Flex Therapist CEUs

Elbow Injuries Worker's Compensation General Guidelines

Work-Related Ulnar Neuropathy at the Elbow (UNE)

1. Ulnar nerve entrapment occurs most commonly at the elbow due to mechanical forces that produce traction or ischemia to the ulnar nerve.

A. True B. False

2. Establishing work-relatedness requires with of the following?

A. Exposure: Workplace activities that contribute to or cause UNE. B. Outcome: A diagnosis of UNE that meets the diagnostic criteria under Section III. C. Relationship: Generally accepted scientific evidence, which establishes on a more probable than not basis (greater than 50%) that the workplace activities (exposure) in an individual case contributed to the development or worsening of the condition (outcome). D. All of the above.

3. All of the following work-related activities have been associated with UNE, except for:

A. Repetitive or sudden elbow flexion or extension. B. Handling of loads greater than 1kg. C. Intensive use of hand tools. D. Repeated trauma or pressure to the elbow.

4. Which of the following is the primary symptom associated with UNE?

A. Diminished sensation or abnormal unpleasant sensation (dysesthesias) in the ring and small fingers (4th or 5th digits), often coupled with pain in the proximal medial aspect of the elbow. B. Weakness of intrinsic hand muscles demonstrated with Froment's sign. C. Pain or aching over the proximal, lateral forearm. D. Difficult extending the thumb, fingers, or wrist.

5. Parameters for accurate nerve conduction velocity testing include moderate flexion of the elbow (50 - 70 degrees) and a consistent and documented distance across the elbow.

A. True B. False

6. To exclude the presence of polyneuropathy as a cause of the abnormalities, evaluation of another motor nerve must be normal.

A. True B. False

7. Control for skin temperature should be documented, as temperatures lower than 30 degrees Celsius will be associated with falsely accelerated nerve conduction velocity results.

A. True B. False

8. The goal of conservative treatment is which of the following?

A. Reduce the frequency of symptoms. B. Reduce the severity of symptoms. C. Prevent further progression of the condition. D. All of the above.

Work-Related Radial Nerve Entrapment

9. Radial tunnel syndrome and posterior interosseous nerve syndrome occur at all of the following sites, except for:

A. Fibrous bands of the radiocapitellar joint. B. Radial recurrent vessels. C. Flexor-pronator aponeurosis. D. Tendinous edge of the extensor carpi radialis brevis.

10. Symptoms associated with radial nerve entrapment include all of the following, except:

A. Weakness in radial innervated muscles. B. Aching over the distal, lateral forearm. C. Increase in pain severity with an increase in activity or during sleep. D. Loss of motor function with posterior interosseous nerve syndrome.

11. Conservative treatment for radial nerve entrapment include:

A. Modification of activities that exacerbate symptoms. B. Splinting to maintain forearm supination and/or wrist extension. C. Physical therapy. D. All of the above.

Work-Related Proximal Median Nerve Entrapment (PMNE)

12. Which of the following is the primary symptom associated with proximal median nerve entrapment?

A. Pain in the proximal volar area of the forearm. B. An increase in pain severity with an increase in activity. C. Weakness in the forearm and the hand. D. Paresthesia or numbness in the first three digits.

13. Surgical treatment for PMNE should include exploration of the median nerve throughout its proximal course and release all compressive structures which may include:

A. ligament of Struthers (if present) B. lacertus fibrosis C. fascia of pronator teres D. fascia of flexor digitorum superficialis E. All of the above

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