Arm , Elbow , Wrist

Question 1

Elbow Flexion

Answer 1

70

Question 2

Elbow extension

Answer 2

0-5

Question 3

Pronation

Answer 3

80-90

Question 4

Supination

Answer 4

90

Question 5

Elbow flexor

Answer 5

Biceps brachii
Brachialis
Brachioradialis
Flexor carpi radialis ( assist) ulnaris ( assist)
Palmaris longus (assist)
Pronator teres ( assist)
Extensor carpi radialis longus , brevis ( assist)

Question 6

Elbow extensor

Answer 6

Tricep brachii (all heads)
Anconeus

Question 7

Forearm supinator

Answer 7

Biceps brachii
Supinator
Brachioradialis ( assist)

Question 8

Forearm pronator

Answer 8

Pronator teres
Pronator qaudratus
Brachioradialis ( assist)

Question 9

Wrist flexion

Answer 9

75-90

Question 10

Wrist extension

Answer 10

70-90

Question 11

Abduction ( radial flexion )

Answer 11

15-25

Question 12

Adduction( ulnar flexion)

Answer 12

20-35

Question 13

Extension of the wrist

Answer 13

Extensor carpi radialis longus , Brevis 
Extensor carpi ulnaris 
Ext digitorum ( assist) indicis( assist)

Question 14

Flexion of the wrist

Answer 14

Flexor carpi radialis, ulnaris
Palmaris longus
Flexor digitorum superficialis , profundus (assist)
Flexor pollicis longus

Question 15

Abduction of he wrist ( radial deviation)

Answer 15

Extensor carpi radialis longus, brevis
Extensor pollicis longus, brevis
Flexor carpi radialis
Abductor pollicis longus

Question 16

Adduction ( ulnar deviation)

Answer 16

Extensor carpi ulnaris ,

Flexor carpi ulnaris

Question 17

Flexion of the thumb

Answer 17

Flexor pollicis longus, brevis 
Adductor pollicis ( assist) 
Palmar interossei

Question 18

Extension of the thumb

Answer 18

Extensor pollicis longus, brevis 
Abductor pollicis longus 
Palmar interossei(1st assist)

Question 19

Opposition of the thumb

Answer 19

Opponens pollicis
flexor pollicis brevis (assist)
Abductor pollicis brevis( assist)

Question 20

Abduction of the thumb

Answer 20

Abductor pollicis longus, brevis

Question 21

Adduction of thr thumb

Answer 21

Adductor pollicis

Palmar interossei

Question 22

Degree of Dupuytren’s Contracture

Answer 22

Record flexion contractores found in dupuytrens contracture
1: add degree of AF at MCP , Prox ITP and Distal ITP of each affected digit , this will give a total number of degree of flexion deformity for each finger
Stages
0- no flexion deformity , only thickening of palmar fascia and nodules are present
1- 0-45 most occur MCP
2- 45-90 at MCP
3-90-115 including Distal ITP
4- greater than 135 terminal phalanges become Hyperextend , while other are flexed

Question 23

Phalen’s test

Answer 23

P- presence of Carpal tunnel or compression of median nerve
Clt
1: seated
2: instruct client put Back hand Together , wrist flex , elbow held horizontally , shoulder are not elevated
3: ask client to strongly compress the back of hand together 1 minute ( this produce maximum compress within carpal tunnel )
+ = tingling reported in thumb , index finger , middle finger and lateral half of the ring finger is positive for carpal tunnel

Question 24

Reverse Phalen’s

Answer 24

Variation on Phalen

1: put palms of hands together and to strongly compress the palms together for 1 minute

Question 25

Cyriax , variation on Phalens test

Answer 25

Asses for presence of carpal tunel syndrome
1: place hands as Phalens
2: variation , After full 1 minute of bilateral wrist hyperextension
3: instruct clt to sudden add wrist extension
+ = reproduction clt symptom

Question 26

Finger flexion test

Answer 26

Asses presence Trp on Scalene mm group
1: seated
2: instruct clt to hold MCP joint of affected side in ful extension throughout the test
3: instruct clt to flex ITP joint attempting to touch fingertips to palmar surface ( do not let clt make a fist)
+ = four fingertips cannot touch mcp , Trp scalene
Variation Trp in Extensor digitorum will presence full index finger flexion only

Question 27

Finkelstein’s Test

Answer 27

Detemine presence of deQuervain ‘s tenosyvitis
1: seated
2: clt make fist of affected hand
3: thumb firlmly held in flexion inside flexed fingers
4: stabilize the arm proximal to clt wrist with one hand
+ pain along abductor pollicis longus and extensor policis brevis at wrist is positive for tenosynovitis

Because this test can be painful even if tendinitis is not present , perform bilaterally , comoaring affected and unaffected

Variations; clt ulnar deviate wrist , keeping thumb and fingers flexed in a fist as in the first version
+ = pain along tendon sheaths is positive

Question 28

Froment’s Sign

Answer 28

Asses ulnar nerve lesion
1: instruct clt to grasp piece of paper btw extended thumb and index finger
2: try pull paper away from clt
+ positive adductor pollicis weakenss or paralysis will allow ternimal phalax of the client thumb to flex

Question 29

Wrist extension Ligamentous Stress test , PR

Answer 29

Asses: sprain of Palmar wrist ligamentous or strain of wrist flexor mm
1: seated with Affected hand in pronation
2: stabilize clt hand proximal to wrist with one hand
3: place other hand agaisnt clt affected hand so two palm are in opposition
3:Passively mve clt wrist into Extension , apply over pressure at end range
+ pain and hypermobility at joint are positive for sprain of palmar radiocarpal ligament
+ pain along flexor mm or tendon is positive for strain , mm spasm end feel maybe present with subacute strain
+ pain dyesthesia into palm and from wrsit proximally along the flexor surface may indicate cts
+ pain on PR wrsit extension on dorsal surface of the joint mat indicate extensor tenosynovitis

Question 30

Wrist flexion Ligamentous stress Test , PR

Answer 30

Asses sprain of dorsal wrist lig or strain of wrist extensors
1: seated
2: pronate clt affected hand and stabilize proximal to the wrist
3: with other hand , passively flex clt wrist with over pressure at end range
+ pain hypermobility at joint are positivevfor sprain of dorsal radiocapal lig
+ pain extensor on mm or tendon is positive for strain
+ pain with dyesthesis palm wrist proximally along flexor may indicate cts

Question 31

Radial Ligamentous Stress Test , PR

Answer 31

Asses sprain of ulnar collateral ligament or strain of wrist adductor mm
1: seated affected hand supination
2: stabilize proximal wrist with one hand
3: passive movements affected hand into Radial deviation with over pressure at end range
+ pain and hypermobility at joint positive for sprain of ulnar collateral lig
+ pain local to extensor carpi ulnaris or flexor carpi ulnaris mm tendon is positive for strain of either of these mm
Mm spasm may present with subacute strain

Question 32

Ulnar ligamentous stress test PR

Answer 32

Asses sprain for sprain of the radial collateral ligament or strain of wrist abductor mm

Question 33

Mills test

Answer 33

Asses tendinosis of the common extensor tendons
1: seated
2: Passively flex the client wrist with elbow extended
+ pain local to the cet

Question 34

Reverse Mill test

Answer 34

Asses CFT

1: seated
2: passively extend wrist with elbow in extension

Question 35

Extensor tendinosis test( Cozen test

Answer 35

Asses for tendinosis
1: seated
2: elbow extend , wrist pronate , slight extension
3:Instruct clt hold this position
4: attempt to flex the wrist
To isolate Extensor Carpi radialis Brevis which often extensor tendonisis pain
1: seated in fromt of table
2: instruct clt lean forwrad fully flex elbow resting forearm on table , test proceeeds ax above clt resting wrist flexion

Question 36

Flexor Tendinosis test

Answer 36

Asses tendinosis
1: seated, elbow extension , supinate slight flexion
2: instruct to hold
3: attp to extend wrist
+ pain in common flexor tendon and weakenss positive for tendinosis

Question 37

Abductor pollicis Brevis Strength test AR

Answer 37

Asses strength abductor pollicis brevis

Attemp adduct clt abduction of thumb