Hot Tip Ultrasound Demonstration of Ulnar Nerve Dislocation Snapping Triceps Syndrome
Hi, my name is Jon Jacobson, and I will be demonstrating Ultrasound of the Cubital Tunnel. So to begin, I have the elbow extended. I'm using two palpable landmarks for orientation the medial epicondyle of the humerus, and the olecranon process. If you connect these two lines with the transducer, this will give you an axial plane of the cubital tunnel region and the ulnar nerve. If you look on the ultrasound image, you can identify the medial epicondyle bone contour and its apex. Directly behind that, you will see the hypo echoic ulnar nerve.
More posterior, you can identify the bone landmark of the olecranon process. Now, this area is not the cubital tunnel itself, but just proximal to it. If you move the transducer distally, you will find you will lose the bone landmarks and then we will see the ulnar nerve between the two heads of the flexor carpi ulnaris and under the arcuate ligament. Therefore, this is the true cubital tunnel. Backing up to the medial epicondyle, this is an ideal starting point given the bone landmarks. Its important not to scan with.
The elbow flexed at this point because what will happen is the triceps will be moved into view and therefore diagnosis of an Anconeus epitrochlearis will not be possible. However, with the elbow completely extended there should be nothing in the space between the medial epicondyle and the olecranon process other than the ulnar nerve. So we will look at the nerve proximally and distally in short axis, or enlargement, as it goes into the cubital tunnel. We can also look at the ulnar nerve in long axis, as shown here. Often this is.
Difficult as the nerve is not always in one single imaging plane. Lastly, we will look dynamically at the cubital tunnel region. We will again identify the medial epicondyle apex for bone landmark as shown here. I will then passively flex the patient, his elbow, and the key is to keep this bone landmark in view. If I lose the bone landmark, I stop moving my patient and I change my position of the transducer to get the bone landmark back in place, then I will continue movement. And I will do this passively back and forth.
Tennis Elbow Golfers Elbow Pain Stretches Ask Doctor Jo
Playing on guitar Oh man, my elbow hurts. Hey everybody, it's Dr. Jo! And today we are going to talk about elbow injuries. So I'm going to go through some stretches to show you how to get that elbow feeling better. You might have heard of tennis elbow or golfer's elbow. So we'll go through a set of those, and hopefully get you feeling better soon. What I'm going to show you now, is some stretches for medial or lateral epicondylitis. Say what! Most of you have been diagnosed as probably tennis elbow or golfer's elbow. And basically.
What that is, is a tennis elbow is when you have pain on the outside of your elbow. These muscles coming through here. Those are your extensor muscles, and then your golfer's elbow is going to be on medial side, and that's the inside. Those are your flexor muscles, then ones that pull it in. So what I'm going to have you do is you're just going to start off with your arm out. You want to go gently first, so to stretch out your outer muscles, those wrist extensors, you're going to pull your arm down. Now this is a stretch so you're.
Going to hold it for 30 seconds, do it 3 times each. Now you can alternate if they are both kind of hurting a little bit. You can go back up this way. Now that's going to stretch out those underneath muscles, those flexor muscles. So same thing, 3 times for 30 seconds. Now if that feels pretty good, and that's not getting quite the stretch you want, then you can use your other hand for some overpressure. So what you're gonna do is bring your other hand across, go down, stretch out those extensor muscles. Pull that hand all the way down,.
You can see how far down that goes. Now if it's hurting, you're probably not going to be able to go that far right away. You're still going to hold it for 30 seconds, do it 3 times, and for those inner flexor muscles, you're going to go out. You're going to hold that there for 30 seconds. Now you can also do this against a wall if you want to. If that's a little hard for you to pull, you can put your hands up against a wall and put.
Hot Tips Ultrasound Evaluation of the Median Nerve
Hi, I'm Theresa Jorgensen and today's Gulfcoast Hot Tip will teach you how to more confidently locate and follow the median nerve into the carpal tunnel. At the level of the wrist, telling the difference between the median nerve and nearby tendons, can be very difficult. Can you tell which is which If you're not feeling confident that what you're looking at is the nerve, there are a few things you can do. First, try beginning more proximal. Place the transducer in transverse orientation, right down, smack down, in the middle of the forearm.
Approximately five centimeters proximal to the flexoret macculum, the median nerve will be its brightest as it courses around the lateral edge of the flexor digitorum profundus. Try this on yourself, and then try it on your friends. I promise it will work. Hello! Straight down. Mid forearm. Can you see it Next. Straight in the middle. Smack in the middle. Absolutely gorgeous. Well maybe not this one. In the midforearm, if you don't see the nerve right away, try changing the angle of the transducer's beam by wagging the tail of the transducer slightly.
You'll see a dramatic change in the echogenicity as you adjust that angel of insonation. Now that your eye is adjusted to that structure, and you truly are confident it is the nerve, start following it distally, by sliding the transducer lower and lower towards the wrist. Remember, as you approach the wrist, as those other tendons come into view, if you get confused, between the tendons, muscles, and nerves, once again, wagging the tail of the transducer, will demonstrate that the tendons and muscles are more affected by anisotropy, than the nerves.
David Kawamura, MD, a hand surgeon with The Everett Clinic talks about nerve compression.
There are a couple of different nerve compressions in the upper extremity. The most common one, the most widely known one is carpal tunnel syndrome, but there's a second nerve in the arm that can be compressed at the elbow that's called the ulnar nerve. The ulnar nerve generally can get compressed behind a little bony prominence at the elbow. It can cause symptoms in the hand frequently numbness and tingling in particular involving the pinky finger. Numbness and tingling involving the remainder the hand, like the thumb and the index finger, that's more typical carpal tunnel syndrome. But if you have numbness and tingling.
On the pinky side of the hand that's more typical of cubital tunnel or ulnar nerve compression at the elbow. That's a treatable condition, often treated with surgery, if conservative, nonoperative, treatments don't work. Patients, prior to surgery, will have significant numbness and tingling. It's bothersome. If it's significant they can also have potentially permanent loss of sensation. So trying to avoid longterm problems like that would be a benefit of the surgery. In general results are very good. Most patients are very pleased. Depending on how long standing their symptoms are.
Eliminate Cellulite Block Therapy for the Legs
The next position we're placing the block is the iliotibial band on the outside of the leg. This is one of my favourite positions because there's so much pain here for people. The iliotibial band is a thick band of fascia that goes from the knee all the way up to the hip joint. So we really want to work the block the entire length of that band. But we're going to start higher up because there is less pain at the top as we approach closer to the knee, it becomes a little more painful. And also notice where your elbow is in relation.
To your shoulder. If the elbow is too far away, you're going to create tension in through the shoulder and the neck which can cause you pain. For some people you might want to prop yourself up with pillows through here so that you have a little bit of cushioning. And again, if this is too painful for you here, do it on a mattress so that you have a bit less intensity to begin with, with the goal of moving onto the flatter surface. Now this is a fantastic area to work with the block because of this thick band of fascia,.
Martial Arts Warrior Training Martial Arts Warrior Training Right Leg Kick
In this clip for warrior training, we are going to talk about the right leg kick. The leg kick, the target is the sciatic nerve of the outside of the thigh which is called the vastius lateralis. We're using the tibia which is the hardest bone of the lower leg. So from my fighting position, my opponent is going to bring the pad against his thigh, I'm going to target an area on the pad and I'm going to kick it. I wait three seconds, one, two, three, one, two, three. The beauty behind the leg kick is that you can launch.
Shoulder Arthritis Symptoms and Treatment QA
My name is Uma Srikumaran. I'm an orthopedic surgeon with Johns Hopkins and Howard County General Hospital. I specialize in shoulder surgery. Shoulder arthritis refers to degeneration of the lining of the joint. The lining of the joint is made of smooth cartilage that can wear out over time or can be diseased by inflammatory conditions such as rheumatoid arthritis or from a traumatic condition or posttraumatic arthritis after a shoulder dislocation. The typical wear and tear arthritis is called osteoarthritis. Pain is the most common symptom of shoulder arthritis. Pain can occur throughout the.
Day and worsen with certain activities. ing and catching may also be noticed coming from the shoulder. As arthritis progresses the pain and stiffness will progress as well. Nonsurgical treatment for shoulder arthritis includes simple measures such as rest and activity modifications or avoiding activities that are painful for your shoulder. Nonsteroidal antiinflammatory medications can also be beneficial for pain relief. Other options include icing, physical therapy and cortisone injections that may also provide symptomatic relief. When nonsurgical treatments fail to provide pain relief over a period of time or the pain becomes unbearable, surgical shoulder replacement surgery is an option.
The goals of shoulder replacement surgery are pain relief as well as improved function so you may resume everyday activities. The surgery is performed under general anesthesia often with a nerve block and involves an open incision in front of your shoulder. The arthritic bone is carefully removed along with scar tissue and a metal prosthesis and a plastic component are inserted to recreate the ball and socket joint of the shoulder. Recovery after shoulder replacement surgery involves a one to two day hospital admission. After this, an outpatient physical therapy program is performed.
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