Pulled Elbow

Chest stretch. With your arm outstretched behind you, hold onto the side of a doorway with your hand at shoulder height and with your elbow slightly bent. Lean forward as you step through the doorway with the opposite foot, letting your weight pull your arm straight. Hold for a slow count of 10. Then do the same using the other arm. 

Shoulder stretch. Stand with your feet shoulder-width apart and knees slightly bent. Place your right arm on your left shoulder. Use your left hand to pull your right elbow toward your left shoulder and hold it in a stretched position for a slow count of 10. Change arms and repeat the exercise. 

Ifmesser will pardon... The big torturer pulled my arms behind me and knotted the rope around my wrists and forearms, hauling my elbows together. The torture known as the cord, or strappado, is more feared than the rack. A man who denies his crime on the cord cannot be hanged for it afterwards. Since he will no longer have any use of his arms, that is a doubtful blessing, and one that cannot be earned very often. 

The past medical history was significant for a dislocated left elbow at 6 months of age that resolved spontaneously, left femur fracture at 16 months of age that occurred while she was trying to pull up to stand, and chronic sinusitis due to an underdeveloped ethmoidal-sphenoid sinus (air-filled cavity in the skull behind the bridge of the nose). Her psychosocial development appeared normal. She was able to crawl and scoot but could not cruise yet. 

You continue turning until your left hand can, by reaching behind you, grip his right arm just above his elbow. Then by pulling his elbow up and toward you he will be thrown. 

The elbow joint is a comparatively weak part of the body and a forceful blow can dislocate it. Grasp your opponent s wrist or forearm and pull it behind him, stiffening his whole arm (fig. 29). As... 

Of course, if the idea is to capture the victim alive, be a little gentler. As you pull the garotte, bend down on your knees, dragging him down on his rear. Be sure your knees are completely bent, to protect yourself from back elbow strikes. Y our balance is better if you sit on the heel of one foot and keep the other foot flat. 

The sleeper hold is a way to garotte without a garotte. Place one wrist on your opponent s throat, one on the back of his neck. Lock your hands on your elbows and squeeze. Pull him down in the basic garotte style. 

To obtain reliable measures of skinfold thickness, procedures are carefully defined. For example, in the triceps measurement, a fold of skin in the posterior aspect of the nondominant arm midway between shoulder and elbow is grasped gently and pulled away from the underlying muscle. The skinfold thickness reading is taken at a precise time, 2 to 3 seconds after applying the caliper, because the caliper compresses the skin. Even when these procedures are performed by trained dieticians, reliable measurements are difficult to obtain. 

The ServoPro, an exclusive feature of the Utah Arm, is designed for amputees with shoulder disarticulation, interscapulothoracic, or brachial plexus injuries. The ServoPro eliminates the electrodes normally required to operate the Utah Arm. The system may be the only option, which can provide functional control of both elbow and hand. The ServoPro is based on a harness, but instead of cables, electronic components are pushed and pulled to generate command signals that will control the electrically powered prosthesis. The ServoPro requires much smaller excursion of movement and less effort compared with body-powered cables in equivalent mechanical systems. The servo control is accurate and it uses feedback from sensors in the elbow and hand. 

A backhoe is essentially a mechanical arm that is under the control of an operator. To control this mechanical arm the operator uses both aims, both feet, both eyes, and all his or her concentration (Fig. 32.1). The driver uses both arms to pull levers, both feet to press pedals to operate the arm, and both eyes to monitor the task being performed by the digger—all this to control a single mechanical arm. Now consider a person with amputations of both arms above the elbow and one begins to have some appreciation of the task such a limbless person faces in controlling an artificial (prosthetic) arm or arms. 

For the cervical spine C7/T1 is often visualised on the initial film however, if not, traction to the arms will improve visualisation. This needs to be applied by an experienced medical practitioner who holds the child above their elbows and gently pulls the arms towards the child s feet. Older children can be asked to stretch down to their toes to allow the cervical/thoracic junction to be demonstrated. The AP cervical spine positioning and resultant radiographs are shown in figures 2.30 and 2.31. 

A number of equivalent lesions have also been described. Commonest of these is the Type 1 variant Where the radial head is dislocated anteriorly but the ulna has plastic deformation rather than a fracture. Other variants include dislocations with associated radial neck fractures, olecranon fractures and dislocations of the ulnar-humeral joint. In some respects, the pulled elbow , commonly seen in infants, can also be considered a Bado I equivalent. The injury occurs when the elbow has traction applied, usually resulting in hyperextension and pronation. The radial head subluxes through the annular ligament but does not truly dislocate and radiographs are either normal or will show an effusion with elevation of the fat pads. 

Pulled elbow does not require manipulation under anaesthesia. The forearm is flexed and supi-nated. Often this results in a gratifying pop and the child resumes normal activity. If this manoeuvre is unsuccessful, simply resting the arm in a sling will allow swelling in the annular ligament to subside and the radial head will reduce within 2-3 days. 

In a flexed elbow, a direct blow to the posterior aspect of the ulna, just anterior to the distal humerus, can cause a shear stress on the olecranon metaphysis, breaching the anterior cortex and with the radius and distal ulnar fragment displaced anteriorly by the pull of the brachialis and biceps. This may occur with the elbow either flexed or extended, leading to either a transverse or oblique fracture pattern (Table 18.2). 

Tricep stretch Raise one arm straight up, so your upper arm is near your ear. Bend your arm at the elbow and let your hand fall to the back of your neck. With the other arm, reach behind your head and place your hand on top of the bent elbow. Gently pull down and back on the elbow. Repeat with other arm. 

Underflow Dams, While mechanical boom, pneumatic barriers, and water jet systems may be adapted to almost any size of waterway, a number of simple confinement methods, such as the underflow dam, are best suited to smaller waterways. As shown in Figure 13.3, an underflow dam uses a series of pipes extending through an earthen harrier to confine a floating spill. The pipes allow water to pass through the barrier, and when the pipes are positioned with the upstream end lower than the downstream end, the water level is raised above the intake of the pipes and the floating spill is retained. In order to control the flow of water, a sufficient number of pipes must be installed in the dam. The width, depth, and speed of the water can be used to calculate the flow rate and thus determine the number of pipes that need to be used. The use of elbows on the upstream end of the pipes will help prevent the formation of a vortex that can sometimes occur, pulling surface material down... 

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