ligament injury

Question 17

Which of the following measures are taken to regain full elbow extension in patients having difficulty achieving full extension?

A) Flexion/extension ROM exercises more frequently during therapy
B) Pretherapy treatment with phonophoresis and active range of motion (AROM)exercises for the affected elbow
C) Low-load,long-duration stretches
D) None of the above

Question 18

What does the counterforce brace do for the patient with lateral epicondylitis?

A) Provides support to the upper arm when performing routine activities
B) Dissipates the overload forces on the origin of the wrist extensors
C) Provides a reminder to the patient to perform activities and sports carefully to prevent further injury to the wrist extensors
D) Supports the forearm during sports activities

Question 19

Which of the following injuries occurs from overuse and affects the origin of the pronator teres,flexor carpi radialis,and the flexor carpi ulnaris?

A) Lateral epicondylitis
B) Medial epicondylitis
C) Medial valgus stress overload
D) Carpal tunnel syndrome

Question 20

What does the PTA do in the case of a patient in the acute phase of the inflammatory overuse condition known as medial epicondylitis?

A) Protect the elbow from further injury with a cast for immobilization and provide isometric exercises
B) Focus on ice to protect the ulnar nerve,phonophoresis,and relative active rest
C) Provide resistance training with submaximal isometrics
D) Instruct the client to actively use the shoulders and follow a conditioning program