HWE 330 Ashworth College Week 4 Structures of The Shoulder Learning Activity

Question Description

Lippert, L. S. (2017). Clinical kinesiology and anatomy (6th ed.). Retrieved from https://redshelf.com

Chapter 11: Elbow Joint
Chapter 12: Wrist Joint
Chapter 13: Hand

MULTIMEDIA

Sechrest, R. [Randale Sechrest]. (2012, October 14). Hand anatomy animated tutorial [Video file]. Retrieved from

This video will provide further insight into the structure and function of the hand and will assist you with your Poster Design: Elbow, Wrist, and Hand assignment this week. This video has closed captioning and a transcript.
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WEB PAGES

Elbow injuries and disorders. (2019). Retrieved from http://www.nlm.nih.gov/medlineplus/elbowinjuriesan…

This web page provides helpful information on elbow injuries and disorders and will assist you with your Pathologies of the Elbow, Wrist, and Hand discussion forum this week.
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Hand injuries and disorders. (2019). Retrieved from http://www.nlm.nih.gov/medlineplus/handinjuriesand…

This web page provides helpful information on hand injuries and disorders and will assist you with your Pathologies of the Elbow, Wrist, and Hand discussion forum this week.
Accessibility Statement
Privacy Policy

Wrist injuries and disorders. (2019). Retrieved from http://www.nlm.nih.gov/medlineplus/wristinjuriesan…

This web page provides helpful information on wrist injuries and disorders and will assist you with your Pathologies of the Elbow, Wrist, and Hand discussion forum this week.
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This weeks work will focus on the elbow, wrist, and hand. In the discussion forum, you will consider pathologies of the elbow, wrist and hand. You will choose one of the case studies presented, assess the cause of the pathology, locate and evaluate a video related to the pathology, which will also be shared with your peers in the discussion forum, and analyze how the change in the structure will impact function as well as activities of daily living. Think about the following potential impacts of your chosen pathology on your case study: brushing teeth, using the bathroom, driving a car or bicycle, typing on a keyboard, job-related impacts, cutting veggies, opening cans or other items, etcetera. Again, many examples exist so think about common activities you perform daily and evaluate whether your patient could perform these, given his/her pathology.

The learning activity will focus on these structures to reinforce this weeks concepts, based on your assigned readings. Last, you have the Poster Design assignment in which you will design three posters. One will address the elbow, one will address the wrist, and one will address the hand. Additional details can be found below for further clarification on options for completing this assignment. Be creative and have fun with this! Here is our Week 4

Review of last week’s concepts:

Last week, you learned about the shoulder structures and how it functions. You also learned about the different dysfunctions that can occur with the shoulder girdle and joint. Your discussions included dysfunctions of the shoulder girdles and the shoulder joint. From last weeks guidance, you learned about rotator cuff tears, shoulder dislocations, frozen shoulder syndrome, and referred pain patterns. Here are several videos that review some of these topics.

Guidance for this week’s concepts:

The elbow, wrist and hand each contain multiple joints. Each of those joints must be considered in a physical exam in order to learn which joint(s) is/are the cause of the problem. The elbow is made up of three bones: the distal end of the humerus and the proximal ends of the radius and ulna. The combination of these three bones allow for movement in several ways. First is the normal flexion and extension. The structure of the joints at the elbow also allow for pronation and supination of the forearm. Structurally, the stability occurs in the humero-ulnar joint due to the trochlear notch on the ulna and trochlea on the humerus. These structures limit the amount of extension in the elbow. The humero-radial joint allows for supination and pronation. The head of the radius is circular which allows for the turning movement needed. In addition to the bony structures and muscles of the elbow, there are a number of ligaments that keep the structures in place. As a reminder, please be sure to know the different landmarks of the body (Lippert, 2017).

The wrist and hand are made up of 27 bones total. There are eight carpal bones, five metacarpals, and 14 phalanges. There are numerous ligaments connecting the bones in the wrist and an aponeurosis that spans the palm of the hand. Ligaments function to keep the bones together, support proper movement, and limit movements outside the normal range of motion. The aponeurosis protects the fragile structures in the hand from damage; consider how the hands are used and often battered. We use our hands for everything, including a hammer sometimes when we desperately need one but cant find it. The aponeurosis protects the fragile, small bones, blood supply, muscles, and nerves from the myriad of activities we do with our hands every day.

As with the other joints we have studied or will study in the upper and lower extremities, the region of body can be injured either from a traumatic event or from overuse. Sports that involve contact with others contribute to the traumatic injuries. Sports where you repeat the same motion contribute to overuse injuries. Some common traumatic injuries in athletes include joint dislocations, sprains, muscle strains, broken bones, tendon inflammation, and ligament tears.Overuse injuries are stress-induced and include tendon inflammation and dislocation, nerve injury, and overuse stress fractures (The American Orthopaedic Society for Sports Medicine, 2016, p. 1).

We will begin studying common elbow pathologies with Lateral Epicondylitis. Lateral epicondylitis, also known as tennis elbow, is a very common overuse condition that affects the common extensor tendon where it inserts into the lateral epicondyle of the humerusit is common in racquet sports and other repetitive wrist extension activities (Lippert, 2017, p. 175). This is an overuse injury. A common presentation seen in many healthcare providers practices is that a patient started a home remodel project that involved scraping for long periods of time. If the person does not normally do that motion, they begin doing work with weak muscles in this region and are more prone to injury.

What is tennis elbow? (2011). Retrieved from http://digital.films.com.proxy-library.ashford.edu…

When the medial side of the elbow is injured, this is called Medial Epicondylitis. Medial epicondylitis, also known as golfers elbow, is an inflammation of the common flexor tendon that inserts into the medial epicondyle.it is an overuse condition that results in tenderness over the medial epicondyle and pain on resisted wrist flexion (Lippert, 2017, p. 175). This injury occurs due to the repetitive actions of swinging a golf club, but it can be due to other activities as well, such as painting, raking, hammering, chopping wood, using a computer, doing assembly-line work, and cooking.The activity generally needs to be done for more than an hour a day [over] many days to cause a problem (Mayo Clinic, 2019, para. 7).

Elbow injuries can also occur in a child. Nursemaids elbow is seen in young children under the age of five years who have experienced a sudden strong traction force on the arm.This force causes the radial head to sublux out from under the annular ligament (Lippert, 2017, p. 176). Usually, this is seen when a parent grabs a young child by the forearm as the child runs off or when the parent picks the child up by the one hand and lifts the child off the ground. The childs weight is more than the elbow can support.

Next, we will consider carpal tunnel syndrome, which can be caused by either an injury or by overuse. The median nerve travels between bones and ligaments of the wrist. When the bones are out of alignment, or the surrounding tissues have inflammation, pressure can build up on the nerve. This causes pain, weakness, and difficulties moving the wrist or using it for long periods. Further, chronic diseases, such as Rheumatoid Arthritis and Diabetes can cause carpal tunnel syndrome (National Institute of Neurological Disorders and Stroke, 2019).

Carpal tunnel syndrome. (2007). Retrieved from: http://digital.films.com.proxy-library.ashford.edu…

Your poster design assignment this week addresses the elbow, wrist and hand. This means, you will prepare three posters. You can create this work in a Word document, PowerPoint, in a Publisher document that is saved as a PDF prior to submission, or one of the technology options listed in the directions. The posters need to be informative as to the structures in the region, function, and anatomical relationships.

Please note: if you use images from Microsoft Word Clip Art, NO CITING IS NECESSARY. APA statement regarding Microsoft Word Clip Art: Normally the source of a figure must be included in the reference list, but reference entries are not necessary for standard software and programming languages, such as Microsoft Word or Excel (APA Publication Manual, 6th ed., 7.08, p. 210).

For other images, APA Style treats all graphic images as figures, which require captions. If you did not create the figure, its creator must be acknowledged in the caption, along with its copyright status and permission status (if permission is necessary). See p. 38 of the APA Publication Manual for guidelines on formatting the note in the caption. Images should be cited in APA format directly under the image, like this:

Figure number. Description. Author/creator (Role of Author/Creator). (Year image was created). Title of work [Type of work]. Retrieved from: URL (address of website).

An example of this from our Week 3 guidance is

Week 3 Guidance Arm Image.gif

Figure 1. Structures of the shoulder [image]. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Retrieved from: http://www.niams.nih.gov/Health_Info/Sports_Injuri…

Additional resources:

Elbow Conditions

Cubital Tunnel Syndrome (American Society for Surgery of the Hand)
Elbow (Olecranon) Bursitis (American Academy of Orthopaedic Surgeons) – PDF
Elbow Fractures (American Society for Surgery of the Hand)
Golfer’s Elbow (Mayo Foundation for Medical Education and Research)
Osteochondritis Dissecans (OCD)(American Academy of Family Physicians)
Repetitive Motion Disorders (National Institute of Neurological Disorders and Stroke) – Short Summary
Tennis Elbow (Mayo Foundation for Medical Education and Research)
Tennis Elbow (Lateral Epicondylitis)(American Academy of Orthopaedic Surgeons) – PDF
Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome) (American Academy of Orthopaedic Surgeons) – PDF

Wrist Conditions

Arthritis of the Wrist (American Academy of Orthopaedic Surgeons) – PDF
De Quervain’s Tendinitis (De Quervain’s Tendinosis) (American Association for Hand Surgery, American Academy of Orthopaedic Surgeons) – PDF
De Quervain’s Tenosynovitis (Mayo Foundation for Medical Education and Research
Distal Radius Fracture (Broken Wrist)(American Academy of Orthopaedic Surgeons) – PDF
Golf Injuries to the Hand, Wrist, or Elbow (American Society for Surgery of the Hand)
Scaphoid Fracture of the Wrist(American Academy of Orthopaedic Surgeons) – PDF
Scaphoid Non-Union (American Society for Surgery of the Hand)
Wrist Fractures (American Society for Surgery of the Hand)

Hand Conditions

Animal Bites of the Hand (American Society for Surgery of the Hand)
Arthritis of the Hand (American Society for Surgery of the Hand, American Academy of Orthopaedic Surgeons) – PDF
Arthritis of the hand – Rheumatoid(American Society for Surgery of the Hand)
Dupuytren’s Contracture (American Society for Surgery of the Hand)
Ganglion Cysts (American Society for Surgery of the Hand) – PDF
Hand Fractures (American Society for Surgery of the Hand)
Hand Infections (American Society for Surgery of the Hand)
Osteoarthritis of the Hand (American Society for Surgery of the Hand)
Psoriatic Arthritis of the Hand (American Society for Surgery of the Hand)

References

The American Orthopaedic Society for Sports Medicine (2016). Hand and wrist injuries.Retrieved from https://www.sportsmed.org/aossmimis/STOP/Downloads…

Lippert, L. S. (2017). Clinical kinesiology and anatomy (6th ed.). Philadelphia, PA: F.A. Davis Company.

Mayo Clinic. (2019). Golfers elbow: causes. Retrieved from http://www.mayoclinic.org/diseases-conditions/golf…

National Institute of Arthritis and Musculoskeletal and Skin Diseases [shoulder image] (2019). Handout on health: Sports injuries. Retrieved from http://www.niams.nih.gov/Health_Info/Sports_Injuri…

National Institute of Neurological Disorders and Stroke. (2019). Carpal tunnel fact sheet. Retrieved from