Field of vision: outline. There are three plump muscle groups in front of the elbow, the upper part is the distal end of the brachial muscle and biceps brachii, the lower part is the forearm flexor muscle group, the outer part is the forearm extensor muscle group, and there are elbow stripes in the middle; Behind the elbow is the distal end of triceps brachii and its attached olecranon, and its two sides are concave, namely radial fossa and ulnar fossa.
Deformity. Elbow varus deformity: when the elbow joint is extended normally, the radial deviation of the forearm is about 65438 00 degrees, that is, the carrying angle is valgus when the carrying angle increases, and cubitus varus when the forearm is reduced or the forearm is deviated; Some diseases of elbow joint cause elbow flexion deformity; When the humeral ribs are fractured above the ankle joint or dislocated behind the elbow joint, the olecranon of the ulna is obviously kyphosis.
In mild swelling, only the olecranon lateral fossa of ulna swelled. When swollen severely, the whole elbow becomes thicker, and even the horizontal stripes of the elbow disappear; Diamond swelling is the manifestation of chronic joint inflammation, that is, elbow joint swelling, while upper and lower muscles atrophy. One side swelling is mostly caused by fracture of medial epicondyle or lateral condyle of humerus.
In addition to chronic inflammation of joints, muscle atrophy can also cause extensive muscle atrophy when nerve paralysis occurs.
Palpation: the lateral epicondyle of peptide bone is attached to the extensor forearm, and the tenderness is obvious when lateral epicondylitis (tennis elbow) occurs; The medial epicondyle of humerus is attached by forearm flexors, which can be tender due to inflammation. The olecranon of ulna may be tender or hypertrophy due to fracture or trochlear inflammation; You can touch the radial head at the radial fossa behind the elbow and rotate the forearm at the same time, and you can feel the rotation of the radial head. Examination can be performed at different flexion angles of elbow joint. When a fracture occurs, this fossa is swollen and tender; The coracoid process of ulna is covered by muscle and is not easy to touch. You need to press deeply with your thumb in front of your elbow, which will cause pain when you fracture. The ulnar nerve is located on the ulnar side behind the elbow, which causes numbness in the hand when pressed. When it is abnormal, it may have hypertrophy, tenderness and numbness.
Fracture of humeral lateral condyle, medial epicondyle, cartilage and olecranon, that is, local swelling and tenderness, can touch bone friction and abnormal activity.
Abnormal swelling of elbow joint If there is a sense of fluctuation during palpation, it belongs to hydrops, such as bursitis behind elbow; If it is substantial, it belongs to hypertrophic joint capsule or hyperplastic connective tissue, or myositis ossificans.
Activity: the elbow joint is mainly flexion and extension, and the active joint is mainly in the humeral-ulnar joint. Forearm rotation depends on the interaction between the upper and lower joints of ulna and humerus and the interosseous membrane. Although the brachioradialis joint is involved in flexion, extension and rotation, it is only in a secondary position.
Passive activity. The elbow joint can be extended to 0 degrees, and the flexion is above 150 degrees, that is, the angle between the forearm and the upper arm is 30 degrees, and it is limited if it is less than this range. The neutral position of the forearm is 0 degrees with the thumb up, and in the elbow flexion position of 90 degrees, the supination (80 degrees to 90 degrees) and pronation (about 80 degrees to 90 degrees) can be measured with different angle scales.
There is no lateral displacement of elbow joint in straight position, but the elbow joint with collateral ligament injury will have abnormal lateral displacement.
Active activities mainly check the muscle strength of elbow extension and elbow flexion.