Clinical Exam Elbow, Wrist, Hand Flashcards
which side of the elbow is most prone to injury?
lateral epicodyle
the lateral epicondyle is the origin of which muscles?
wrist extensors
what is the elbow joint space bounded by?
it is a triangular gap bound by the olecranon, lateral epicondyle, and radial head
where do most nerve entrapments occur?
wrist extensor region
what muscles attach to the medial epicondyle?
flexor tendons
what nerve runs through the medial elbow?
ulnar
how many bones are in the wrist?
8
what is special about the scaphoid?
it spans the proximal and distal rows and is the most common carpal bone to fracture
what type of injury usually causes wrist fracture?
FOOSH - fall on outstretched hand
what two tendons does the most dorsal compartment of the wrist hold?
abductor policis longus, extensor policis brevis - that together can cause DeEuervian’s tenosynovities
how many tendons in the carpal tunnel?
9 flexor tendons
what nerve runs through the carpal tunnel?
median
the deep flexor tendon goes to which phalynx?
distal phalynx
the superficial flexor goes to which phalynx?
middle phalynx
what are the 5 palpations for the elbow exam?
lateral epicondyle, radial head, olecranon, lateral triangular space, biceps tendon
what is the special test for the elbow?
resisted long finger extension
elbow in near full extension, wrist in neutral
press on 3rd dorsal finger to force flexion while patient resists
positive test - pain at lateral epidicondyle - suggests lateral epicondylitis
what are the two node inspections in the fingers?
heberdon’s (DIP) and bouchard’s (PIP)
what side is thenar atrophy on
thumb side
what four things are you palpating in the hand/wrist?
distal radius, distal ulna, anatomic snuffbox, scaphoid tubercle
what is the test for rotational abnormality
flex fingers - all should point towards scaphoid
how do you test flexor profundis?
(DIP) isolate dip and ask patient to flex only dip
how do you test flexor superficialis?
(PIP) hold hand down on table in extension, as patient to flex finger - should flex at PIP
what could weakness in thumb abduction indicate?
median nerve injury
what are the three special tests for the hand and wrist?
carpal tunnel phalen maneuver, tinel’s test median nerve, dequervain’s tenosynovitis
what is carpal tunnel phalen maneuver?
put dorsums of hands together and hold for 30s
numbness and tingling in distribution of median nerve is positive test
what is tinel’s test median nerve?
lightly tap median nerve at distal palmar crease; parasthesias in median nerve distribution is a positive test
what is dequervain’s tenosynovitis test?
(aka finkelstein’s test)
fist with thumb inside and push fist in ulnar deviation
pain in dorsoradial aspect of wrist indicates positive test and dequervain’s tenosynovitis
