Arm Exam Flashcards
Visual inspection of arm includes:
- Carrying angle
- Resting flexion angle of elbow
- Resting position of supination/ pronation at the forearm
- Resting position of hand (duprenes: flexed finger)
What tests to rule out more proximal contributors?
ULTT, Wright Test, Thoracic Slump
Elimination test for Cubital Tunnel Syndrome?
Pressure Provocation Test
Elimination test for Fracture at elbow?
Elbow Extension, Flexion, Supination, Pronation Tests
Elimination test for biceps tear?
Biceps Squeeze Test
Elimination test for elbow instability?
Moving Valgus Stress Test
Varus Stress Test (LCL)
Valgus Stress Test (MCL)
Elimination test for thumb instability?
Ulnar Collateral Ligament Test
Elimination test for DeQuervain’s Tenosynovitis?
Finkelstein’sTest
Elimination test for Scaphoid Fracture?
Anatomic Snuffbox Tenderness
Elbow extension/flexion/supination/pronation elimination test: Indications - Pt Position - Procedure - Positive test-
Indications - elbow fracture
Pt Position - supine, supinated forearm
Procedure - Pt instructed to fully extend the elbow
Positive test- Inability compared to contralateral UE
Pressure provocation elimination test: Indication - Pt Position - Procedure - Positive test-
Indication - cubital tunnel syndrome
Pt Position - sitting/standing
Procedure - Supporting UE at distal wrist, place the patient’s elbow in 20° of elbow flexion & full supination
Apply pressure just proximal to the cubital tunnel & hold 1 minute
Positive test- Provocation of concordant symptoms along the ulnar nerve distribution
Biceps squeeze elimination test: Indications - Pt Position - Procedure - Positive test-
Indications - biceps tear
Pt Position - Sitting, UE resting in lab with ~60-80° elbow flexion & slight pronation
Procedure - With one hand at the myotendinous junction and the other at the biceps muscle belly, use both hands to squeeze the biceps
Positive test- no passive supination observed
Moving valgus elimination stress test: Indications - Pt Position - Procedure - Positive test-
Indications - elbow instability
Pt Position - upright, shoulder abducted 90 (support mid-upper arm), elbow fully flexed (clinician grab wrist)
Procedure - Apply valgus torque as shoulder reaches full external rotation -> Quickly extend elbow to 30° while maintaining valgus torque at elbow
Positive test- medial elbow pain provocation from 120-70° flexion
T/F Moving valgus elimination stress test is very provocative.
True
Varus stress elimination test: Indications - Pt Position - Procedure - Positive test-
Indications - Compromise to structural integrity of LCL
Pt Position - sitting, forearm supinated & elbow extended
Procedure - Stabilize the patient’s wrist between your trunk and proximal upper arm -> Grasp the patient’s distal upper arm with both hands -> Apply varus force to elbow Repeat in 20-30° of flexion
Positive test- elbow pain provocation
Valgus stress elimination test: Indications - Pt Position - Procedure - Positive test-
Indications - Compromise to structural integrity of MCL
Pt Position - sitting, forearm supinated & elbow extended
Procedure - Stabilize the patient’s wrist between your trunk and proximal upper arm -> Grasp the patient’s distal upper arm with both hands -> Apply valgus force to elbow Repeat in 20-30° of flexion
Positive test- elbow pain
Ulnar collateral lig elimination test: Indications - Pt Position - Procedure - Positive test-
Indications - gamekeeper’s thumb
Pt Position - sitting
Procedure - stabilize 1st MC with pincer grip -> grasp proximal phalanx of the 1st digit with other hand -> extend patient thumb -> apply valgus stress to MCPJ
Positive test- valgus > 30
Positive Ulnar collateral lig elimination test indicates what?
Complete tear
Finkelstein's Elimination test: Indications - Pt Position - Procedure - Positive test-
Indications - de Quervain’s Tenosynovitis
Pt Position - sitting, grasping ipsilateral thumb
Procedure - can passively take through procedure first -> patient then adducts wrist
Positive test- Pain over APL/ EPB tendons