ch 16 skills

Question 1

MMT: flexion & extension

Answer 1

flexion- trying to do a bicep curl
extension- trying to straighten arm out

Question 2

MMT: pronation & supination

Answer 2

pronation- trying to flip forearm over so back of hand is facing up
supination- trying to flip forearm over so palm is facing up

Question 3

valgus stress test

Answer 3

• tests for: integrity of UCL
• elbow is flexed 20-30 degrees, apply a valgus force (force on lateral side)
• positive test: increased laxity compared with the opposite side, or pain, or both

Question 4

varus stress test

Answer 4

• tests for: integrity of RCL
• elbow is flexed to 25 degrees, apply a varus force to the elbow
• positive test: increased laxity compared with the opposite side and/or pain is produced

Question 5

moving valgus stress test

Answer 5

• tests for: UCL tear
• procedure: shoulder abducted to 90 with humerus externally rotated, externally rotate the glenohumeral joint & apply a valgus force on the elbow, extend the elbow to 30 degrees while maintaining a valgus force on the joint, noting the positions in which pain is evoked, then move elbow from extension into flexion while maintaining a valgus stress on the joint
• positive test: pain at medial elbow that reproduces functional pain & pain that occurs between 120 & 70 degrees

Question 6

pivot shift test

Answer 6

• tests for: chronic posterolateral instability of elbow
• procedure: patient supine, shoulder & elbow flexed to 90 (forearm is fully supinated), apply a valgus stress & axial compression, extend the patients elbow, with the forearm maintained in full supination, return the elbow to the flexed position
• positive test: elbow sublimes as it is extended & can be felt to reduce as it is flexed, a dimple located proximal to the radial head when the elbow is at 40 degrees flexion which disappears as the radial head reduces with increasing flexion (better results under anesthesia)

Question 7

tennis elbow test

Answer 7

• tests for: lateral epicondylalgia
• procedure: elbow flexed to 90, forearm pronated & fingers flexed, resist wrist extension while palpating the lateral epicondyle & common attachment of the wrist extensors
• positive test: pain at the lateral epicondyle

Question 8

hook test

Answer 8

• tests for: distal biceps tendon rupture
• procedure: shoulder abducted to 90, elbow flexed to 90, resist forearm supination while attempting to hook the distal biceps tendon with finger
• positive test: inability to catch the distal biceps tendon with the finger